CPR for Infants and Children: Key Differences from Adults

Cardiac arrest in children and infants is usually caused by a breathing problem rather than a sudden heart rhythm problem, which is the opposite of what typically causes cardiac arrest in adults. That single difference shapes almost everything about how CPR is adapted for younger patients, from hand position through to how much rescue breathing is emphasised.

Table of Contents

Recognising Cardiac Arrest in a Child or Infant

Check for a response and normal breathing the same way you would in an adult. In a child or infant who is unresponsive and not breathing normally, begin CPR without delay. Because the underlying cause is so often respiratory, getting oxygen into the child through effective rescue breaths matters just as much as chest compressions.

Compression Ratio

A single rescuer, whether trained or a lay bystander, uses the same 30 compressions to 2 breaths ratio as adult CPR. Where two trained rescuers are present, the ratio changes to 15 compressions to 2 breaths for children and infants, reflecting how important adequate ventilation is in paediatric arrests. If you are alone with a collapsed infant or child and no phone is immediately at hand, current guidance generally supports performing about five cycles of CPR, roughly two minutes, before leaving to call for help, since a short course of effective CPR can matter enormously in a respiratory arrest.

Compression Technique for Children (Aged 1 to Puberty)

Use the heel of one hand on the lower half of the breastbone, or two hands for a larger child, similar to the adult technique but adjusted for their smaller chest. Compress to a depth of about 5 centimetres, or roughly one third of the depth of the chest, at the same rate of 100 to 120 compressions per minute used for adults.

Compression Technique for Infants (Under 1 Year)

Current guidance no longer recommends the two finger technique for infant compressions. Instead, use either the heel of one hand or, where two rescuers are present, the two thumb encircling hands technique, where you place both thumbs side by side on the lower breastbone and encircle the infant’s chest with your fingers to compress while your fingers support the back. Compress to a depth of about 4 centimetres, or roughly one third of the chest depth, at the same 100 to 120 compressions per minute rate.

Giving Rescue Breaths to a Child or Infant

Tilt the head to a neutral or only slightly tilted position rather than the fuller tilt used in adults, since over extending a young child’s neck can itself block the airway. For an infant, seal your mouth over both their mouth and nose together, since their face is often too small to seal your mouth over the mouth alone. Give a gentle breath just strong enough to make the chest visibly rise, since a young child’s lungs are small and easily over inflated.

Using an AED on a Child

Use paediatric pads and settings if they are available on the AED, which deliver a lower energy shock suited to a smaller body. If paediatric pads are not available, use the standard adult pads rather than withholding defibrillation, taking care the pads do not touch each other on a very small child’s chest.

Why the Differences Matter

Treating a child exactly like a small adult during CPR can genuinely reduce their chance of survival, because it underweights the breathing side of resuscitation in exactly the group of patients where breathing problems are usually the actual cause of the arrest. Learning the specific technique, rather than assuming adult CPR simply scaled down will do, is worth the extra half hour in any first aid course.

Frequently Asked Questions

Is the CPR ratio different for children than for adults?
For a single rescuer it is the same, 30 compressions to 2 breaths. With two trained rescuers present, children and infants use 15 compressions to 2 breaths instead.

What technique is used for infant chest compressions now?
The heel of one hand for a single rescuer, or the two thumb encircling hands technique for two rescuers. The older two finger technique is no longer recommended.

Why do children more often need rescue breaths during CPR?
Cardiac arrest in children is more commonly caused by a breathing problem than a heart rhythm problem, so restoring oxygen through breaths matters more than it typically does in adult cardiac arrest.

References and Last Reviewed

American Heart Association, Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
International Liaison Committee on Resuscitation (ILCOR), Consensus on Science and Treatment Recommendations

Jurisdiction: General first aid guidance, based on current American Heart Association and ILCOR recommendations.
Last technically reviewed: September 2026
Reviewed by: EHS Guidelines Editorial Team

This article is educational and does not replace accredited paediatric first aid training or professional medical care. In a real emergency, call your local emergency number immediately.

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CPR for Infants and Children: Technique and Key Differences from Adults