If a child is unresponsive and not breathing normally, shout for help, call 9-1-1 (or have someone call), and start chest compressions right away. Push hard and fast in the center of the chest, about 100 to 120 times a minute, and add two rescue breaths after every 30 compressions if you are trained to give them. This guide walks through each step for children and for babies, explains how the techniques differ, and shows where an AED fits in.

We work with children, families and school teams every day, and the same thing comes up again and again: people freeze because they are afraid of doing it wrong. Knowing the sequence ahead of time is the best cure for that fear.

TL;DR

• Check that the scene is safe, then tap the child’s shoulder (or the baby’s foot) and shout. Take no more than 10 seconds to decide whether they are responding and breathing normally.
• No response, and no breathing or only gasping? Call 9-1-1 and send someone for an AED, then begin CPR. You do not need to check for a pulse.
• Compress at 100 to 120 per minute, about 2 inches deep for a child and about 1½ inches for an infant, letting the chest fully recoil each time.
• Use 30 compressions to 2 breaths. Trained healthcare professionals working as a pair switch to 15:2.
• If you are alone with no phone nearby, give about 2 minutes of CPR before leaving to call for help.

Table of Contents

• Who counts as a child, and who counts as an infant
• Why pediatric CPR is a little different from adult CPR
• Step 1: Check the scene and the child
• Step 2: Call 9-1-1 and get an AED
• Step 3: Start chest compressions
• Compression rate and depth at a glance
• Step 4: Give rescue breaths
• Understanding the compression-to-breath ratio
• Step 5: Use an AED as soon as it arrives
• Keep going until help takes over
• Common mistakes to avoid
• Our perspective
• Build the skill before you need it
• How Building Block Resolutions can help
• FAQ
• Sources

Who counts as a child, and who counts as an infant

The techniques change with size, so the first decision is which group your patient belongs to. In first aid guidance, an infant is a baby under 1 year old. A child is anyone from age 1 up to the start of puberty, as MedlinePlus describes in its young-child CPR guidance. Beyond puberty, adult technique applies.

You do not need to guess a birthday in an emergency. If the person is clearly a baby, use the infant method. If they look like a small or school-age child, use the child method. Chest compressions delivered with imperfect technique are far better than no compressions at all.

Why pediatric CPR is a little different from adult CPR

In adults, cardiac arrest is often a heart rhythm problem. In young people, it usually starts with the lungs and airway. The 2025 American Heart Association pediatric basic life support guidelines state that respiratory conditions remain the major cause of cardiac arrest in infants and children, which is why they call for quick action to support ventilation and oxygenation.

In practice, that means breaths matter more for a child than they do for an adult. If you are trained and willing, give the rescue breaths. If you are not, compressions alone are still far better than doing nothing.

Step 1: Check the scene and the child

Before you touch anyone, look around. Is there traffic, water, a fire, a loose electrical cord? You cannot help if you become a second patient.

Then check responsiveness. The Red Cross instructions for child and baby CPR say to shout and tap the child’s shoulder, or the baby’s foot. At the same time, look at the chest. Spend no more than 10 seconds deciding whether they are breathing normally. Gasping is not normal breathing.

If the child responds, is crying, or is breathing normally, you do not need CPR. Stay with them, keep them calm, and call for medical advice if you are worried.

Step 2: Call 9-1-1 and get an AED

If the child does not respond and is not breathing, or is only gasping, call 9-1-1 and get equipment such as an AED, or tell a specific person to do both. Pointing at someone and saying “You, call 9-1-1 and bring the AED” works better than a general shout.

The same Red Cross guidance sets out this sequence. The AHA guidelines add one useful point for bystanders: lay rescuers should start CPR right away for any child or infant who is unresponsive, not breathing normally and showing no signs of life, without stopping to check for a pulse. Pulse checks are unreliable under stress, and delay costs time.

If you are alone

This is the question that worries parents most. If you are the only rescuer and no one can call for you, MedlinePlus advises about 2 minutes of CPR before leaving to call 911 or your local emergency number. Mayo Clinic’s parenting guidance describes the same approach as five cycles, or two minutes, of CPR before calling for help or using an AED. If you have a phone with you, the practical move is to call first and keep the phone nearby so the dispatcher can guide you.

Step 3: Start chest compressions

Place the child on their back on a firm, flat surface. The floor works well. A bed or sofa absorbs your push.

Compressions for a child (age 1 to puberty)

1. Kneel beside the child.
2. Place the heel of one hand in the center of the chest, with your other hand on top and fingers interlaced. The Red Cross describes this placement and notes that for a small child a one-handed technique may be used.
3. Keep your arms straight and your shoulders over your hands.
4. Push straight down about 2 inches, which is at least one-third of the depth of the chest.
5. Let the chest come all the way back up between pushes. This recoil is what allows the heart to refill.

Compressions for an infant (under 1 year)

For babies, the AHA guidelines recommend either the two-thumb encircling-hands technique or the one-hand technique. They consider the old two-finger method ineffective for reaching proper depth.

• Two-thumb encircling hands: Wrap both hands around the baby’s chest and place your thumbs side by side on the center of the chest. Press down with both thumbs while your fingers support the back. This is often easier to keep up and gives good depth.
• One-hand technique: Use the heel of one hand on the center of the chest. This helps if you need your other hand to support the baby or if your hands are small.

Push about 1½ inches deep, and let the chest recoil fully each time.

Compression rate and depth at a glance

The AHA gives one rate for both groups: 100 to 120 compressions per minute, to at least one-third of the chest’s front-to-back diameter. That works out to about 1½ inches (4 cm) for infants and 2 inches (5 cm) for children. These figures come from the AHA 2025 pediatric guidelines.

A tip for rhythm: many people find it easier to keep a steady 100 to 120 by counting aloud or pushing along with a familiar song of that tempo. Practice it once, so it feels natural on the day you need it.

Step 4: Give rescue breaths

After 30 compressions, open the airway and give two breaths. The Red Cross instructions describe the head-tilt/chin-lift maneuver: tilt the head back gently and lift the chin. For an infant, keep the head in a neutral, slightly tilted position rather than tipping it far back.

Give each breath so that you can see the chest rise. Keep breaths gentle: a child’s lungs are smaller than yours, and you only need enough air to make the chest lift. Then go straight back to compressions with minimal pause.

If the chest does not rise, tilt the head again and try another breath. If you still cannot get air in, think about choking. Our guide to 5 and 5 choking first aid for children covers what to do, and this walkthrough of back blows and chest thrusts for infant choking shows the baby version step by step.

Understanding the compression-to-breath ratio

This is the question behind many searches for pediatric CPR ratios. The AHA guidance sets it out this way:

• Lay responders (parents, teachers, coaches, bystanders): 30 compressions to 2 breaths, whether one person or two.
• One healthcare professional: 30:2.
• Two healthcare professionals: 15:2.

The lower ratio for two trained professionals gives more frequent breaths, which fits the fact that children’s cardiac arrests are so often caused by breathing problems. If you are not a healthcare professional, you only need to remember one number: 30 and 2.

Step 5: Use an AED as soon as it arrives

When an AED arrives, turn it on and follow its voice prompts. Keep doing CPR while the pads are being applied, and stand clear when the device analyzes and, if advised, delivers a shock. Then resume compressions immediately.

Pad size and placement depend on the child’s age and size, and many devices have pediatric pads or a pediatric setting. We cover this in more detail in our guide to AEDs for children aged 1 to 8, including pad placement. If you work in a school, our practical AED guide for staff and parents explains how to be ready before anything happens.

Keep going until help takes over

Do not stop to check whether things have changed every few seconds. Continue CPR until one of the following happens:

1. The child starts breathing normally, moves, or cries.
2. Emergency responders arrive and take over.
3. An AED tells you to stop while it analyzes, or the device delivers a shock and gives you new instructions.
4. You are too exhausted to continue. If another adult is present, swap with them about every 2 minutes so compressions stay strong.

Compressions are tiring. Pushing to the right depth at the right speed takes effort, and quality declines faster than most people expect. Switching rescuers keeps the pushes effective.

Common mistakes to avoid

• Pushing too gently. Fear of hurting a child leads many people to compress too shallowly. The depth figures above are the target. Rescuers worry about rib injury, but without circulation the child cannot survive.
• Leaning on the chest. Staying on the chest between pushes prevents recoil. Lift your weight completely each time.
• Long pauses. Keep breaks for breaths short. Do not stop for a pulse check.
• Using two fingers on a baby. The AHA considers this technique ineffective at achieving proper depth. Use the thumbs or one-hand method.
• Waiting to be sure. If a child is unresponsive and not breathing normally, begin. A false start costs very little compared with a late one.

Our perspective

We spend our days with children and the adults who care for them: parents, teachers, aides, respite providers and clinicians. Across more than 20 years of working in behavioral support, we have seen that preparation changes how people respond when a moment turns frightening.

Children on the autism spectrum can have particular needs in a crisis. A child may not respond to a stranger’s voice, may not tolerate being touched, or may be unable to tell an adult what is wrong. That is one reason we pair behavioral support with crisis management and crisis prevention training for families and school teams. Calm, practiced adults make safer scenes.

We believe CPR and AED skills belong alongside the other tools a caregiver carries. They sit naturally next to the work we do in parent coaching and in staff training, because the goal is the same: adults who feel confident and capable on the hardest day. Reading this guide is a good start. Hands-on practice with a trained instructor is what turns knowledge into confidence.

Jennifer

Build the skill before you need it

Reading the steps is a start, but muscle memory comes from practice on a manikin with an instructor who can correct your hand position and depth. If your certification is nearing its end, our guide to CPR certification renewal with blended training explains how a short hands-on session can fit into a busy schedule. If you work in childcare, see our checklist of the documents inspectors will ask for. Teachers can check their obligations in our state-by-state CPR requirements guide.

For a quick comparison of what each type of training covers, see CPR versus first aid and a one-minute action plan.

How Building Block Resolutions can help

Building Block Resolutions offers ABA therapy for children with autism, parent coaching, behaviorally based staff training, and crisis management and crisis prevention support. We also run CPR/AED workshops and crisis management courses for families, schools and organizations. If you want your whole team, classroom or household to be ready, we can help you plan training that fits your setting.

To learn how we support families and professionals, visit our crisis management and crisis prevention page, or see our full list of services. For staff teams, our behavioral staff training is a good place to start. Contact us to talk through what your family or organization needs, including the current schedule for workshops.

FAQ

What is the compression-to-breath ratio for pediatric CPR?

Lay rescuers use 30 compressions to 2 breaths for both children and infants. Healthcare professionals use 30:2 when alone and 15:2 when two of them are working together, according to the AHA 2025 pediatric guidelines. If you are not a professional, remember 30 and 2.

How deep should I push on a child’s chest?

Push at least one-third of the depth of the chest, which is about 2 inches (5 cm) for a child and about 1½ inches (4 cm) for an infant. The rate is 100 to 120 compressions per minute. Allow the chest to rise fully between pushes.

Should I call 911 first or start CPR first?

If someone else is there, have them call 9-1-1 while you begin compressions. If you are alone, the Red Cross says to call and get equipment when the child is unresponsive and not breathing normally. If you cannot reach a phone, MedlinePlus advises about 2 minutes of CPR before leaving to call. A phone on speaker lets you do both.

Do I need to check for a pulse before starting CPR?

No. The AHA guidance says lay rescuers should begin CPR for any child or infant who is unresponsive, not breathing normally and showing no signs of life, without checking for a pulse. Starting promptly matters more than confirming.

Can I use the same technique on a baby as on a child?

Not quite. For babies, use two thumbs with your hands encircling the chest, or one hand, and push about 1½ inches deep. Children need the heel of one or two hands and about 2 inches of depth. The rate and the 30:2 ratio stay the same.

Sources

• How to Perform Child and Baby CPR, American Red Cross
• Part 6: Pediatric Basic Life Support, American Heart Association
• CPR for a young child, MedlinePlus
• Child and baby CPR: Essential steps for emergencies, Mayo Clinic Press
• Infant choking: back blows and chest thrusts

Recommended

• Parents & Caregivers: AEDs for Children 1–8 — Pad Placement and When to Act
• 5 and 5 Choking First Aid Every U.S. Parent Must Know
• Caregivers: CPR vs First Aid and Your One Minute Action Plan
• AED Use in Schools: A Practical Guide for Staff and Parents