4. Perform chest compressions:
- Place 2 fingers on the breastbone -- just below the nipples. Make sure not to press at the very end of the breastbone.
- Keep your other hand on the infant’s forehead, keeping the head tilted back.
- Press down on the infant’s chest so that it compresses about 1/3 to 1/2 the depth of the chest.
- Give 30 chest compressions. Each time, let the chest rise completely. These compressions should be FAST and hard with no pausing. Count the 30 compressions quickly: “1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30, off.”
5. Open the airway. Lift up the chin with one hand. At the same time, push down on the forehead with the other hand.
6. Look, listen, and feel for breathing. Place your ear close to the infant’s mouth and nose. Watch for chest movement. Feel for breath on your cheek.
7. If the infant is not breathing:
- Cover the infant’s mouth and nose tightly with your mouth.
- Alternatively, cover just the nose. Hold the mouth shut.
- Keep the chin lifted and head tilted.
- Give 2 breaths. Each breath should take about a second and make the chest rise.
8. Continue CPR (30 chest compressions followed by 2 breaths, then repeat) for about 2 minutes.
9. After about 2 minutes of CPR, if the infant still does not have normal breathing, coughing, or any movement, leave the infant to call 911.
10. Repeat rescue breathing and chest compressions until the infant recovers or help arrives.
If the infant starts breathing again, place them in the recovery position. Periodically re-check for breathing until help arrives.
Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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