Infant CPR and First Aid UK: A Must-Read Guide for Every Parent

Every parent and carer of a baby should know how to perform infant CPR and how to respond to a choking baby. These are not skills you will likely ever need — but if you do need them, no amount of reading in the moment will substitute for having learned them in advance. This guide covers the correct sequences for infant CPR and choking response as per UK Resuscitation Council guidelines. Reading this is a starting point: we strongly recommend attending a hands-on infant first aid course as well.

Note: Guidelines are updated periodically. The information in this article reflects current Resuscitation Council UK guidance, but always check for the most recent recommendations.

Recognising When CPR Is Needed

You need to start CPR if a baby is:

• Unresponsive — they do not react to stimulation (a gentle tap on the foot, calling their name)
• Not breathing normally — this includes not breathing at all, or only occasional gasps (which are not effective breaths)

Do not wait to see whether the baby is "really" unconscious. Check quickly, and if they are not responding and not breathing normally, begin immediately.

The Infant CPR Sequence

Step 1: Check for Response

Gently tap the sole of the baby's foot and call their name loudly. Do not shake a baby.

Step 2: Shout for Help

Shout for help from anyone nearby.

Step 3: Open the Airway

Place the baby on a flat surface on their back. Place one finger under the chin to tilt the head back very slightly — neutral position for a baby, not the extended head tilt used for adults and older children. A baby's airway is easily obstructed by over-tilting.

Look, listen, and feel for breathing for no more than 10 seconds. Look for chest movement, listen for breath sounds, feel for air on your cheek.

Step 4: Give 5 Rescue Breaths

If the baby is not breathing:

• Cover the baby's mouth and nose with your mouth, forming a seal
• Give 5 slow, gentle rescue breaths — each lasting about one second and just enough to see the chest rise. Do not over-inflate; baby lungs are small
• If the chest does not rise, recheck head position and try again

Step 5: Start Compressions

After 5 rescue breaths, begin chest compressions without checking for a pulse (pulse checks are unreliable even for trained rescuers in emergency conditions).

• Place two fingers (index and middle finger) on the centre of the chest, just below the nipple line
• Press down approximately one-third of the depth of the chest — this is roughly 4 cm for most babies
• Allow the chest to fully recoil between compressions
• Rate: approximately 100–120 compressions per minute (this is fast — roughly two per second)

Step 6: Continue the 30:2 Ratio

Alternate 30 compressions with 2 rescue breaths.

Step 7: Call 999

If you are alone: give 1 minute of CPR (approximately 5 cycles of 30:2) before stopping to call 999. Then continue CPR.

If someone else is present: send them to call 999 immediately while you begin CPR. Ask them to put the call on loudspeaker so the operator can guide you.

Do not stop CPR unless the baby starts breathing normally, qualified help takes over, or you are physically unable to continue.

Using an Automated External Defibrillator (AED)

AEDs are available in many public places. If one is available:

• For babies under 8 kg (approximately 1 year of age), a paediatric AED or paediatric pads are preferred
• If only adult pads are available, use them — it is better than not using the AED
• Follow the AED voice instructions; they are designed to be used by non-specialists
• Continue CPR whenever the AED is not actively analysing or delivering a shock

Infant Choking: The Response

A baby who is choking is conscious but unable to cry effectively, cannot breathe, or is making a high-pitched noise or no sound. They may appear distressed and their face may redden or darken.

Do not attempt blind finger sweeps in the mouth. This can push the object further down.

Back Blows

1. Lay the baby face down along your forearm, supporting the head so it is lower than the chest (head-down position)
2. Give up to 5 firm back blows between the shoulder blades with the heel of your hand
3. Check the mouth after each blow — if you can see the object, remove it with a finger

Chest Thrusts (if back blows are unsuccessful)

1. Turn the baby face up along your forearm (or your thigh), still head-down
2. Place two fingers on the centre of the chest, as for CPR
3. Give up to 5 chest thrusts — sharper and more rapid than CPR compressions, one per second
4. Check the mouth after each thrust

Alternate 5 back blows and 5 chest thrusts.

Call 999 immediately if the baby is not responding, if the object does not come free after two cycles of back blows and chest thrusts, or if the baby becomes unconscious — in which case, begin CPR.

Abdominal thrusts (the Heimlich manoeuvre) are not used for babies under one year because of the risk of injury to the liver and other abdominal organs.

After a Choking Episode

Even if you successfully dislodge the object and the baby recovers quickly, you should seek medical assessment — particularly if there is any possibility that the object may have been partially inhaled into the airway rather than fully expelled through the mouth.

Getting Proper Training

Reading about CPR and first aid is valuable, but it is not a substitute for practical training. You will not know how hard to press, how large a breath to give, or how to hold a baby correctly without hands-on practice.

In the UK, infant first aid courses are offered by:

• The British Red Cross
• St John Ambulance
• The British Heart Foundation (offers free hands-only CPR training, though full infant first aid courses cover more)
• Many NHS trusts and children's centres offer free or low-cost infant first aid sessions for new parents

A two to three hour infant first aid course will give you skills that could, in an extreme situation, save your baby's life.