Infant CPR: Do you know what to do?

If you found your baby unconscious, would you know what to do? Could you pull it off correctly while in a panic? Every moment without Cardiopulmonary Resuscitation (CPR) increases your child’s possibility of brain damage and death. Learning CPR is just one of a number of safety precautions any parent should take.

Well-performed CPR can mean the difference between a good and bad outcome, which could be the difference between life or death. In this article, we’ll go over important aspects of CPR. After reading this article, you should have a good understanding of why CPR works and how to perform it effectively. CPR is different for when it comes to performing it on a baby. So you might have been trained in giving CPR to adults, but it won’t be the same for infants.

CPR stands for Cardiopulmonary Resuscitation, or more simply, “heart-lung support.” The two main components include chest compressions and rescue breaths. When the heart stops beating, chest compressions are used to maintain some blood circulation. Since the body continues to use oxygen even when breathing has stopped, we help replenish oxygen by providing rescue breaths. The idea is to help pump oxygenated blood to the body’s organs — most importantly, the brain.

The guidelines for infants (children less than 1 year old) are to provide 30 chest compressions and alternate with 2 rescue breaths.

For each chest compression, place the baby on a hard flat surface then place two fingers in the center of the child’s chest. Quickly press down 1.5 inches, or about 1/3 of the thickness of the baby’s chest. Then release until the chest recoils, which allows the heart to refill with blood for the next compression. Do this at a rate faster than 100 compressions per minute.

To deliver rescue breaths, first attempt to open the infant’s airway by tilting their head and lifting his or her chin. After opening the airway, put your mouth over the infant’s mouth and nose, and make a good seal. For each breath, blow gently for about 1 second. A good breath will make the baby’s chest rise. Avoid blowing too hard since that can damage the baby’s small lungs.

If someone is with you, send them for help right away while you perform CPR. If you are alone with the baby, perform 2 minutes CPR before calling for help, then immediately resume CPR as soon as possible.

Babies are not just tiny little adults. They have special needs and therefore require special care. You may have heard about hands-only CPR for adults. This does NOT apply to infants. Since they are so small, they have limited oxygen reserves in their body. You need to provide rescue breaths regularly to replenish these reserves.

The previous American Heart Association (AHA) guidelines asked people to do compressions at exactly 100 per minute, but the newest 2010 guidelines now simply ask to go faster than 100 compressions a minute. Researchers found that with the previous guidelines, most people were going too slow and had overly long breaks between sets. The new guidelines encourage people to focus on improving blood circulation in the baby.

Tip: Following the beat of songs in your head like “Staying Alive” or “Mary Had a Little Lamb” can help you maintain the correct timing while you do chest compressions.

If you learn CPR correctly and then practice correctly, you won’t lose any precious time when your baby needs saving. Practicing allows you to quickly recognize what to do and cements the skills. That way, you can remember what to do even when in a panic. Your baby’s life may depend on this.

I covered some basic aspects of infant CPR here but there are more details that are important to know, including what to do when your baby is choking. Traditional CPR classes are available in many areas and usually take about 3-4 hours. The American Red Cross provides many of these courses and The American Heart Association has a class locator on it’s website.

Looking for other ways to learn? A new method of learning CPR is iphone app BabyCPR (available on itunes). This app allows you to practice on a simulated baby.

Raymond Wu, MD