Infant vs. Child vs. Adult CPR:
Why Adult CPR Doesn’t Work on Babies
In a life-or-death emergency, panic is your worst enemy. While the fundamental goal of Cardiopulmonary Resuscitation (CPR) remains the same—to pump oxygenated blood to the brain and heart—the technique you use must change drastically depending on the age of the victim.
Imagine trying to inflate a balloon. If you blow too gently into a large balloon, nothing happens. If you use an air compressor on a tiny water balloon, it bursts. The human body is similar. Treating a baby like a small adult can cause catastrophic damage to their fragile ribs and internal organs. Conversely, treating an adult like a child won't generate enough pressure to circulate blood to the brain, rendering your efforts useless.
At RupIELTS Institute in Surrey and Edmonton, we emphasize that while the ratio (30:2) is universal for lay rescuers, the mechanics differ. This comprehensive guide breaks down exactly how to adjust your approach for Infants, Children, and Adults.
Why Size & Physiology Matter
The physiological differences between an infant and an adult are not just about size; they are about bone density, organ placement, and respiratory needs.
- Bone Structure: An infant's bones are more pliable but largely cartilaginous. They are flexible but delicate. An adult's ribcage is rigid and requires significant force to compress.
- Organ Protection: In babies, the liver and spleen are relatively larger and less protected by the ribcage compared to adults. Excessive force or incorrect hand placement can cause internal bleeding.
- Respiratory Drive: Cardiac arrest in adults is usually cardiac in origin (heart attack). In children and infants, it is almost always respiratory (choking, drowning, asthma). This makes the rescue breaths incredibly vital for younger victims.
1. Infant CPR (0 to 12 Months)
This is the most delicate category. "Infant" generally refers to babies under one year old. The approach here is about precision and gentleness.
Critical Adjustments:
- Checking Pulse: Do not check the neck. An infant's neck is short and chubby, making the carotid artery hard to find. Instead, feel for the brachial pulse on the inside of the upper arm, between the elbow and shoulder.
- Hand Placement: Forget the "two hands" rule. Use only two fingers (index and middle) placed in the center of the chest, just below the nipple line. Alternatively, you can use the "two-thumb encircling" technique if your hands are large enough to wrap around the torso.
- Compression Depth: Push down about 1.5 inches (4 cm). This is about one-third the depth of the chest. It feels shallow compared to an adult, but it is enough to squeeze the small heart against the spine.
- Rescue Breaths: Cover both the nose AND mouth with your mouth. An infant's face is too small to pinch the nose separately. Deliver gentle "puffs" of air using only the volume of your cheeks—not the full power of your lungs.
2. Child CPR (1 Year to Puberty)
"Child" is defined as age 1 up to the first signs of puberty (chest hair for males, breast development for females). This is a transition phase where judgment is key.
Critical Adjustments:
- Hand Technique: Depending on the size of the child, you may use one hand (heel of the hand only) or two hands (interlocked). The goal is to compress the chest without putting weight on the ribs or stomach.
- Compression Depth: Increase depth to about 2 inches (5 cm). You need to press firmly enough to circulate blood but be mindful of the child's smaller frame.
- Checking Pulse: You can check the carotid artery (neck) or the femoral artery (groin).
- Rescue Breaths: Use the standard "pinch nose, seal mouth" technique. However, reduce the volume of air compared to an adult breath. Watch for the chest to rise; stop blowing as soon as you see it move.
3. Adult CPR (Puberty and Older)
Once a person hits puberty, their chest wall becomes rigid. You are fighting against strong bone and muscle resistance.
Critical Adjustments:
- Full Force: You must use two hands interlocked. Lock your elbows and use your upper body weight. Do not just use arm strength; lean over the victim so your shoulders are directly above your hands.
- Compression Depth: Compress at least 2 inches (5 cm), but no more than 2.4 inches. Shallow compressions are the most common mistake in adult CPR—if you don't push deep enough, blood doesn't leave the heart.
- Recoil: Equally important to pushing down is letting the chest come all the way up (recoil) between compressions. This allows the heart to refill with blood for the next pump.
What About the AED?
An Automated External Defibrillator (AED) is a crucial tool, but electricity dosage matters.
Pediatric Pads
Ideally, use pediatric pads for infants and children under 8 years old (or under 55 lbs). These pads reduce the shock energy. If the AED has a "child key" or switch, turn it on.
The Placement Trick
If you only have adult pads for a small child or infant, you can still use them. The golden rule is that pads must not touch. Place one pad in the center of the chest and the other in the center of the back ("sandwiching" the heart).
The Universal Constant: 30:2
Despite all these mechanical differences, the compression-to-breath ratio remains the same for single lay rescuers to reduce confusion.
100-120 beats per minute
Frequently Asked Questions
Can I hurt the baby by doing CPR?
It is a common fear, but remember: it is better to have a broken rib than to be dead. If a baby requires CPR, they are already clinically dead. Your actions can only help. However, using the correct "two-finger" technique minimizes injury.
What if I am alone with an infant?
If you are alone and did not see the collapse, perform 2 minutes (5 cycles) of CPR before leaving to call 911. Because respiratory issues are common in infants, those 2 minutes of oxygen are critical.
How hard should I blow for rescue breaths?
Only enough to make the chest rise. For an infant, this is a tiny puff. Blowing too hard can force air into the stomach (gastric inflation), causing vomiting and blocking the airway.
Get Certified: Hands-On Practice is Essential
Reading a blog post gives you knowledge, but it doesn't give you muscle memory. At RupIELTS Institute, you practice on infant, child, and adult manikins that provide feedback on your depth and speed.
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