If a baby under 1 year old is unresponsive and not breathing normally, put the phone on speaker and call 120 (China's ambulance number), and give infant CPR: 30 pushes and 2 breaths

In a real emergency, call 911 first, then read this.

Cost

Free. Infant CPR needs a class to practice once, half a day to a day. The hard part is breathing into the child's mouth and nose, and not daring to press hard.

What you get

The American Heart Association and the American Academy of Pediatrics published their 2025 pediatric basic life support guidelines. The guidelines say that the main cause of cardiac arrest in infants and children is still a breathing problem. Of infants whose hearts stopped outside a hospital, only 6.6% left the hospital alive. When an ordinary person finds an infant or child who is unresponsive, not breathing normally and showing no signs of life, they "should start CPR at once" and should not feel for a pulse. The compression depth is at least one third of the front-to-back depth of the chest, and for an infant "about 1.5 inches (4 cm)." The rate is 100 to 120 per minute. When one person does it, give 30 pushes and 2 breaths. When two people do it, give 15 pushes and 2 breaths. For infants, use the heel of one hand, or encircle the chest with both hands and press with two thumbs. If you can't encircle it, use the heel of the hand. The two-finger method has been dropped because it does not press deep enough. The guidelines also say that for infants and children in out-of-hospital cardiac arrest, adding breaths to compressions improves survival. A U.S. registry counted 3,900 children under 18 in out-of-hospital cardiac arrest, of whom 59.4% were infants. When a bystander did CPR, the adjusted share leaving the hospital alive was 13.2%, and when no one did, 9.5%. The adjusted OR was 1.57 (about 57% higher odds of survival), 95% CI 1.25–1.96 (confidence interval, the range the true value likely falls in). Among infants, CPR with breaths was linked to higher survival, and the surviving children also recovered better brain function. With compressions only and no breaths, results were about the same as when no one did anything. The 2025 international first aid guidelines of the International Federation of Red Cross and Red Crescent Societies say: to check whether an infant responds, pick the child up or tap the soles of the feet. If you are alone, put the phone on speaker and call the emergency number yourself. If you have no phone you can use while pressing, do 1 minute of CPR first and then go to call. The Capital Institute of Pediatrics (首都儿科研究所) has a public-education article that the Beijing Municipal Health Commission reposted. It says: "if only 1 person is present, do 2 minutes of CPR first and then call 120." The compression depth is "4 cm for infants." For breaths for children under 1 year, use "mouth over mouth and nose"

Notes

Graded B because the survival figures come from a registry study that only followed and recorded cases, and they are for all children together; the abstract gives no separate figure for infants. The benefit is rated "large" from the figures for all children: leaving the hospital alive rose from 9.5% to 13.2%, about 40% more in relative terms. The beneficiary is almost always your own child. There are three differences from §13.1 (press hard on the chest). One, infants need breaths, and compressions alone work poorly for infants. Two, use two thumbs or the heel of one hand, pressing about 4 centimeters, and do not stack both hands. Three, when you are alone and can't press and phone at the same time, press first and then go to call. How long to press first differs by source: the single-rescuer procedure of the Capital Institute of Pediatrics and the American guidelines is 2 minutes, and the international Red Cross says 1 minute. With the phone on speaker, this problem doesn't arise. The European Resuscitation Council teaches 5 breaths first and then compressions, and the American guidelines say compressions first and then breaths, and either is better than doing nothing. Old Chinese tutorials teach two-finger compressions, and the 2025 American guidelines have dropped that method. When choking was the cause, look in the mouth before giving breaths and remove only an object you can see; see §13.43 (choking baby).

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. Joyner BL et al. (2025). Part 6: Pediatric Basic Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 152(suppl 2):S424–S447. https://doi.org/10.1161/CIR.0000000000001370; full text at https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/pediatric-basic-life-support
2. Naim MY et al. (2017). Association of Bystander Cardiopulmonary Resuscitation With Overall and Neurologically Favorable Survival After Pediatric Out-of-Hospital Cardiac Arrest in the United States: A Report From the Cardiac Arrest Registry to Enhance Survival Surveillance Registry. JAMA Pediatrics 171(2):133–141. https://doi.org/10.1001/jamapediatrics.2016.3643
3. International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025, pages 186–188. https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf
4. Capital Institute of Pediatrics (2022). [Doctors of the Institute Speak] CPR: First Aid Knowledge Every Parent Needs [in Chinese] (republished by the Beijing Municipal Health Commission). https://wjw.beijing.gov.cn/bmfw_20143/jkzs/jksh/202210/t20221017_2837684.html
5. European Resuscitation Council (2025). ERC Guidelines 2025 for the lay public (chapter on Paediatric Basic Life Support). https://www.erc.edu/media/p5ymaeej/gl2025_layperson_book_ipdf-v11-e.pdf

Translated from the Chinese original. Original book, section 13, tip 44. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer