Infant rescue breaths are given by covering both the baby’s mouth and nose with your mouth, then blowing gently for about 1 second, just enough to make the chest visibly rise. The technique differs from adult or child CPR in several important ways, from how you position the head to how much air you deliver. Getting these details right can make the difference between air reaching the lungs and air going nowhere, or worse, into the stomach.
When an Infant Needs Rescue Breaths
Before giving rescue breaths, you need to determine that the infant is not breathing normally. An infant who is unresponsive and not breathing, or only gasping irregularly, needs immediate help. Gasping is not the same as breathing. It looks like occasional, labored attempts to inhale, often with long pauses between them. A normal infant breathes 30 to 60 times per minute, so the chest should be rising and falling steadily and visibly.
Other warning signs that breathing has failed or is about to include a bluish tint to the skin (especially around the lips and fingers), limpness, and minimal or no response to stimulation. If you see any combination of these, begin rescue breaths immediately after calling for emergency help.
Positioning the Head Correctly
Infant airways are small and flexible, which means positioning matters more than it does with older children or adults. Place one hand on the baby’s forehead and gently tilt the head back. With the fingertips of your other hand, lift the chin upward. The goal is a neutral-to-slightly-extended position, sometimes called the “sniffing position.” A good visual cue: tilt until the nose points straight at the ceiling.
Two common mistakes can block the airway before you even deliver a breath. First, tilting too far back can actually kink the soft, flexible airway shut. Second, pressing on the soft tissue under the chin can compress the airway from below. Use your fingertips on the bony part of the chin only, and be careful not to push the mouth completely closed, as that can seal off airflow.
Creating the Seal
Because an infant’s face is so small, you cover both the mouth and nose with your mouth at the same time. This is different from child and adult CPR, where you pinch the nose and breathe into the mouth alone. Place your mouth over the baby’s mouth and nose to form a complete seal. If the baby is larger and you cannot cover both, you can seal your mouth over the nose and close the mouth with your hand, or seal over the mouth and pinch the nose. But for most infants, a single seal over both works best and is simplest under pressure.
Delivering the Breath
Once you have a seal, blow gently into the baby’s mouth and nose for about 1 second. Watch the chest as you blow. You should see it rise, similar to a normal breath. Then remove your mouth, let the chest fall, and feel the air escape before giving the next breath. Take a normal breath yourself between each rescue breath.
The key word here is “gently.” An infant’s lungs are tiny. You are not giving a full adult exhalation. Think of it as a puff from your cheeks, not a deep blow from your lungs. Delivering too much air too forcefully pushes air past the lungs and into the stomach, a problem called gastric inflation. A distended stomach presses upward against the lungs, making it harder for them to expand and reducing the effectiveness of both breaths and chest compressions. It can also cause vomiting, which creates a choking risk.
If the first breath does not make the chest rise, retilt the head, check your seal, and try again. A breath that doesn’t produce visible chest rise is not getting to the lungs.
Compression-to-Breath Ratios
If the infant has no pulse or you are unsure, you will alternate chest compressions with rescue breaths. For a single rescuer, the ratio is 30 compressions to 2 breaths. Perform 30 compressions, then pause to give 2 rescue breaths, and repeat.
If a second person is available to help, the ratio changes to 15 compressions to 2 breaths. The tighter ratio means the infant gets more frequent breaths, which is especially important because cardiac arrest in infants is most often caused by a breathing problem rather than a heart problem. More ventilation addresses the root cause.
Rescue Breathing Without Compressions
There is one scenario where you give breaths but skip compressions: when the infant has a detectable pulse but is not breathing normally. In this case, you provide rescue breaths alone at a rate of roughly 1 breath every 2 to 3 seconds, which works out to about 20 to 30 breaths per minute. Check for a pulse roughly every 2 minutes. If the pulse disappears or you are no longer confident you feel one, begin full CPR with compressions.
What Success Looks Like
Each rescue breath should produce a small, visible rise of the chest. That chest rise is your single most reliable indicator that air is reaching the lungs. If you see it, your technique is working. If you do not see it after two attempts, reposition the head, recheck the seal, and try once more. Repeated failure to get chest rise may mean there is an object blocking the airway.
Between breaths, the chest should fall back down as air escapes passively. You should feel warm air coming out. If the belly is rising instead of the chest, you are likely blowing too hard or the airway is not properly open. Slow down, use less force, and readjust the head tilt.
After the Infant Starts Breathing Again
If the baby begins breathing on their own, with steady chest rise and fall and improving color, keep them in a safe position and monitor closely until emergency medical services arrive. For a baby with good muscle tone who is breathing and responsive, holding them against your skin can help regulate their temperature and keep them calm. Continue watching their breathing, because it can stop again. Do not leave the infant unattended, and be ready to resume rescue breaths if breathing becomes irregular or stops.