NRP certification is a credential awarded to healthcare professionals who complete the Neonatal Resuscitation Program, a course that teaches the skills needed to stabilize and resuscitate newborns immediately after birth. The program is developed by the American Academy of Pediatrics and grounded in guidelines from the International Liaison Committee on Resuscitation. Nearly every hospital in the United States requires some version of NRP certification for staff who attend deliveries or care for newborns.
Who Needs NRP Certification
NRP certification is designed for any healthcare professional who may be present when a newborn needs help breathing or circulating blood in those critical first minutes of life. The program is built for physicians, registered nurses, nurse practitioners, respiratory therapists, physician assistants, certified midwives, and certified nurse midwives who work in hospitals or accredited birth centers.
In practice, the list of people who hold NRP certification is broad. Labor and delivery nurses, NICU nurses, obstetricians, pediatricians, neonatologists, anesthesiologists covering obstetric units, and emergency department staff at hospitals with labor units all commonly maintain it. Many hospitals make it a condition of employment or credentialing for anyone who could be called to a delivery.
Two Curriculum Levels: Essentials and Advanced
The current edition of NRP splits the curriculum into two distinct tracks based on the level of intervention a provider is expected to perform.
- NRP Essentials (Lessons 1–4): Covers initial newborn assessment, warming, stimulation, clearing the airway, and providing breathing support through face-mask ventilation and laryngeal mask insertion. This level is aimed at providers assigned to attend births without known risk factors who will not need to perform resuscitation beyond assisted ventilation.
- NRP Advanced (Lessons 1–11): Builds on Essentials and adds chest compressions, emergency vascular access, and medication administration. This track is for providers who attend high-risk births or participate in more complex resuscitations, such as neonatologists, NICU nurses, and pediatric residents.
The level you pursue depends on your role. A nurse working in a well-baby nursery might only need Essentials, while a respiratory therapist assigned to the NICU would need Advanced.
What the Course Teaches
The core of NRP is a step-by-step algorithm that guides providers through escalating interventions based on how the newborn responds. Everything revolves around the “golden minute,” the first 60 seconds after birth, with the goal of starting assisted ventilation by the one-minute mark if the baby is not breathing effectively or has a heart rate below 100 beats per minute.
The sequence begins with a rapid assessment: Is the baby breathing? Is the heart rate adequate? If not, providers perform initial steps like drying and stimulating the infant, then reassess. If the newborn still isn’t breathing well, positive pressure ventilation begins. After 15 seconds, providers check for visible chest movement. If the chest is rising, ventilation continues. If not, corrective steps are applied, such as repositioning the head, clearing the airway, or adjusting the mask seal.
When corrective steps fail to produce chest movement, an alternative airway is placed. If the heart rate remains below 60 beats per minute after 30 seconds of ventilation through that airway, chest compressions begin and oxygen is increased to 100%. After 60 seconds of compressions, if the heart rate is still below 60, epinephrine is administered. Each step is time-bound and decision-driven, which is why the program emphasizes hands-on practice and team coordination rather than memorizing facts.
How to Get Certified
NRP certification uses a two-part structure: an online learning component followed by an in-person, instructor-led skills session.
First, you complete the online portion through the AAP’s learning platform. Essentials providers work through the Essentials Online Learning Assessment. Advanced providers complete both the Essentials and Advanced assessments. This online component covers the science, the algorithm, and decision-making frameworks.
Second, you attend a hands-on session led by an NRP instructor. There are two formats for this part. In the sequential practice format, you work through skills from each lesson with an instructor, then lead your team through practice scenarios of increasing complexity. Each scenario builds on earlier ones, and the instructor evaluates your ability to lead the resuscitation in the correct sequence and perform the relevant technical skills. When you complete all scenarios without needing significant corrections, you pass.
Experienced providers who resuscitate newborns regularly can opt for a “test out” format. This involves leading a team through at least one full resuscitation algorithm sequence while demonstrating role-relevant skills. It is not a solo check-off; it requires a team-based resuscitation scenario. Providers who pass either format then move into a simulation and debriefing session, which presents challenging scenarios designed to sharpen critical thinking and teamwork under pressure.
Certification Duration and Renewal
NRP provider cards are valid for two years. The expiration falls at the end of the month, two years after the course completion date. If you completed the course on January 1, 2026, for instance, your card would expire January 31, 2028. No extensions are granted.
To renew, you repeat the same two-part process before your expiration date: complete the online learning assessment for your curriculum level, then attend another instructor-led event. This two-year cycle is designed to keep providers current with evolving evidence and to maintain hands-on proficiency in skills that most providers use infrequently.
Cost and Continuing Education Credits
The AAP does not charge fees for the NRP provider course itself, nor does it charge for the digital provider card issued upon completion. However, the institution or instructor hosting the hands-on session may charge fees to cover space, equipment use, and instructor time. These costs vary by hospital and training site, so you’ll need to check with your local program for specific pricing.
Completing the online portions of NRP earns continuing education credits. The Essentials provider curriculum awards 5.0 credit hours, while the Advanced provider curriculum awards 12.0 credit hours. Instructor candidates and those completing instructor renewal earn 13.0 credit hours. For providers using the RQI (Resuscitation Quality Improvement) platform, the initial course awards 5.0 credits, quarterly refreshers provide 1.0 credit each, and the Advanced endorsement adds 8.0 credits. The type of credit you can claim (CME, CNE, or CRCE) depends on your professional discipline.