The compression-to-breath ratio for infant CPR is 30 compressions to 2 breaths when one person is performing CPR. If two trained rescuers are present, the ratio changes to 15 compressions to 2 breaths. These ratios come from the American Heart Association and remain current through the 2025 guidelines.
Why the Ratio Changes With Two Rescuers
A single rescuer uses the 30:2 ratio because they’re doing everything alone: compressions, breaths, and monitoring the infant. Fewer pauses for breaths means more consistent blood flow to the brain and heart. When a second rescuer arrives, one person handles compressions while the other delivers breaths. This teamwork allows a lower ratio of 15:2, which gives the infant more frequent ventilation without sacrificing compression quality.
Rescue breaths matter more for infants than for adults. Most adult cardiac arrests stem from a heart problem, which is why hands-only CPR works reasonably well for grown-ups. Infant cardiac arrest, on the other hand, is almost always caused by a breathing problem first: choking, suffocation, infection, or drowning. The heart stops because the body runs out of oxygen. Skipping breaths during infant CPR removes the very thing the infant needs most. Large observational studies have consistently shown better outcomes when infant CPR includes breaths at either a 30:2 or 15:2 ratio compared with compressions alone.
How to Perform Chest Compressions
Place two fingers on the center of the infant’s chest, just below the nipple line. Push down about 1.5 inches (roughly one-third the depth of the chest) and let the chest fully recoil between each compression. Aim for a rate of 100 to 120 compressions per minute. That pace is faster than one per second, roughly the tempo of the song “Stayin’ Alive.”
If two rescuers are working together, the person doing compressions should switch to the two-thumb technique: wrap both hands around the infant’s torso and press on the breastbone with both thumbs. This method generates better pressure and is less tiring than the two-finger approach, but it only works when someone else is free to deliver the breaths.
How to Deliver Rescue Breaths
Because an infant’s face is so small, you cover both the mouth and nose with your mouth to create a seal. Tilt the head back gently (not as far as you would for an adult) and lift the chin to open the airway. Take a normal breath, not a deep one, and blow just enough air over one second to see the chest rise. If the chest doesn’t rise, reposition the head and try again before continuing compressions.
Between breaths, lift your mouth away and let the air escape naturally as the chest falls. Blowing too hard or too much air can force air into the stomach, which makes vomiting more likely and ventilation less effective. A gentle puff that visibly raises the chest is all you need.
Putting It All Together
For a single rescuer, one full cycle looks like this: 30 compressions with two fingers, then 2 breaths. Repeat continuously. If you’re alone and don’t have a phone within reach, perform about one minute of CPR (roughly five cycles of 30:2) before leaving the infant briefly to call emergency services. If you do have a phone, call 911 on speaker immediately and begin CPR while on the line.
For two rescuers, the cycle is 15 compressions and 2 breaths. One person compresses while the other gives breaths, and they should switch roles every two minutes to prevent fatigue. The person delivering breaths can check for a pulse during these switches. The recommended spot for a pulse check on an infant is the inside of the upper arm (the brachial artery), though placing your ear directly against the chest to listen for a heartbeat has been shown to be faster and more accurate. Spend no more than 10 seconds checking before resuming compressions.
Using an AED on an Infant
If an automated external defibrillator is available, use it as soon as possible. For infants, use pediatric pads or a pediatric dose attenuator if one is available, which automatically lowers the energy delivered to a safe level. If only adult pads are available, place one on the chest and one on the back so they don’t touch each other. The AED will analyze the heart rhythm and tell you whether a shock is advised. Resume CPR immediately after any shock, starting again with compressions.
Between AED prompts, continue cycles at the appropriate ratio: 30:2 if you’re alone, 15:2 with a partner. Keep going until the infant starts breathing on their own, emergency medical services take over, or you become too exhausted to continue.