How to Provide Rescue Breathing for an Infant During First Aid

Co-authored by Laura Marusinec, MD and Jessica Gibson

Last Updated: October 11, 2022

Being alone with an infant who stops breathing can be scary, but knowing the basics of rescue breathing can help save a baby's life. Keep a calm head and assess the baby's condition. Always alert emergency medical services (call 911) and begin rescue breathing until help comes. You may need to do chest compressions to make up a modified cardiopulmonary resuscitation (CPR) or give back thrusts to assist a choking baby. Follow up with medical attention as soon as possible.

Part 1

Part 1 of 3:

Giving Rescue Breaths During an Assessment

1
Check the infant for responsiveness. Determine if your baby is conscious and responsive. Try to get your baby's attention so that she makes eye contact with you. One of the best ways to check a baby for responsiveness is to tap or flick the bottom of her foot. The baby should flinch, kick, or move the foot as a response.^{[1]
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- If the baby doesn't respond, you'll need to immediately determine if the baby is breathing.
2
Determine if the infant is breathing. Set the baby on a firm surface. The baby should be on his back so you can easily check breathing. Open the baby's airway by gently tilting his head back with one hand. Avoid twisting the baby's neck while you do this. Use your other hand to lift the baby's chin. This will open the airway and you can see if the baby's chest is rising and falling (because of breathing). You should also get right next to the baby's mouth so you can listen and feel for breathing.^{[2]
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- Do this step quickly. You should only spend about 10 seconds figuring out whether or not the infant is breathing.
- If the baby is coughing or making sounds, he is breathing, but may be having trouble. The baby may need help because he is choking or having other difficulties with breathing.
3
Get immediate medical treatment. If the baby isn't responsive or is having trouble breathing, call for emergency medical help. If there are other people around you, shout for help and get someone to call 911 or a local emergency number while you stay with the baby. If you're alone, give two minutes of rescue breathing and care. Then you should call for emergency medical help.^{[3]
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- If the baby is unresponsive and not breathing, you'll need to do two minutes of modified CPR before you can call for help.
4
Give rescue breaths. If the baby isn't breathing, you'll need to immediately give two rescue breaths. Make sure the airway is open by tilting the head back and lifting the chin up. Cover the baby's nose and mouth with your mouth so you make a complete seal. Breathe one breath lasting one second into the baby's mouth. Pause a second and breathe into her again.
- If the baby's nose and mouth are too large for you to cover with your mouth, pinch the baby's nose while covering her mouth with yours. This will create a seal.
5
Reassess the situation. After giving two rescue breaths, you should see the baby's chest raise. Hopefully, the baby will begin breathing on his own. If you don't see the chest move with the rescue breaths, there is probably something lodged in the baby's airway. You'll need to respond to choking in an unconscious infant. If you successfully perform the rescue breathing (and see the chest rise), but the baby does not breathe on his own, you'll need to do CPR modified for an infant.^{[4]
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- If the baby breathes on his own, hold him in recovery position and continue to monitor the baby closely until help arrives. Cradle the baby while tilting his head downwards. This prevents choking and keeps the airway open.
- If you suspect the infant has a head or neck injury, move him onto his side while keeping the head, neck, and back in a straight line.
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Part 2

Part 2 of 3:

Performing Modified CPR on Infants Under 12 Months Old

1
Give chest compressions. If the baby still isn't breathing after giving rescue breaths, open or remove the baby's shirt and place her on a firm surface. Place two or three fingers near the middle of the chest below the nipple line. Press straight down about 1 1/2 inches. Do 30 compressions at a rate of at least 100 per minute.
- Try to keep the compressions smooth, not jerky. Don't worry about pressing too hard. In an emergency situation, it's more important to press hard so that the blood pumps through the body or the heart restarts.
- To keep rhythm with the compressions, try saying and counting "one and two and one and two and..." Press down while saying the number and release while saying "and."
2
Give two rescue breaths. After doing 30 chest compressions, pause and give the baby more oxygen. Tilt the baby's head back while lifting the chin up. Completely seal the baby's nose and mouth with your mouth and gently blow in for one second. Give one more rescue breath.
- You should see the baby's chest rise with each rescue breath.
3
Continue the cycle. Do another 30 chest compressions, followed by two more breaths, and continue alternating between the compressions and rescue breaths. Do not stop doing CPR on the baby unless:
- The baby begins breathing on his own
- A trained responder or emergency medical services take over
- The surrounding area becomes unsafe
- You become too exhausted to keep doing it
4
Get medical attention. If the baby recovers and begins breathing before medical help arrives, you should stop giving chest compressions and rescue breaths. You'll still want the baby to be examined by emergency help if it arrives. Or, you should immediately take your baby to the nearest doctor or hospital. This way, a doctor will ensure that the baby's airway is open and that the baby is ok. The doctor will want to watch the baby for a while to make sure she is ok.^{[5]
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- If you're unsure why the infant stopped breathing, the doctor will want to run tests to determine the cause of respiratory problems.
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Part 3

Part 3 of 3:

Responding to Choking in an Unconscious Infant

1
Give rescue breaths. If the initial rescue breaths weren't successful (you didn't see the chest rise with each breath), re-tilt the baby's head and try again. Be sure to lift the chin up and cover the baby's nose and mouth with your mouth so you make a complete seal. Breathe one breath lasting one second into the baby's mouth. Pause a second and breathe into it again.
- Avoid blowing forcefully into the baby. Since a baby's lungs are smaller, they only need regular breaths. Blowing forcefully could damage the baby's lungs.
2
Give chest compressions. If the baby still isn't breathing after giving rescue breaths, open or remove the baby's shirt and place him on a firm surface. Place two or three fingers near the middle of the chest below the nipple line. Press straight down about 1 1/2 inches. Do 30 compressions at a rate of at least 100 per minute.^{[6]
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- If you were using a clear plastic CPR barrier, you should remove while doing compressions.
3
Look for a foreign object. Make sure the baby's head is tilted back and look inside her mouth for an obstruction. If you see an object lodged in your baby's mouth, remove it quickly. Give two more rescue breaths.
- Avoid sticking your finger in the baby's mouth and sweeping it around blindly. You don't want to push the foreign object further down the baby's throat.
4
Reassess the situation. If you've removed the foreign object or it's passed on its own, the baby should begin breathing on his own (following the rescue breaths). But if the baby still isn't breathing on his own, you'll need to do 30 more chest compressions. Look again for a foreign object and give two more rescue breaths.
- Continue the cycle of compressions, checking for an object, and rescue breaths until the infant breaths on his own or medical help arrives.
5
Get medical attention. If emergency medical help comes, let them take over. If you manage to dislodge the object blocking the baby's airway, you should still get medical attention. A doctor will want to make sure that the baby's airway is completely open.^{[7]
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- The doctor may want to run tests to make sure the infant doesn't have any internal injuries.
6
Begin with back blows and chest thrusts if the infant is conscious while choking. Use the heel of one hand to give five back blows between the infant's shoulder blades. Turn the infant over and give five chest compressions by pushing two fingers about 1 1/2 inches into the chest just under the nipple line. Keep alternating between back blows and chest thrusts until the object comes out, the infant loses consciousness, or the infant begins coughing, breathing or crying.
- Be sure to support the baby's head while giving back blows and chest compressions. The head should be lower than the chest.
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