A child who suddenly collapses, becomes unresponsive, or is found face-down in water needs immediate action – not a perfect response. Knowing how to perform child CPR gives you a clear sequence to follow while emergency help is on the way. CPR can keep oxygen-rich blood moving to the brain and other vital organs until the child begins breathing normally or advanced care arrives.
Child CPR applies to children from age 1 until the onset of puberty. An infant requires different hand placement and compression techniques, while a teenager who has reached puberty is generally treated with adult CPR steps. When you are unsure of a child’s age category, start with the best technique you can use safely and follow the instructions of the 911 dispatcher.
Know When a Child Needs CPR
First, make sure the area is safe for you and the child. Look for hazards such as traffic, fire, electrical danger, water, or an unsafe structure. Once it is safe to approach, tap the child’s shoulder and shout, “Are you okay?”
If there is no response, shout for help. Have someone call 911 and get an automated external defibrillator, or AED, if one is available. If you are alone with the child and do not have a phone nearby, provide about two minutes of CPR before leaving to call 911 and retrieve an AED. If your phone is with you, call 911 on speaker so the dispatcher can guide you while you begin care.
Check for normal breathing. Occasional gasps, snorts, or irregular breaths are not normal breathing. If you are trained to check a pulse, check for no more than 10 seconds at the carotid artery in the neck or the femoral artery in the groin. If there is no pulse, or you are not certain a pulse is present, begin CPR.
How to Perform Child CPR Step by Step
The goal is simple: provide high-quality chest compressions with as few interruptions as possible, then give effective rescue breaths. Start CPR even if you feel nervous. A fast, imperfect start is far more helpful than waiting for confidence to arrive.
Position the Child and Your Hands
Place the child flat on their back on a firm surface. Kneel beside their chest. Put the heel of one hand on the center of the chest, on the lower half of the breastbone. Keep your hand off the ribs and away from the very bottom tip of the breastbone.
For a smaller child, one hand may provide enough force. For a larger child, place one hand over the other, as you would for adult CPR. Keep your arms straight when using two hands and position your shoulders directly over your hands. This helps you compress effectively without tiring as quickly.
Give 30 Chest Compressions
Push hard and fast at a rate of 100 to 120 compressions per minute. A useful rhythm is the beat of a brisk, familiar song, but focus on maintaining an even, controlled pace rather than counting a tune.
Compress the chest at least one-third of its front-to-back depth, or about 2 inches for most children. Let the chest return fully to its normal position after every compression. Full recoil matters because it allows the heart to refill with blood before the next compression.
Avoid leaning on the chest between compressions, and keep interruptions as short as possible. Count out loud from one to 30. Clear counting helps you stay focused and lets another rescuer know where you are in the cycle.
Open the Airway and Give 2 Breaths
After 30 compressions, open the airway with a head-tilt, chin-lift. Place one hand on the child’s forehead and gently tilt the head back. Use the fingers of your other hand to lift the bony part of the chin forward. Do not press deeply into the soft tissue under the chin.
Pinch the child’s nose closed, make a complete seal over their mouth with yours, and give one breath over about one second. Watch for the chest to rise. Give a second breath the same way.
If the chest does not rise, reposition the head and try again. Do not spend a long time attempting breaths. Return to compressions promptly. If you can see an object blocking the mouth, remove it carefully, but do not perform a blind finger sweep.
Continue Until Help Takes Over
Continue cycles of 30 compressions and 2 breaths if you are the only rescuer. If two trained rescuers are present, use 15 compressions followed by 2 breaths. Switching the person giving compressions about every two minutes can reduce fatigue and improve compression quality.
Keep going until the child shows signs of life, another trained person takes over, EMS personnel tell you to stop, or the scene becomes unsafe. If the child begins breathing normally but remains unresponsive, place them on their side in a recovery position if you can do so safely, and continue to monitor their breathing until help arrives.
Use an AED as Soon as One Is Available
An AED can analyze the child’s heart rhythm and, when needed, advise a shock. Turn it on immediately and follow the device’s voice prompts. Do not wait to finish several CPR cycles before using it.
Pediatric AED pads or a pediatric setting are preferred for children, especially smaller children. However, if pediatric pads are not available, use adult pads rather than delaying defibrillation. Place the pads exactly as shown in the diagrams. If the pads might touch because the child is small, place one pad on the center of the chest and the other on the back between the shoulder blades.
Make sure nobody is touching the child while the AED analyzes the rhythm or delivers a shock. Say clearly, “Everyone clear,” and look to confirm. Resume CPR immediately after the AED gives its instruction, whether or not a shock is advised.
If the Child Has a Pulse but Is Not Breathing Normally
A child with a definite pulse who is not breathing normally may need rescue breathing rather than chest compressions. Give one breath every two to three seconds, or about 20 to 30 breaths per minute. Each breath should last about one second and make the chest visibly rise.
Check the child’s pulse and breathing about every two minutes. If the pulse becomes absent, becomes very weak, or you are no longer sure it is present, begin CPR. This is one reason hands-on training is valuable: recognizing the difference between a child who needs rescue breaths and one who needs full CPR is easier after guided practice.
Common Mistakes That Can Slow Care
The most common problem is waiting too long to start. Fear of hurting a child can make a bystander hesitate, but a child without normal breathing needs urgent intervention. Properly performed compressions may cause injury, but the immediate threat is cardiac or respiratory arrest.
Other mistakes include compressing too slowly, not pressing deeply enough, leaning between compressions, and giving breaths that are too forceful or too long. Focus on a steady rate, full chest recoil, and just enough air to make the chest rise. Do not pause repeatedly to check whether CPR is working unless the child clearly starts moving or breathing normally.
For a child pulled from water, rescue breaths are particularly important because the emergency often begins with a breathing problem. Still, call 911, begin CPR, and use an AED if available. Do not delay care while trying to remove water from the child’s lungs.
Training Makes the Steps Easier to Recall
Reading the steps is a strong first step, but CPR is a physical skill. Practicing hand placement, compression depth, rescue breaths, AED pad placement, and team communication on a manikin builds the muscle memory that helps in a real emergency.
East Coast Safety Consulting provides hands-on CPR and AED training for individuals, workplaces, schools, and community groups. A recognized course also gives you the chance to ask questions, practice under instructor feedback, and leave with a clearer sense of what to do when seconds count.
The child in front of you will not need a flawless rescuer. They need someone who recognizes the emergency, calls for help, starts CPR, and keeps going until help arrives. Practicing those actions now can make you the person who is ready when a family, school, or community needs you most.
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