Preparation

• Before giving care, the American Heart Association and the American Red Cross advise the rescuer to check the scene. Checking the scene involves determining whether or not the environment is safe for the rescuer to enter. If the rescuer can enter safely, he will then check the victim. When the victim is an infant, he must tap her lightly and shout to see if she is unconscious.
  
  

Check

• After the rescuer determines that the infant is unconscious, call 9-1-1 and then proceed to check for signs of life. The rescuer must check for breathing and a pulse to know whether he should give rescue breaths, chest compressions or both. To check for a breath, open the airway by tilting the infant's head back gently to avoid neck injury. Listen for breathing and examine the chest to see if it rises and falls. To check an infant's pulse, place an index and middle finger against the inner left arm near the armpit. The check should take no longer than a few seconds before the rescuer determines his course of action.
  
  

Breathing

• Infant CPR begins with two rescue breaths. Because the infant's airway is smaller than that of an adult, the rescuer's mouth must make a seal over both the infant's mouth and nose. Tilting the head back gently, the rescuer will breathe once, count to three, and breathe a second time. With each breath, the rescuer should examine the chest to see if the breaths are going in. If the chest does not rise, the airway may be obstructed by an object.
  
  

Compressions

• The ratio of compressions to breaths is the same for adults, children and infants. For every two rescue breaths, a rescuer will give 30 chest compressions. Because an infant is so small, she only requires two or three fingers for an effective chest compression. The rescuer will place his fingers at the center of the infant's chest at the nipple line and compress 1/2 to 1 inch deep 30 times. The pace should be a steady "one-and-two-and-three-and..." If the rescuer noticed that the airway was obstructed, he should check for an object in the infant's mouth after giving compressions. When the object emerges, it must be swept out with the index finger.
  
  

Cycles

• The American Red Cross and the American Heart Association advise the rescuer to stop after every five cycles of CPR on a child or an infant. Five cycles of rescue breathing takes approximately two minutes when performed at the right pace. After every two minutes of CPR on an infant, the rescuer should check for signs of life again for 10 seconds. It may be more difficult to be aware of when an infant is coming back to consciousness.