CPR Ratio for a Child: A Practical Guide for Parents and Caregivers

The Correct CPR Ratio for a Child

Understanding the ratio is the starting point, but knowing what it means and who it applies to is also important. A CPR ratio describes how many chest compressions are delivered before rescue breaths. Getting the right number for a child specifically can make a real difference in an emergency.

Child Age Range

In CPR guidelines, a child is defined as approximately age 1 through the onset of puberty. This is a distinct category from infant CPR (for babies under 1 year old) and adult CPR (for those who have begun puberty). If you are unsure, use the technique that matches the person's apparent size.

One vs. Two Rescuers

The ratio changes based on how many trained rescuers are present:

Situation	CPR Ratio
One rescuer (any level of training)	30 compressions: 2 breaths
Two trained rescuers	15 compressions: 2 breaths

Think of it this way: a parent responding alone at home uses a 30:2 ratio, keeping compressions the priority. Two trained responders, such as two healthcare workers or two CPR-certified caregivers, can split roles more efficiently and switch to a 15:2 ratio to deliver breaths more frequently. The American Heart Association's pediatric basic life support guidelines confirm these ratios.

How to Perform CPR on a Child

Knowing the ratio is one thing. Knowing the full sequence is what enables you to act. Here is the order of steps to follow if you ever face this situation.

Assess and Call for Help

Before starting compressions, take a few seconds to confirm the situation:

• Check that the scene is safe to approach
• Tap the child firmly on the shoulder and call their name
• Look for normal breathing (gasping does not count as normal breathing)
• If the child is unresponsive and not breathing normally, call 911 immediately
• Put the phone on speakerphone so you can follow dispatcher instructions while keeping your hands free
• If someone else is present, have them call while you begin CPR

Give Chest Compressions

Position the child on their back on a firm, flat surface. Then:

• Place the heel of one or two hands on the lower half of the breastbone, in the center of the chest
• Use one hand for smaller children and two for larger children, depending on your hand size and the child's build
• Push down approximately 2 inches (about one-third of the chest depth)
• Compress at a rate of 100 to 120 per minute (think of the rhythm of "Stayin' Alive")
• Allow the chest to fully recoil between each compression; do not lean on the chest
• Minimize any pauses in compressions

Add Breaths and an AED

After 30 compressions (or 15 if a second trained rescuer is giving breaths), deliver 2 rescue breaths:

• Tilt the head back gently and lift the chin to open the airway
• Cover the child's mouth with yours and give a breath lasting 1 second
• Watch for visible chest rise; if the chest does not rise, reposition the head and try once more
• Deliver the second breath and return immediately to compressions

Use an AED as soon as one becomes available. Turn it on and follow the audio prompts. Use pediatric pads or pediatric settings when available for children. If only adult pads are available, do not delay; use them.

One important reason rescue breaths matter, especially for children: unlike adult cardiac arrest, which is often caused by a sudden heart rhythm problem, pediatric cardiac arrest commonly begins with a breathing emergency. Getting oxygen into a child's body early is a critical part of the response.

How Child CPR Differs by Age Group

Before beginning CPR, it helps to know whether you are dealing with an infant, a child, or an adult. Using the wrong technique for the situation can affect the effectiveness of your response.

Child vs. Infant

Factor	Infant (under 1 year)	Child (age 1 to puberty)
Compression depth	About 1.5 inches	About 2 inches
Hand placement	Two-finger or two-thumb encircling technique	Heel of one or two hands, center of chest
Single-rescuer ratio	30:2	30:2
Two-rescuer ratio	15:2	15:2
AED pads	Pediatric pads are strongly preferred	Pediatric pads are preferred when available

The ratios are the same across both age groups, but the compression technique and depth differ. Infant compressions are gentler and use fewer contact points.

Child vs. Adult

Factor	Child (age 1 to puberty)	Adult (puberty and older)
Single-rescuer ratio	30:2	30:2
Two-rescuer ratio	15:2	30:2
Compression depth	About 2 inches	At least 2 inches, up to 2.4 inches
Hand placement	One or two hands, depending on size	Two hands, heel of dominant hand

The key difference is that two-rescuer CPR for children uses a 15:2 ratio, while two-rescuer CPR for adults uses a 30:2 ratio. For single-rescuer situations, 30:2 applies to both.

Child CPR Mistakes to Avoid

Even with the right information, panic can lead to errors in the moment. Being aware of the most common mistakes helps you stay on track.

• Compressions that are too shallow: Aim for a depth of approximately 2 inches. Light pressure does not circulate blood effectively.
• Compressions that are too slow: Maintain 100-120 per minute throughout. Slowing down reduces the effectiveness of each cycle.
• Leaning on the chest between compressions: The chest must fully recoil after each compression. Leaning prevents that and reduces blood flow.
• Long pauses between compressions: Minimize interruptions. Every second without compressions counts.
• Too many breaths or breaths that are too forceful: One breath per second, just enough to see the chest rise. Excessive ventilation can cause complications.
• Delaying the AED: Use it as soon as it is available. Do not wait.
• Checking for a pulse: Current guidelines advise untrained lay rescuers not to perform pulse checks. If the child is unresponsive and not breathing normally, start CPR.

Reading about CPR is a meaningful first step, but it does not replace the muscle memory and confidence that come from hands-on practice.

A Mother's Haven's Pediatric CPR + Family Safety class in Encino covers child and infant CPR with certified instructors, giving you the chance to practice technique in real time and ask questions in a supportive setting.

Building Your Lifesaving Skills at A Mother's Haven

Memorizing a ratio is a good start. Knowing how to apply it calmly under pressure takes practice, and that is precisely what hands-on CPR training provides. The 2025 AHA updated pediatric CPR guidelines reinforce that early, effective CPR with proper technique gives children the best chance of recovery.

If you are in the greater Los Angeles area, A Mother's Haven in Encino has been supporting families since 2002 with the education, products, and community they need to feel prepared. 

Enroll in the Pediatric CPR + Family Safety class, explore the full range of baby safety essentials in the shop, or browse prenatal classes to start your preparation even before your little one arrives. You can reach the team at (818) 380-3111 or team@shopthehaven.com.

Frequently Asked Questions About Child CPR

What CPR ratio should one rescuer use for a child?

One rescuer should use a 30:2 ratio: 30 chest compressions followed by 2 rescue breaths. Rescue breaths are recommended when the rescuer is trained and able to provide them. If not, compression-only CPR is better than no CPR at all.

When does child CPR become adult CPR?

Child CPR applies from age 1 through the onset of puberty. Once puberty begins, adult CPR guidelines apply. If you are unsure, use the technique that fits the person's apparent size. Certified training provides the clearest guidance for these transitions.

Should you give rescue breaths during child CPR?

Yes, conventional CPR with rescue breaths is preferred for children because pediatric cardiac arrest commonly begins with a breathing emergency. If you are unable to give breaths, compression-only CPR is still valuable and significantly better than doing nothing.

Can you use an AED on a child?

Yes. Use an AED as soon as one becomes available. Pediatric pads or pediatric settings are preferred for children when available. If only adult pads are available, use them rather than delay treatment. Turn the AED on and follow the audio instructions.