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CPR is a lifesaving procedure that is performed when an infant's breathing or heartbeat has stopped, as in cases of drowning, suffocation, choking, or injuries. CPR is a combination of:

• Rescue breathing, which provides oxygen to the infant's lungs.
• Chest compressions, which keep the infant's blood circulating.

Permanent brain damage or death can occur within minutes if an infant's blood flow stops. Therefore, you must continue these procedures until the infant's heartbeat and breathing return, or trained medical help arrives.

CPR can be lifesaving, but it is best performed by those who have been trained in an accredited CPR course. The procedures described here are not a substitute for CPR training.

Time is very important when dealing with an unconscious infant who is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 - 6 minutes later.

• Choking
• Drowning
• Electrical shock
• Excessive bleeding
• Head trauma or serious injury
• Lung disease
• Poisoning
• Suffocation

• No breathing
• No pulse
• Unconsciousness

• Lift the infant's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.
• If the infant has signs of normal breathing, coughing, or movement, DO NOT begin chest compressions. Doing so may cause the heart to stop beating.
• Unless you are a health professional, DO NOT check for a pulse. Only a health care professional is properly trained to check for a pulse.

• If you have help, tell one person to call 911 while another person begins CPR.
• If you are alone, shout loudly for help and begin CPR. After doing CPR for about 2 minutes, if no help has arrived, call 911. You may carry the infant with you to the nearest phone (unless you suspect spinal injury).

Unlike adults, who often require CPR because of a heart attack, most children need CPR because of a preventable accident.

Never underestimate what an infant can do. Play it safe and assume the child is more mobile and more dexterous than you thought possible. Never leave an infant unattended on a bed, table, or other surface from which the infant could roll. Always use safety straps on high chairs and strollers. Never leave an infant in a mesh playpen with one side down. Follow the guidelines for using infant car seats.

Start teaching your infant the meaning of "Don't touch." The earliest safety lesson is "No!"

Choose age-appropriate toys. Do not give infants toys that are heavy or fragile. Inspect toys for small or loose parts, sharp edges, points, loose batteries, and other hazards.

Create a safe environment and supervise children carefully, particularly around water and near furniture. Keep toxic chemicals and cleaning solutions safely stored in childproof cabinets. Dangers such as electrical outlets, stove tops, and medicine cabinets are attractive to infants and small children.

To reduce the risk of choking accidents, make sure infants and small children cannot reach buttons, watch batteries, popcorn, coins, grapes, or nuts. It is also important to sit with an infant while he or she eats. Do not allow an infant to crawl around while eating or drinking from a bottle.

Never tie pacifiers, jewelry, chains, bracelets, or anything else around an infant's neck or wrists.