Picture the moment no parent wants to imagine: a baby who is unresponsive and not breathing normally, an AED cabinet on the wall nearby, and a small voice in your head asking whether that machine is even safe to use on someone so small. It is one of the most common questions we hear at our first aid courses in Port Macquarie and Taree, and the answer is yes — you can use an AED on an infant. The longer answer, which is the one worth knowing before an emergency rather than during one, involves pad placement, paediatric settings and a few things the machine will work out for you.
This post sits alongside a few others we have written about acting decisively in the first minutes of an emergency. If you have read our breakdown of the SAMPLE acronym and why it matters in first aid, or our look at what bystander first aid achieved after the Coogee shark attack, you will already know the theme: the person standing closest almost always matters more than the equipment. This time, though, the equipment deserves a proper explanation.
The Short Answer: Yes, You Can
The Australian and New Zealand Committee on Resuscitation (ANZCOR) Guideline 7 is clear: an automated external defibrillator can be used on infants and children who are unresponsive and not breathing normally. An infant, in resuscitation terms, is a child under one year of age.
Sudden cardiac arrest in infants is rare, and that rarity is exactly why the question causes so much hesitation. Most people have seen an AED demonstrated on an adult manikin, if they have seen one demonstrated at all, and a device with pads nearly the size of a baby’s torso does not exactly invite improvisation. But an AED will not deliver a shock unless it detects a heart rhythm that needs one. The machine analyses first and acts second — which, in an emergency, makes it considerably more level-headed than most of us.
The worst thing you can do with an AED and an infant in cardiac arrest is not use it.
Why Infants Arrest Differently to Adults
In adults, cardiac arrest is often a heart problem first: an electrical malfunction, frequently linked to heart disease, that stops effective pumping. In infants, cardiac arrest is usually the end point of a breathing problem — choking, drowning, severe asthma or another airway or breathing emergency that starves the heart of oxygen until it stops.
This difference matters for two practical reasons. First, it is why resuscitation guidelines place such emphasis on effective CPR with rescue breaths for infants and children: oxygen is usually the missing ingredient. Second, it explains why a shockable heart rhythm is less common in infants than adults — but “less common” is not “never”, which is why ANZCOR still recommends attaching an AED. If the infant’s rhythm is shockable, defibrillation is the treatment, and no amount of excellent CPR replaces it.
How to Use an AED on an Infant, Step by Step
The placement of a standard AED pad on the front of an infant (training model displayed)
The placement of a standard AED pad on the back of an infant (training model displayed)
- Check for response and breathing. If the infant is unresponsive and not breathing normally, call Triple Zero (000) — or better, get someone else to call while you start CPR. If you are alone, put your phone on speaker so the operator can guide you while your hands stay free.
- Start CPR immediately. Do not wait for the AED to arrive. Compressions and rescue breaths are what keep oxygen moving until the defibrillator can do its job.
- Turn the AED on as soon as it arrives. Every AED talks you through the process with voice prompts. You cannot use it in the wrong order; it will not let you.
- Use paediatric pads or paediatric mode if available. Many AEDs come with smaller paediatric pads or a child setting that delivers a reduced-energy shock designed for infants and young children. If they are there, use them.
- If only adult pads are available, use them. ANZCOR is explicit on this point: standard adult pads may be used on an infant, provided the pads do not touch each other. Do not withhold defibrillation because the “right” pads are missing.
- Place the pads front and back. On an infant, place one pad in the centre of the chest and the other on the back, between the shoulder blades. This front-and-back (anterior-posterior) placement keeps the pads from overlapping on a small torso.
- Let the AED analyse. Stop CPR when the device tells you to, and make sure no one is touching the infant while it checks the heart rhythm — and again if it advises a shock.
- Follow the prompts and keep going. If a shock is advised, deliver it and resume CPR straight away. If no shock is advised, resume CPR immediately. Continue until the infant responds or paramedics take over.
Paediatric Pads Versus Standard Pads
Paediatric pads are smaller and, paired with the device’s child mode, deliver a lower-energy shock. They are generally recommended for children under eight and for infants where available. The practical catch is that many public AEDs — the ones mounted outside surf clubs, in shopping centres and at sporting grounds — carry only adult pads. That is not a reason to walk away. A reduced-energy shock is preferred for an infant; a standard shock is acceptable; no shock, when one is needed, is the only truly bad option on the list.
What If the AED Says No Shock Advised?
“No shock advised” does not mean the infant is fine, and it does not mean the machine is broken. It means the heart rhythm the AED detected is not one that responds to defibrillation. Your job stays the same: high-quality CPR until help arrives. The AED will re-analyse at regular intervals and will tell you if the situation changes.
CPR Comes First: The Infant Basics
An AED supports CPR; it does not replace it. For an infant, CPR follows the same DRSABCD framework taught in every accredited course, with a few adjustments for size: compressions with two fingers (or two thumbs) on the lower half of the breastbone, pushing down about one third of the depth of the chest, at 100 to 120 compressions per minute, with two rescue breaths after every 30 compressions. An infant’s rescue breaths are gentle puffs covering the mouth and nose together — not adult-sized breaths scaled down by enthusiasm.
Reading those numbers is not the same as having done it on a manikin with an instructor watching your technique. Our Provide CPR course (HLTAID009) covers infant, child and adult CPR along with AED use, and takes a few hours out of your life in exchange for a skill that has, on occasion, given someone else the rest of theirs.
The Mid North Coast Reality: Minutes Matter More Out Here
Here is the part of this topic that is specific to where we live. Survival from cardiac arrest falls with every minute that passes without CPR and defibrillation — the commonly cited figure is a drop of roughly 10 per cent per minute when nothing is done. In parts of Sydney, an ambulance may be minutes away. Across the Mid North Coast — from Port Macquarie and Wauchope down through Taree and the smaller villages between — response times can stretch well beyond that, through no fault of the paramedics covering long distances between towns.
The maths is uncomfortable but useful: in a regional area, the bystander is not a stopgap until the professionals arrive. For the first and most critical minutes, the bystander is the resuscitation service. NSW Health and ambulance services actively encourage community CPR and AED awareness for precisely this reason. If you live outside a major centre and you are the parent, grandparent or carer of a baby, the case for hands-on training is about as strong as it gets.
Common Myths, Corrected
“An AED can hurt the baby.” An AED only delivers a shock if it detects a rhythm that needs one. Used on an infant in cardiac arrest, it is treatment, not risk. The real hazard in that moment is doing nothing.
“You need training to legally use an AED.” No. Anyone can use an AED in an emergency in Australia, and the device instructs you as you go. Training makes you faster and calmer — worth having — but the absence of a certificate should never keep an AED in its cabinet.
“You can’t use an AED on a wet or small chest.” Dry the chest quickly if it is wet, then attach the pads. Size is handled by front-and-back placement, as above.
“CPR alone is enough for babies.” Usually the arrest is respiratory in origin, and CPR with breaths is the priority — but if the rhythm is shockable, only a defibrillator fixes it. Attach the AED whenever one is available.
Who Especially Needs to Know This
Parents and grandparents top the list, but there is a professional dimension too. Educators in early childhood services are required to hold first aid qualifications that cover exactly these scenarios — ACECQA sets out the approved qualifications, including HLTAID012. Our Child Care First Aid course is built for this group, with infant CPR and AED practice as a core component rather than an afterthought. Family day care providers, swim instructors, and anyone who runs a workplace where babies and toddlers come through the door — cafés with play areas, we see you — sit in the same category.
After the Shock: Handover and Looking After Yourself
If the infant starts breathing normally again, place them on their side, keep the AED pads attached, and stay with them until paramedics arrive — the device keeps monitoring and the ambulance crew will want its data. When help arrives, a clear handover matters: what happened, when you started CPR, how many shocks were delivered. This is exactly where a structured history framework like SAMPLE earns its keep, turning a frightening blur into information paramedics can act on.
One more thing, because it gets skipped in most articles: performing CPR on an infant, whatever the outcome, is a heavy experience. Talk to someone afterwards — your GP, a counsellor, or the follow-up support ambulance services can point you to. Being shaken by it is not a sign you did anything wrong.
Frequently Asked Questions
Can you use an AED on an infant under 12 months?
Yes. ANZCOR guidelines state an AED can be used on an infant who is unresponsive and not breathing normally. Use paediatric pads or a child mode if available; if not, standard adult pads placed front and back are acceptable.
Where do AED pads go on a baby?
One pad on the centre of the chest and one on the back between the shoulder blades. This anterior-posterior placement stops the pads touching each other on a small torso.
What if only adult pads are available?
Use them. ANZCOR advises that adult pads may be used on infants and children when paediatric pads are unavailable, as long as the pads do not touch. Do not delay defibrillation waiting for the ideal equipment.
Should I do CPR before or after attaching the AED?
Start CPR immediately and attach the AED as soon as it arrives, pausing compressions only when the device tells you to. If a second person is present, one does CPR while the other fetches and attaches the AED.
Do I need a certificate to use an AED on a child or infant?
No. In an emergency, anyone may use an AED and the device guides you through each step. Formal training simply makes you quicker and more confident when it counts.
Where can I learn infant CPR near Port Macquarie or Taree?
Coastal First Aid runs regular accredited courses covering infant, child and adult CPR and AED use, with sessions in both Port Macquarie and Taree.
Learn It Properly, Close to Home
Knowing that the answer is “yes, you can use an AED on an infant” is a good start. Having practised it — pads in hand, manikin on the floor, instructor pointing out that you have just knelt on the imaginary baby’s arm — is better. Enrol in a course with Coastal First Aid, or view upcoming course dates across Port Macquarie and Taree to find a session that suits. If you manage a childcare centre, sporting club or workplace on the Mid North Coast, you can also request workplace or group training and we will bring the manikins to you.
