Automated External Defibrillators (AEDs) are powerful, lifesaving tools designed to restore a normal heart rhythm during sudden cardiac arrest. But using one on an infant can feel overwhelming, especially if you're unsure about proper pad placement.
In this guide, you’ll learn exactly how to place AED pads on infants safely and effectively. We'll also walk you through when to use an AED, key considerations to keep in mind, and what to do if pediatric pads aren’t available.
Whether you're a parent, caregiver, or safety officer responsible for emergency preparedness, this article will help you act with clarity and confidence.
When to Use an AED on an Infant
Cardiac arrest in infants—defined as children under one year of age—affects more than 20,000 infants and children annually in the United States alone. While this data reflects U.S. figures, the risks are just as real here in Canada. Unlike adult cardiac arrest, pediatric cases are more often caused by respiratory problems, choking, drowning, or congenital heart conditions.
If an infant suddenly becomes unresponsive and isn’t breathing normally, don’t wait. Immediate action can save their life.
Here’s what to do, according to the American Heart Association:
- Check for responsiveness by tapping the infant and shouting their name.
- If there's no response and the infant is not breathing or only gasping, call 9-1-1 immediately (or have someone else call).
- Start CPR right away if you're trained.
- Use an AED as soon as it becomes available, and follow its voice prompts.
These steps are based on current guidelines widely followed across North America, including in Canada.
AEDs are designed to guide you step by step, even if you’ve never used one before. When used quickly and correctly—especially in combination with CPR—they can significantly improve survival outcomes. Every minute without defibrillation lowers the chance of survival by about 7-10%. [1]
AED Pad Placement for Infants
Using an AED on an infant requires a slightly different approach than with older children or adults, especially when it comes to pad placement. Because of their smaller chest size, placing the pads in the right position is essential to ensure the shock reaches the heart effectively and safely.
Below, we’ll walk through the correct placement, why it matters, and what to do if you’re using adult pads or don’t have access to child-specific ones.
Correct Placement
What is the correct AED pad placement for an infant?
For infants under 12 months old, the pads should be placed in the anterior-posterior position:
- One pad goes in the centre of the chest, just below the collarbone.
- The second pad goes on the centre of the back, between the shoulder blades.
This placement is recommended by the American Heart Association's Pediatric Advanced Life Support guidelines for infants when the pads risk touching each other on the small chest.[2]
This configuration allows the electric shock to pass through the heart effectively without the pads touching or overlapping on the small chest of an infant.
If you're using a device with child-specific pads or a pediatric key, follow the AED's voice prompts and diagrams, as they're designed to guide you through the placement step by step.
Why This Placement?
Because infants have much smaller chests, the usual pad placement used on adults—one on the front and one on the side—just doesn’t work the same way. The pads can end up too close together or even overlapping, which makes the shock less effective and can irritate the skin.
That’s why the anterior-posterior placement is recommended for infants. It helps:
- Deliver the shock more directly through the heart
- Avoid interference from bones or other tissue
- Keep the pads a safe distance apart so they work properly
It’s a small adjustment, but it makes a big difference in an emergency.
What AEDs and AED Pads Are Suitable for Infants?
Choosing the right AED or AED pads for infants helps ensure the shock is delivered safely, effectively, and with the appropriate energy level.
Below are some reliable options that work with young children and infants:
LIFEPAK CR2
The LIFEPAK CR2 includes a dedicated child mode button that instantly lowers the shock energy and adjusts instructions for pediatric use. With this feature, responders can treat children under 8 years old or weighing less than 25 kg without changing pads, making it a highly efficient solution for mixed-age environments.
ZOLL AED 3
The ZOLL AED 3 features a built-in child mode button that lets responders quickly switch to pediatric settings using the same set of pads. This not only simplifies preparation but also reduces the need for keeping separate pediatric pads on hand. It’s perfect for schools, daycares, or families with young children.
Philips FRx Infant/Child Key
The Philips FRx doesn’t require separate pediatric pads—instead, it uses the FRx Infant/Child Key to switch the device into pediatric mode. Once inserted, the AED automatically adjusts its shock level and voice prompts for infants, making it a straightforward and easy-to-use option in high-stress situations.
LIFEPAK Pediatric Electrodes
The LIFEPAK Pediatric Electrodes are made specifically for children under eight years old or weighing less than 25 kg (55 lbs). They reduce the energy delivered to suit smaller bodies and include clear diagrams for pad placement, helping responders act quickly and accurately.
HeartSine samaritan Pediatric Pad-Pak
The HeartSine samaritan Pediatric Pad-Pak combines both the battery and pediatric pads into a single cartridge, so there’s only one component to install during an emergency. It’s ideal for infants, thanks to its simplified setup and reduced energy output, which is designed for younger patients.
Powerheart G3 Pediatric Electrode Pads
The Powerheart G3 Pediatric Electrode Pads are clearly labelled for use on children and infants, which helps prevent mistakes during high-pressure moments. They deliver lower-energy shocks appropriate for smaller patients and are compatible with the Powerheart G3 AED.
What Should You Do When Using an AED on an Infant or Young Child?
Emergencies are stressful, but knowing what to do helps you stay calm and act quickly. Here’s a clear, step-by-step guide to using an AED on an infant or a young child under eight years old.
1. Check for Responsiveness and Breathing
Gently tap the infant and speak their name to see if they respond. Look closely for signs of normal breathing. If they’re gasping or not breathing at all, it’s time to act.
2. Call for Emergency Help
Call 9-1-1 right away or ask someone nearby to make the call. Emergency responders can guide you over the phone while help is on the way.
3. Start CPR if Needed
If you're trained in infant CPR and the scene is safe, begin CPR right away while someone else retrieves the AED. Push in the centre of the chest and follow your training as best you can.
If you're alone, get the AED if possible, then begin CPR.
If you’re not trained or simply unsure, this step-by-step guide from the American Red Cross offers clear instructions for performing CPR on a baby.
4. Turn On the AED and Follow the Voice Prompts
As soon as the AED arrives, turn it on. The device will give clear voice instructions to guide you through each step, even if you’ve never used one before.
5. Place Pads in the Correct Position
Apply the pads in the anterior-posterior position as described above: one on the centre of the chest, and one on the back between the shoulder blades. Use pediatric pads if available.
6. Deliver Shock if Advised
Before delivering the shock, make sure no one is touching the infant. Press the shock button when prompted, or let the AED deliver it automatically, depending on the model.
7. Resume CPR Immediately
Start CPR again right after the shock, or if the AED advises no shock. Continue until emergency help arrives or the infant shows signs of recovery.
Key Considerations to Remember When Using an AED on a Child
Using an AED is safe and effective, but there are a few critical details to keep in mind, especially when treating infants or young children. These reminders can help you avoid common mistakes and deliver care as effectively as possible.
Avoid Placing Pads Over Medical Patches or Wet Skin
Before applying pads, quickly check the infant’s chest for any medication patches or moisture. If you see a patch, remove it and wipe the area dry. Wet skin or adhesive barriers can prevent the pads from working properly.
Do Not Touch the Infant During Shock Delivery
When the AED is ready to deliver a shock, step back and make sure no one else is touching the infant. Even a light touch can interfere with the shock or put others at risk.
Reassess Regularly and Follow AED Prompts
AEDs aren’t just for delivering shocks; they continue to monitor the heart and guide you through the entire event. Listen closely and respond to each prompt. If the device says to resume CPR or recheck the pads, do so without delay.
Don’t Place the Pads Too Close Together
Spacing matters. If pads are too close or overlapping, the shock won’t pass through the heart the way it should. This is why using the anterior-posterior position on infants is so important, as it ensures both safety and effectiveness.
FAQs
If no child-size pads are available, can adult pads be used on a child?
Yes, if pediatric pads aren't available, you can use adult pads in a life-threatening emergency. It's far better to use an AED with adult pads than to delay treatment.
That said, child-specific pads are always the safer option. Pediatric pads deliver approximately 50 joules of energy compared to 150-360 joules from adult pads.[2] This reduced energy level is calibrated for smaller hearts and bodies, helping ensure effectiveness while minimizing the risk of injury to delicate tissue.
What should you do when using an AED on an infant or a child younger than 8 years of age?
The 8-year age cutoff is based on weight and body development. Children under 8 years old or weighing less than 55 pounds (25 kg) require pediatric settings to ensure the energy delivered is appropriate for their smaller heart size.[2]
Use pediatric pads or a child key if the AED supports it. Follow these steps:
- Turn on the AED
- Place pads as indicated (anterior-posterior for infants)
- Deliver a shock if prompted by the AED
- Resume CPR immediately
If neither pediatric pads nor adult pads are available, having an AED is better than having none at all.
What is important to remember about AED pad placement on infants?
The most important thing is to use the anterior-posterior pad placement: one pad in the centre of the chest, the other on the back between the shoulder blades. This setup helps ensure the shock travels directly through the heart, where it’s needed most.
Also, check that the infant’s skin is dry and free from anything that could interfere with the pads, like medication patches, lotions, or thick clothing. Proper placement and good contact make all the difference in an emergency.
What is the correct AED pad placement for an infant?
For infants under one year of age, the correct placement is anterior-posterior:
- Place one pad in the centre of the chest, just below the collarbone.
- Place the second pad on the back, between the shoulder blades.
This positioning allows the AED to deliver the shock safely and effectively through the heart, without the pads overlapping or interfering with each other.
Be Prepared With the Right Pediatric AED Pads
In a cardiac emergency, knowing how to use an AED on an infant—and having the right equipment on hand—can truly save a life. Proper pad placement helps ensure each shock is delivered safely and effectively.
Preparation is key. Make sure your AED is equipped with pediatric pads or accessories, and that everyone on your team knows how to respond. Whether you’re a parent, teacher, coach, or safety officer, having the right tools in place offers complete peace of mind.
Shop our pediatric AED pads today and give yourself the confidence to act.
References
[1] Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O'Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., & Berg, K. M. (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000916
[2] Topjian, A. A., Raymond, T. T., Atkins, D., Chan, M., Duff, J. P., Joyner, B. L., Lasa, J. J., Lavonas, E. J., Levy, A., Mahgoub, M., Meckler, G. D., Roberts, K. E., Sutton, R. M., & Schexnayder, S. M. (2020). Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S469–S523. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000901
