Infant CPR: The Sniffing Position for Airway Management

The sniffing position aligns the oral, pharyngeal, and laryngeal axes to maximize airway patency in an unresponsive, non-breathing infant.

How to Achieve It

1. Place infant supine on a firm, flat surface.
2. Position yourself at the infant's head.
3. Place one hand on the forehead; gently tilt the head back slightly (neutral to slight extension).
4. Use the fingertips of the same hand to lift the bony chin—do not press on soft tissues under the chin (can obstruct airway).
5. The nose should point upward ("sniffing the air"); the external auditory canal aligns with the shoulder.
6. Maintain this position throughout CPR until advanced help arrives.

Critical Nuances

• Overextension closes the airway—infants have large occiputs and flexible tracheas.
• If trauma is suspected, use jaw-thrust without head tilt.
• Only for unresponsive, apneic infants. Do not practice on a breathing child.

Why It Matters

Proper airway alignment is the foundation of effective rescue breathing and chest compressions. Incorrect positioning is a common cause of failed ventilation in infant CPR.

Take a certified infant CPR course (AHA, Red Cross) for hands-on practice.