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Unresponsive but breathing (infant and child)
What is unresponsive but breathing & recovery position?
When an infant or child is unresponsive but breathing normally, they may be unconscious from a head injury, seizure, medical condition or intoxication. The main danger is that the tongue or vomit may obstruct the airway, so you must position and monitor them carefully while arranging urgent assessment.
In this situation the underlying cause still needs medical attention, but the immediate priority is to keep the airway clear and breathing effective while you wait for help. Safe positioning, such as an adapted recovery position, together with continuous monitoring and timely escalation, can prevent avoidable deterioration and buy time for definitive assessment and treatment.
UK sepsis and serious-illness campaigns for children advise parents to call 999 if a child looks mottled, bluish or very pale, is very lethargic or difficult to wake, or is breathing very fast, reflecting official concern that unresponsiveness or marked drowsiness may signal life-threatening illness.
Who needs this skill?
Health & Social Care
In health and social care, policies should be explicit about how staff respond to reduced consciousness and how this links to observation protocols, NEWS2 or paediatric early warning scores and escalation pathways. Staff must recognise when an unresponsive child needs urgent transfer, how to position them safely and how to hand over a concise history to the clinical team.Licensed venues & nightlife
Licensed venues that host under-18s, family events or school groups may encounter young people who collapse due to intoxication, injury or medical issues. Staff must not assume that someone is simply 'sleeping it off'; they should check responsiveness, breathing and airway risk, position appropriately and call for clinical assessment.Schools
Schools and early years settings are often the first place a child's underlying condition is revealed by a collapse; staff should be drilled on the assessment sequence, recovery position and when to call 999 versus parents, in line with school health plans and EYFS expectations.Workplaces
In workplaces and community settings where children are present, first aiders need practical confidence with the paediatric recovery position, including adapting for small spaces, using bystanders to help and judging when not to move a casualty because of suspected spinal injury. Documentation of the incident and clear advice to parents or carers also matter.How to manage unresponsive but breathing & recovery position
- 1Check responsiveness and breathingGently try to rouse the infant or child by calling their name and tapping them (foot for infants, shoulder for children); if there is no meaningful response, open the airway with head tilt and chin lift. Look for regular chest rise, listen and feel for normal breathing for up to 10 seconds.If they are unresponsive but breathing normally, you should protect the airway and arrange urgent assessment; if breathing is absent or abnormal, move straight into paediatric CPR instead.
- 2Call for help and prepare to moveAsk someone to call 999 or 112 and explain that the child is unresponsive but breathing; if you are alone, make the call on speakerphone while staying with the child. Briefly scan for obvious major injuries or hazards before moving them and think about whether spinal injury is likely from the history.Getting help early and thinking about mechanism of injury helps you balance the need to protect the airway against the need to keep the spine still.
- 3Place a child in the recovery positionFor a child (not an infant), extend the arm nearest you outwards, place the far arm across the chest and lift the far leg, then carefully roll them towards you onto their side. Tilt the head back slightly to keep the airway open, adjust the top leg to stabilise them and check that the mouth is downward so fluid can drain.The recovery position helps keep the airway clear and reduces the risk of vomit being inhaled; the key is gentle, controlled movement with continuous monitoring.
- 4Position an infant safelyFor an infant, the classic side-lying recovery position is less practical; options include holding them in a cradled side-lying position with the head slightly lower than the body, or placing them on their side on a firm surface with towels or blankets used to maintain position. Always keep the airway open with gentle head tilt and chin lift and keep watching breathing closely.Infants are more vulnerable to airway obstruction, so positioning must be stable, with the face visible and the airway maintained while you wait for help.
- 5Monitor, reassess and hand overStay with the infant or child, checking breathing regularly and watching for any change in colour or responsiveness. Be ready to roll them onto their back and start CPR if they stop breathing normally, and hand over clearly to the ambulance crew or clinical team with the history, what you saw and what you did.Continuous observation and a clear handover reduce the risk of deterioration being missed and help the receiving team understand what has happened.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
Qualifying courses
Qualsafe Level 3 Award in Paediatric First Aid (RQF)
2 days
3 years
Qualsafe Level 3 Award in Emergency First Aid at Work (RQF) & Qualsafe Level 3 Award in Emergency Paediatric First Aid (RQF) - Combined
1 day
3 years
Qualsafe Level 3 Award in First Aid at Work (RQF) & Qualsafe Level 3 Award in Paediatric First Aid (RQF) - Combined
3 days
3 years
Common questions
Practical answers for employers, venue managers, and healthcare teams about unresponsive but breathing & recovery position training.
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If you suspect a serious neck or spinal injury, you should avoid unnecessary movement and focus on maintaining the airway with manual stabilisation while waiting for the ambulance, unless vomit or airway obstruction forces you to roll them. A good paediatric course will cover how to balance spinal precautions with airway protection.