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The objective of this study was to examine changes in applied force and rate of chest compression (CC) during 5 min of CC with a target CC rate of 90/min (CC90) or 120/min (CC120) with and without metronome guidance during simulated neonatal CPR. We performed a randomized controlled manikin trial. Fourteen Neonatal Resuscitation Program providers performed CC90 and CC120 with or without a metronome in a randomized order. Peak and residual leaning force; and CC rate each minute of CPR were analyzed with Friedman’s ANOVA (within interventions) and two-way repeated measures ANOVA (between interventions). There was a large variability in force application, with no difference between groups. Peak and residual leaning forces in CC90 and CC120 did not change with time with or without a metronome. The CC rate increased with time in all groups except CC90 without a metronome. In conclusion, neither the target CC rate nor using a metronome influenced the peak and residual leaning forces during simulated neonatal CPR.