The objective of this paper was to examine the 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 cardiopulmonary resuscitation (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 analysis of variance (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.