Normal Respiratory Rate In Children And When To See A Doctor

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Respiratory rate is defined as the average number of breaths per minute. It is important to know about the respiratory rate in children to ensure the proper functioning of their lungs. The respiratory rate might vary depending upon age and various factors, such as physical activity, the body’s temperature, blood pressure, and level of electrolytesiXMinerals present in blood and bodily fluids that carry an electric charge and are vital for essential body functions. in the body. The respiratory rate is a vital sign that indicates the proper functioning of the lungs, and thus, it is important to monitor it (1).

Read on to know more about the normal respiratory rate in children, factors that alter it, and when to be concerned.

In This Article

Normal Respiratory Rate For Children

Normal respiratory rate in children
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The table illustrates the normal ranges of the respiratory rate of children (2).

AgeRespiratory Rate (breaths/min)
Infant (birth-1year)30-60
Toddler (1-3 years)24-40
Preschooler (3-6 years)22-34
School-Aged Child (6-12 years)18-30
Adolescent (12-18 years)12-16

Source: The University of Iowa and Stead Family Children’s Hospital

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Periodic breathing is normal in infants. They may breathe fast several times, have a brief rest (usually less than 10 seconds), and breathe again (19).

Measuring Respiratory Rate In Children

Measure respiratory rate in upright position
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Measuring the respiratory rate in children is an easy task as it can be done using observational cues. The rise in the chest indicates inhalation, while a fall signifies exhalation. Therefore, you would measure one rise and one fall of the chest as one complete respiratory cycle. Here are the steps to follow (3).

  • Ensure your child sits in an upright position
  • Set your timer to one minute
  • Start the timer and note down the number of chest wall movements
  • After a minute, compare the count with the standard chart

Do not conduct the test after any strenuous activity to avoid any discrepancies in the count. Similarly, do not let your child know that they’re under observation as they may consciously alter their breath in such observational or clinical settings. Alternatively, you may use a respiratory sensor to avoid any mistakes.

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Respiratory rate is one among the four vital signs useful in monitoring health problems. The others are body temperature, pulse rate and blood pressure (19).

Reasons For Altered Respiratory Rate In Children

Irregular breathing is when a child’s breathing rate is higher or lower than the acceptable ranges for their age.

John Landry, a registered respiratory therapist from Memphis, Tennessee, says, “The ideal respiratory rate varies depending on the individual and their age, but generally, a respiratory rate that is too high or too low can indicate a problem. A high respiratory rate can signify respiratory infection or other conditions, while a low respiratory rate can indicate a problem with the person’s lung function or a side effect of certain medications.”

The reasons may include the following (4) (5).

1. High respiration rate

  • Dehydration: Tachypnea (abnormally fast, shallow breathing) is a sign of severe dehydration among children (6).
  • Respiratory illnesses: Any underlying lung conditions could result in an increased respiration rate. Asthma, obstructive pulmonary disease, pneumonia, emphysemaiXA chronic disease of the lungs resulting in damaged air sacs (alveoli). , or other lung infections could be the reasons.
  • Fever: It is the most common cause of increased respiration rate in children. This increase in breathing rate is a part of the body’s mechanism to get rid of the excess body heat (7).
Fever is the most common cause of increased respiration rate in children.
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  • Anxiety: According to the Morbidity and Mortality Weekly Report by the CDC, approximately 9.8% of children between 3-17 years were diagnosed with anxiety disorders. Panic attacks may cause a child to hyperventilateiXCondition in which one breath at an abnormally fast rate. . This fast breathing rate would recede as the child calms down from the anxiety attack (8).
  • Heart conditions: Heart and lungs work in conjunction. Hence, any cardiovascular health issues that affect the pumping of blood may affect the lungs eventually. The lungs may compensate for this decreased heart function by increasing the respiration rate.

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At high altitudes, the respiratory rate of healthy children was found to be higher than normal (21).

2. Low respiration rate

  • Overdosage: Certain narcotics, especially opioidsiXA class of drugs that are used for relieving pain and as an illegal psychotic drug. prescribed for pain management for children, may affect the respiratory rate. An overdose of opioids could result in respiratory depression (9) (10).
  • Obstructive sleep apnea: Pediatric obstructive sleep apnea is a sleeping disorder occurring due to an obstruction in the airway during sleep. In this condition, the child may show decreased or frequent pauses in breathing while asleep (11).
  • Brain injury: Since the brain and lungs share a reciprocal relationship, respiratory dysfunction is a common complication of a brain injury (12).
  • Hypothermia: Prolonged exposure to cold environments can cause a drop in body temperature, resulting in slower heart rate and breathing.
Hypothermia may lower the respiratory rate in children
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Metabolic disorders, such as hyperthyroidismiXA condition caused by the overproduction of the thyroxine hormone resulting in weight loss, sweating, irregular heartbeat, etc. or hypothyroidismiXA condition caused by the lack of thyroxine hormone in the thyroid glands. , may affect breathing patterns, too. While hypothyroidism decreases the respiratory rate, hyperthyroidism increases it (13). Altered respiratory rates could have benign causes, too. For example, an increased respiratory rate after intense physical activity is common.

When To See A Doctor

Seek medical care for abnormal respiratory rate
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“Parents should be concerned about their child’s respiratory rate if it is consistently above the normal range for their age and if they are experiencing other symptoms such as difficulty breathing, chest pain, or cyanosis (bluish color of the lips or face),” opines Landry.

A breathing rate of more than 40 breaths per minute for a child of 1-12 years or more than 20 breaths for a child older than 12 years indicates irregular breathing patterns. Fewer than 12 breaths per minute could also be a sign of a problem.

Erratic respiration rate due to a problem is mostly accompanied by other signs of respiratory distress. It may help parents determine if the change in respiration rate is normal or due to an underlying condition. Below are some of the notable signs of respiratory distress in children (14) (15) (16).

  1. Increased heart rate: A rapid heart rate could be observed with a decrease in oxygen levels in the body.
  1. Stridor: A high-pitched, wheezing sound that is audible every time the child tries to inhale. It could be an indication of an obstructed airway.
  1. Blue color change (Cyanosis): If the color of the skin is turning blue, it is an indication that the body isn’t receiving sufficient oxygen. This blue color would be more evident near the mouth, inside of lips, and nails.
  1. Grunting: A grunting sound paired with deep breaths indicates respiratory trouble.
  1. Use of accessory muscle: The muscles of the neck appear strained during inhalation.
  1. Flared nostrils: Nostrils open wide during each inhalation if the child is facing issues in breathing.
  1. Chest retractions: The muscles of the chest (between the ribs and below the ribs) get pulled in deeper than normal during inspiration.
  1. Decreased alertness: Low oxygen supply to the brain may result in fatigue and decreased response to verbal cues.

These medical conditions are an emergency and indicate a severe respiratory problem, and require immediate medical intervention.

Frequently Asked Questions

1. Why is the respiratory rate higher in children than in adults?

Children have a higher respiratory rate than adults because they have limited space in their lungs to exchange oxygen and carbon dioxide (17).

2. What is the normal respiratory rate of children while sleeping?

The normal respiratory rate of children while sleeping is as follows (18):

  • Newborn to 12 months (infants): 30 to 60 breaths per minute
  • 1 to 2 years (toddlers): 24 to 40 breaths per minute
  • 3 to 5 years (preschoolers): 22 to 34 breaths per minute
  • 6 to 12 years: 18 to 30 breaths per minute
  • 13 to 17 years (adolescents): 12 to 20 breaths per minute

3. What are the long-term effects of respiratory illnesses on children’s respiratory rate?

Certain respiratory illnesses can have an adverse effect on the child’s overall health. These diseases can alter the structure of the lung tissue, which does not permit them to expand fully. This decreased lung capacity will lead to an increased respiratory rate as the weakened respiratory muscles make it difficult to take in oxygen and release carbon dioxide (22)(23).

4. How can parents prevent respiratory illnesses in their children?

A few steps that parents can take to prevent their children from contracting respiratory illnesses are to teach them good hygiene habits, like washing their hands whenever they come inside after playing or before eating a meal. They should ensure their children have received all the necessary vaccinations at the right time. They should also teach their children to avoid close contact with someone who is showing symptoms of illness (24).

It is important to monitor the respiratory rate in children as it indicates the proper functioning of the lungs. You can measure the respiratory rate in your child using observational cues. Dehydration, asthma, anxiety, overdosage of certain narcotics, and brain injury can trigger altered respiratory rates in children. So keep track of your child’s respiratory rate to know their breaths per minute since this is as important as heart rate or blood pressure. In case you notice any abnormality in your child’s breathing, consult a pediatrician promptly for appropriate diagnosis and treatment.

Infographic: Tips To Maintain A Healthy Respiratory Rate In Children

Irrespective of the underlying condition, some tips may help maintain your child’s respiratory rate within a healthy range. It is suggested to consult your child’s doctor before trying the respiratory rate maintenance tips mentioned in this infographic.

what helps in maintaining a healthy respiratory rate (infographic)

Illustration: Momjunction Design Team

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Key Pointers

  • Respiratory rate in children may be measured by counting the number of rises and falls of the chest or using a respiratory sensor.
  • High respiration rate may be due to dehydration or fever, while low respiration rate may be due to brain injury or hypothermia.
  • Consult a doctor if you notice symptoms such as increased heart rate, cyanosis, or flared nostrils in children.
Respiratory Rate In Children_illustration

Image: Dall·E/MomJunction Design Team

Learn how to measure a child’s respiratory rate, an important vital sign for pediatric health.


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