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 electrolytes 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.
Normal Respiratory Rate For Children
The table illustrates the normal ranges of the respiratory rate of children (2). Source: The University of Iowa and Stead Family Children’s Hospital
Measuring Respiratory Rate In Children
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.
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. The reasons may include the following (4) (5).
1. High respiration rate
Dehydration: Tachypnea (abnormally rapid 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, emphysema, 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).
Anxiety: Panic attacks may cause a child to hyperventilate. This fast breathing rate would recede on its own 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.
2. Low respiration rate
Overdosage: Certain narcotics, especially opioids 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: Lowering of the body temperature due to prolonged exposure to cold environment may lower the respiratory rates.
Metabolic disorders, such as hyperthyroidism or hypothyroidism, 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
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). These medical conditions are an emergency and indicate a severe respiratory problem, and require immediate medical intervention.
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
