Things to know about pediatric vital signs

Vital signs are measures that show important information about the functioning of the heart, lungs, and other important organs. These include such tests as heart rate and blood pressure.

The optimal numbers of pediatric vital signs are different from those of adults. Babies and children, for example, tend to breathe quicker, and have a higher heart rate.

Several factors that cause the vital signs of an infant to deviate from the norm. For example, heavy exercise can elevate body temperature, heart rate, and respiration rate, while tired or cold children may have lower body temperatures and lower heart rate.

Also these vital sign numbers can vary greatly from child to child. Read on to learn more about the vital signs of pediatric illness.

Heart rate

Doctor checking the heart beat of a child
As a child grows older they tend to decrease their heart rate.

Heart rate is one indicator of how many times a minute the heart beats. There are a couple of ways to check the heart rate.

For example, a person could place a finger on the pulse of a child and count the total number of beats per minute (bpm). Similarly, in 10 seconds, they can count the number of beats and subtract the number by six.

Heart rate tends to drop as a child grows older. Teenagers have similar rates of resting heart to healthy adults.

Normal heart rate typically falls within the following ranges:

AgeAwakeSleeping
Under 28 days old100–205 bpm90–160 bpm
1–12 months old100–190 bpm90–160 bpm
1–2 years old98–140 bpm80–120 bpm
3–5 years old80–120 bpm65–100 bpm
6–11 years old75–118 bpm58–90 bpm
12–15 years old60–100 bpm50–90 bpm

Blood pressure

Blood pressure is a gage of how hard the heart works. This tests how much pressure the blood that drives the heart places on the veins and arteries.

Blood pressure levels tend to increase with height and weight, so the blood pressure will be slightly higher for bigger children. Girls also show a significantly higher blood pressure than boys of similar size. Furthermore, pediatric blood pressure increases with age.

Very high blood pressure may show a problem with heart health. Less often, low blood pressure can also be an indicator of a problem. Low blood pressure can also be a symptom of hemorrhage or infection.

Systolic blood pressure refers to the highest number of a measure of blood pressure, and that is always higher. The lowest number is the diastolic blood pressure.

Systolic blood pressure is the “on the beat” reading, when the muscle of the heart contracts to pump blood. Diastolic blood pressure is interpreted as reading between beats. This is when the muscle in the heart relaxes.

For most children, normal blood pressure measurements in millimeters of mercury are as follows:

AgeSystolicDiastolic
Newborn (under 1,000 grams [g])39–5916–36
Newborn (over 1,000 g)60–7631–45
0–1 month old67–8435–53
1–12 months old72–10437–56
1–2 years old86–10642–63
3–5 years old89–11246–72
6–9 years old97–11557–76
10–11 years old102–12061–80
12–15 years old110–13164–83

Breathing rate 

The rate at which a child breathes indicates how hard their body works to inhale oxygen.

A quick respiration can mean that a child has trouble getting enough oxygen. Very slow breathing could be a sign of a neurological problem, like a head injury.

Doctors measure the rate of respiration per minute in breath. Look for signs a child has exhaled, such as air coming out of the nose, to measure a breath. Count the total number of breaths per minute by monitoring their breathing for a minute or counting in 10 seconds the number of breaths and multiplying the number by six.

Typical breathing rates are as follows:

AgeBreaths per minute
1–12 months old30–60
1–3 years old24–40
3–6 years old22–34
6–12 years old18–30
12–18 years old12–16

Symptoms of distress 

Temporary changes can be average in a child’s vital signs. Blood pressure, respiration levels, and body temperatures of children often increase when they are nervous or very active. Such vital signs appear to decline when a child is relaxed or sleeping.

Likewise, if there are no other signs, a small deviation from the norm — such as a heart rate that is 5 bpm above usual — usually does not signify a problem.

Understanding what’s normal for their child is important for parents and caregivers, so they can keep track of vital signs and know when a concern may arise.

Blood pressure is typically the last vital sign in a very ill child to change. Normal blood pressure coupled with an abnormal respiration or heart rate may still be a warning sign for a potential emergency.

Some warning signs of an infant’s distress include:

  • a fever, which most healthcare providers define as a temperature over 100.4ºF (38ºC)
  • grunting or making other noises when trying to breathe
  • bleeding
  • significant changes in multiple vital signs, such as an increase in heart rate and a drop in blood pressure
  • breathing that stops for longer than 20 seconds
  • chest breathing, especially in newborns and babies
  • very fast breathing
  • skin that is white, pale, or blue, especially under the nail beds or on the lips
  • nostril flaring, especially in young babies

Seek immediate treatment for a child or baby experiencing a sudden change in their vital signs. If there are other symptoms, such as high fever or breathing difficulties, go to the emergency room or call 911.

Summary

Knowing the ideal numbers of pediatric vital signs can help parents and carers assess the health of a child.

Unusual vital signs can give early evidence that a seemingly minor health issue is serious.

Try not to panic when you notice the abnormality of one of a child’s vital signs. In most cases, if there are also other symptoms of illness, there is only one problem.

Only a health care professional can determine if anomalous vital signs point to a serious medical problem or not. Don’t delay if they recommend treatment, as prompt treatment can save lives and prevent minor issues from becoming more serious.

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