Respiratory frequency in children during sleep, with fever, illness, after birth. Normal by age

Assessing the state of breathing begins with determining its frequency and rhythm, taking into account the age of the child. It is better to calculate the respiratory rate in a sleeping child, although this is not always possible. When you are awake, your breathing rate is usually higher, so it is important to know the normal range.

The breathing rhythm of a healthy child is not regular; breathing varies both in frequency and depth. Periodically, the child takes a deep breath, which sometimes worries parents.

Features of the respiratory system in a child

During the period of intrauterine development of the fetus, the formation and development of vital organs occurs. Their formation is completed after birth. The respiratory system begins to function at full capacity only in adulthood.

Distinctive features of the respiratory system in children:

• At birth, the baby takes its first breath and the lungs open. Their volume is much smaller than the size of the chest. But it contains a sufficient number of blood vessels. To saturate their organs with oxygen, children make breathing movements more often than adults ;
• The large number of breathing movements of children is also due to the fact that the bulk of oxygen enters through the nasal passages. In children, they are narrow and short and contain a large number of lymphatic and blood vessels. At the slightest irritation (dust, infection or allergens), swelling of the mucous membrane occurs, which further complicates the passage of air into the lungs.

Children are not good at breathing through the mouth, so parents are advised to clean their nasal passages more often.

Differential diagnosis of poisonings accompanied by miosis

Differential diagnosis of poisonings accompanied by mydriasis

Methods for calculating the breathing rate of a child

The respiratory rate in children (the norm by age has significant differences) is checked by pediatricians during monthly examinations and compared with indicators for the child’s age. Parents can count the number of inhalations and exhalations themselves. When determining indicators, you need to take into account the child’s age, weight category, general health condition and time of day.

Sequence of performing the procedure at home:

1. Determine the child's breathing type. Up to 4 years of age, children predominate in belly breathing, that is, when inhaling and exhaling, the peritoneum (abdomen) rises and falls. From 4 to 10 years, predominantly chest breathing is observed. The rise and fall of the chest is visually noted. After 10 years, abdominal breathing predominates in males, and chest breathing in females.
2. After determining the type of breathing, you need to prepare a watch with a second hand and bring the child into a calm state. Playing games, watching cartoons, or being scared about the upcoming procedure will not allow you to obtain accurate data. In infants, it is recommended to take measurements during sleep. The indicator will be slightly lower than during the waking period.
3. A comfortable position for correctly counting inhalations and exhalations is a lying position. Children from 1 to 5 years old can be calmed with a rattle or calm conversation. In this case, the participation of 2 parents will be required.
4. The number of breathing movements can be assessed visually or by placing your hand on your stomach or ribs.
5. The most accurate indicators are those measured in 1 minute. If the child is fidgety, then it is allowed to make calculations for 15 or 30 seconds. Multiply the resulting number by 4 or 2. But the data will have an error.
6. To increase the measurement accuracy, the procedure must be performed 3-4 times. The resulting arithmetic mean will give the exact number that needs to be compared with the age norm.

At the same time, it is recommended to measure the number of heartbeats. If there is a deviation in the indicators, the child should be shown to a pediatrician. The specialist will re-measure the indicator, taking into account accompanying factors (excess weight, presence of a runny nose).

Treatment strategy

After a comprehensive examination of the child, a therapeutic program is developed. Taking into account the severity of the violations, the following technologies are often used:

• Rinsing the nasal passages and prescribing special medications.
• Creating positive pressure on a continuous basis in the airways so that air flow is continuously supplied to the body. This CPAP technique is safe for children.
• Removal of tonsils, that is, denotonsillectomy , is used for pathology and diseases of the ENT organs.
• Positional therapy , that is, treatment by changing body position .
• Surgical treatment vulopalatopharyngoplasty. Its purpose is to widen the airways when soft tissue is partially removed.

Purpose of research

Comparison of respiratory rate with standards is required to assess the development of the respiratory system and heart function. A change in indicators in any direction may indicate the presence of pathology (infectious and non-infectious in nature).

Timely identification of developmental deviations increases the likelihood of a child’s complete recovery, without the development of complications. If the measurements were taken over several days, then they need to be shown to the pediatrician. The data will allow you to make a diagnosis faster.

Norms of breathing rate in newborns

Newborns have the highest respiratory rates. Moreover, in premature babies, a reduced range may be important due to the irregularity of inhalations and exhalations. Deviations from the norm can only be determined by a pediatrician.

The permissible range of breathing rates in children under one year of age:

By the age of one year, the range of respiratory rates in full-term and premature infants narrows. In children born prematurely, breathing stops for 10-15 seconds, which is considered normal, if there is no blueness of the extremities and there is no developmental disorder of the child. If there are deviations, an urgent examination by a pediatrician is necessary.

Amount of water to cleanse the intestines

Norms of respiratory rate in children by age during wakefulness

The respiratory rate in children (the norm by age presented in the table does not take into account the characteristics of the child’s condition) gradually decreases until the child reaches 18 years of age. Since the lungs are fully expanded (over the entire chest), the condition of the nasal passages changes and the child learns to breathe through the mouth.

Respiratory rate indicators for children from one to 18 years of age:

When measuring the frequency of inhalations and exhalations yourself, it is recommended to pay attention to the depth of inhalations.

If your breathing is shallow, then it will naturally become more frequent to replenish the oxygen deficiency. If a child breathes deeply, but often, this signals the development of pathology. An examination of the pulmonary and cardiovascular systems is necessary.

Volume of liquid for gastric lavage

How often should babies breathe in their sleep?

Indicators of the rhythm and frequency of breathing during night sleep differ from the values ​​​​at the time of wakefulness. Infants, during rest, may experience periodic breathing (discussed below) or apnea (stopping breathing for 10-15 seconds with a frequency of repetitions of at least 15 times within 1 hour).

At the moment of sleep, the whole body rests (muscles and nervous system relax, heart rate slows down), as a result, oxygen consumption decreases, as a result, the frequency and depth of inhalations and exhalations decreases. If you are in doubt whether the child is breathing or not, you can determine the presence of breaths by the rise and fall of the ribs or peritoneum.

It is not recommended to wake up the child every 5-10 minutes. This will harm his nervous system.

In the presence of apnea in premature infants, parents are advised to monitor the rhythm of breathing. Sometimes the baby cannot resume the breathing process during sleep due to muscle relaxation. It is recommended to wake the child, if there is no reaction, urgently call emergency help , and additionally take the necessary measures to restore the respiratory process.

As you grow older, the rhythm and frequency of breathing during sleep stabilizes. In rare cases, these deviations are observed in adults.

Arterial pressure

Blood pressure (BP) is one of the few health markers that can be measured at home. Today, almost every family has a device for independently measuring blood pressure. But not all adults know that the norm for children differs from the “120 to 80” we are all used to.

MedVedik reminds that blood pressure depends on the age of the baby. The younger the child, the lower his normal blood pressure. This is due to the fact that the child’s circulatory system and heart continue to develop after birth, so initially the child’s blood vessels and capillaries have less tone than those of adults.

Keep this helpful sign with BP limits for children. These are generalized indicators that are the result of many years of research. They correspond to the working pressure of 95% of healthy children.

Have you noticed a significant discrepancy in the child’s blood pressure readings and in the table? This is already a reason to see a doctor. He will calculate an individual rate specifically for your child and, if necessary, select treatment.

PS By the way, to obtain an accurate measurement result, the size of the tonometer cuff is important. A large cuff on a small child's hand may distort the readings somewhat.

Causes of decreased breathing rate

Factors that reduce the frequency of inhalation and exhalation can be natural or pathological:

Video on what to do if a child is holding his breath:

Whether a violation of the breathing process is a pathology or a natural process can be determined through regular monitoring of the child and a full examination by a pediatrician and pulmonologist.

Why are indicators changing?

If indicators change outside of diseases (for example, due to overheating), then after the end of the external factor they return to normal in 3-7 minutes. A constantly increased heart rate occurs when:

• viral, bacterial infection;
• blood acidification (acidosis);
• anemia (decreased hemoglobin and red blood cells);
• diseases of the bronchi and lungs with respiratory failure (for example, asthma, severe pneumonia);
• increased thyroid function (hyperthyroidism, thyrotoxicosis);
• tumors of the adrenal medulla (pheochromocytoma);
• the use of drugs that stimulate the heart (Eufillin, Atropine, asthma medications, hormones);
• autonomic dysfunction (neurocirculatory dystonia), more often developing in adolescents;
• inflammation of the heart - myocarditis, endocarditis, pericarditis;
• valve defects, large vessels, ventricular and atrial septal defects;
• tuberculosis;
• congenital disorders of the structure of the conduction system of the heart (for example, Wolff-Parkinson-White syndrome).

A slow heart rate is characteristic of increased intracranial pressure (tumor, cerebral edema, sinus thrombosis), severe malnutrition (hypotrophy), renal failure, viral hepatitis, typhoid fever. It may appear during the recovery period after an infectious disease.

The most severe decrease in heart rate occurs when conduction blockade in the myocardium occurs. In a child, such arrhythmia leads to rapid loss of consciousness. Children usually tolerate a moderately accelerated rhythm better.

The respiratory rate increases when:

• bronchospasm or inflammation (bronchial asthma, bronchitis);
• fever;
• lung diseases - pneumonia, tuberculosis, compression due to fluid accumulation in the pleural cavity, tumors;
• blockage of a branch of the pulmonary artery by a thrombus, embolus (thromboembolism);
• chest pain;
• diseases of the nervous system, hysteria;
• severe anemia;
• heart failure due to myocarditis, heart disease;
• fullness of the stomach, bloating.

A decrease in respiratory rate occurs with a brain tumor, edema, or inflammation of the meninges (meningitis). The cause may be severe failure of the kidneys, liver, acute onset of diabetes from a coma, or poisoning.

What does rapid breathing in children mean?

The frequency of inhalation and exhalation may deviate upward from age-related norms, also due to the influence of natural and pathological factors. This pathology occurs more often in children, since they cannot yet regulate the breathing process normally.

Respiratory rate in children: the norm should be checked by a pediatrician during a monthly examination and compared with indicators according to the child’s age

In the absence of natural factors affecting the respiratory process, the child must be examined by a pediatrician.

What is periodic breathing, is it dangerous?

Periodic disturbances in the rhythm and depth of breathing are possible in 4 types:

• Cheyne-Stokes. This type is characterized by initially rare and shallow breathing with a gradual increase in inhalation amplitude and depth. When the maximum threshold is reached, the frequency and depth of inspiration gradually decreases, after which an interval of up to 1.5 minutes is possible. Then the process is repeated.
• Biotta. Rhythmic breathing is interrupted by pauses of 30 seconds or more.
• Kussmaul. The breathing process is accompanied by deep but rare breaths and accompanied by noise.
• Grocco. Breathing occurs according to the Cheyne-Stokes type, but instead of pauses there is shallow, weak breathing.

These types of respiratory processes cause harm to both adults and children:

• in children there is a disruption in the development of the respiratory system;
• Oxygen starvation of tissues and organs periodically occurs, which affects their performance. This is a decrease in the functioning of the brain, cardiovascular and nervous systems;
• the development of pathologies in these systems is possible, as well as deterioration of hearing, vision and the presence of constant headaches;
• there is a regular feeling of weakness. At the peak of rapid breathing, loss of consciousness is possible due to an excess of oxygen. At the peak of low breathing, fainting is possible due to lack of oxygen;
• Metabolic processes are disrupted, which leads to a delay in the child’s development (mental, weight and physical).

If pathological breathing is detected in a newborn or an older child, it is recommended to contact a pediatrician for an examination. The specialist will also explain how to behave to parents during prolonged respiratory arrest and the rules for emergency care before the ambulance arrives.

Relationship between breathing rate and heart rate

Respiratory rate in children (the norm by age is often measured together with the heart rate) and heart rate at rest:

When the heart rate changes, the breathing process is disrupted and vice versa.

Rapid and slow breathing with a normal pulse

An increase or decrease in the respiratory rate value with normal pulse values ​​is possible with the following deviations:

• individual physiological characteristics of the child’s body;
• poor indoor air quality (hot, dry, polluted);
• age-related changes in the child’s body;
• the presence of colic in the digestive tract;
• clogging of the respiratory tract (dried mucus).

These causes are not pathological in nature and go away on their own, without medical intervention. If in doubt, you should be examined by a pediatrician.

With an accelerated heart rate

An increase in the number of heart contractions is accompanied by a change in breathing rate.

Factors causing the violation:

• physical activity, running, as well as stress, fear or increased anxiety;
• increased body temperature due to overheating;
• disruption of the cardiovascular and respiratory systems;
• when an infection enters the body;
• severe poisoning by toxins and poisons;
• side effects from taking medications;
• development of oncology;
• presence of internal or external bleeding;
• entry of a foreign object into the respiratory tract. The body prevents normal breathing, and due to fear, the heart rate increases.

These symptoms (increased or decreased respiratory rate along with an increase in the number of heartbeats) require contact with specialists (pediatrician, pulmonologist, cardiologist) for examination.

With a slow heartbeat

When the heart beats slow down, the breathing process is disrupted in the following cases:

• pathological processes in the cardiovascular system;
• disruption of brain cell activity;
• electric shock;
• when the body is hypothermic;
• the effect of infection;
• side effect from taking medications.

Reduced heart rate and respiration rates are observed in children involved in sports. If a child does not engage in sports activities, then a change in indicators means the development of pathologies. An examination is required.

Clinical symptoms of poisoning

Dependence of breathing rate on body temperature

The respiratory rate in children (the norm for age is a conditional indicator, since in diseases and certain characteristics of the body, breathing is often rapid or slow) depends on body temperature.

Until the child reaches 2 months, with an increase in temperature, only an increase in the respiratory rate occurs, the heartbeat remains normal. After the child reaches 2 months, both indicators increase. This reaction of the body is due to the protective and regenerative reaction of the body.

How to normalize your breathing rate

To restore breathing rate you need:

• during the period of night rest, take a horizontal position on your back, but at the time of an attack it is not recommended to put the child on your back;
• change your diet by increasing the amount of fresh vegetables and fruits;
• perform breathing exercises with the child for 15-20 minutes 3 times a day (slowly inhale through the nose, exhale through the mouth);
• in a playful way, breathe with the child into the bag and inflate the balloons;
• if the attack is caused by fear or stress, then you need to give children's sedatives or herbal decoctions;
• in the absence of breathing (during a prolonged attack of apnea), you need to rouse the child, let him smell ammonia (carefully so as not to burn the nasal mucosa). Sometimes it is recommended to hold the baby upside down for 1-3 minutes. In this case, you need to spank the baby on the buttocks. After this, splash the child’s face with cold water or wash it.

If the breathing rate is severely impaired, emergency assistance must be called.

Medicines, except for sedatives in liquid form, should not be given to a child until the symptoms are eliminated and the cause is determined. Normalization of the frequency of inhalation and exhalation in children varies by age towards a decrease in the indicator. If there are deviations, it is recommended to contact a pediatrician to determine the cause of the breathing disorder. Self-medication is unacceptable.

Author: Kotlyachkova Svetlana

Article design: E. Chaikina