From the Guidelines
The normal respiratory rate in a newborn is below 60 breaths per minute. This is based on the criteria for discharge of healthy term newborn infants, as outlined in a study published in the journal Pediatrics in 2015 1. According to this study, a respiratory rate below 60 per minute is considered within the normal range for newborns, with no other signs of respiratory distress.
Key Points to Consider
- The respiratory rate is typically measured when the baby is calm or sleeping, as crying or activity can temporarily increase breathing rate.
- Newborns breathe faster than older children and adults because their lungs are smaller and less developed, requiring more frequent breaths to maintain adequate oxygen levels.
- Parents and healthcare providers should be concerned if the newborn's respiratory rate consistently falls below 30 or exceeds 60 breaths per minute, or if there are signs of respiratory distress such as labored breathing, retractions, nasal flaring, grunting, or blue discoloration around the lips or face.
Clinical Implications
- Healthcare providers should monitor the respiratory rate of newborns closely, especially in the first few weeks of life, to ensure that it remains within the normal range.
- Any concerns about the newborn's respiratory rate or signs of respiratory distress should be evaluated promptly and thoroughly, as these can be indicative of underlying health issues that require medical attention.
From the Research
Normal Respiratory Rate in Newborns
- The normal respiratory rate in newborns is a key indicator of their health, with abnormal rates potentially signaling disease 2.
- A study published in Pediatrics in 2016 found that the median respiratory rates in healthy term infants were 46 breaths/minute at 2 hours, and 42 to 44 breaths/minute thereafter 2.
- The 95th percentile for respiratory rate was 65 breaths/minute at 2 hours, and 58 to 60 breaths/minute thereafter, while the fifth percentile was 30 to 32 breaths/minute 2.
- Another study published in Respiratory Care in 2014 found that higher levels of respiratory distress were associated with higher breathing frequencies, with a mean respiratory rate of 20,22,27, and 30 breaths/minute for different levels of distress 3.
- However, it's worth noting that these studies were not exclusively focused on newborns, and the results may not be directly applicable to this population.
- A study published in 2016 specifically looked at respiratory rates in healthy term infants, and found that the overall mean respiratory rate was 5.2 breaths/minute higher while awake than during sleep 2.
Factors Affecting Respiratory Rate
- Respiratory rate can be affected by various factors, including sleep state, with rates being higher while awake than during sleep 2.
- Meconium staining of the amniotic fluid and sex can also impact respiratory rate, with higher rates observed in infants with heavy meconium staining and in boys compared to girls 2.
- However, the mode of delivery (vaginal vs cesarean) did not appear to affect respiratory rate in healthy term infants 2.
Clinical Significance
- Abnormal respiratory rates can be a key symptom of disease in newborns, highlighting the importance of monitoring and establishing reference ranges for respiratory rate in this population 2.
- Accurate recognition and diagnosis of respiratory distress and acute respiratory distress syndrome are crucial for providing appropriate care and improving outcomes in critically ill patients, including newborns 3, 4, 5.