From the Guidelines
A normal respiratory rate for adults at rest typically ranges from 12 to 20 breaths per minute, while for children, normal rates vary by age, with rates of 30-60 breaths per minute for newborns and infants, 24-40 for toddlers, 22-34 for preschoolers, 18-30 for school-age children, and 12-20 breaths per minute for adolescents, as indicated by the World Health Organization's guidelines 1.
Normal Respiratory Rates by Age
- Newborns and infants: 30-60 breaths per minute
- Toddlers: 24-40 breaths per minute
- Preschoolers: 22-34 breaths per minute
- School-age children: 18-30 breaths per minute
- Adolescents: 12-20 breaths per minute
Importance of Accurate Measurement
Respiratory rate is an important vital sign that healthcare providers monitor because changes can indicate respiratory distress, infection, or other medical conditions, and accurate measurement is crucial for diagnosis and management, as emphasized in a study on the diagnosis and management of bronchiolitis 1.
Factors Affecting Respiratory Rate
Factors such as altitude, age, and medical conditions can affect respiratory rate, and it is essential to consider these factors when assessing respiratory rate, as noted in a study on the challenges in the diagnosis of pediatric pneumonia 1.
Assessment of Respiratory Rate
When assessing respiratory rate, it's best to count breaths for a full minute while the person is unaware they're being monitored, as conscious awareness may alter their natural breathing pattern, and manual measurement, although often the reference standard, can be imprecise and is affected by intra-observer variation 1.
From the Research
Normal Respiratory Rate
The normal respiratory rate varies by age, with higher rates observed in infants and younger children, and lower rates in older children and adults.
- Infants under 6 months old have a mean respiratory rate of 61 (18) breaths/minute when awake, and 42 (12) breaths/minute when asleep 2.
- Infants under 2 months old have a median respiratory rate ranging from 40 to 44 breaths/minute, with little inter-age variability 3.
- Children from birth to 18 years of age have a declining respiratory rate, with the steepest fall apparent in infants under 2 years of age, decreasing from a median of 44 breaths per minute at birth to 26 breaths per minute at 2 years 4.
- Pediatric patients have a wide range of "normal" respiratory rates, making identification of "abnormal" more difficult, with rates ranging from 12 to 65 breaths/minute in a study of 434 patients aged 2 weeks to 18 years 5.
- Hospitalized adults often have recorded respiratory rates that are not normally distributed, with values clustered at 18 and 20 breaths per minute, suggesting inaccurate recording 6.