From the Guidelines
The normal respiratory rate for a 5-year-old child is typically 20-30 breaths per minute. This rate is based on the most recent and highest quality study available, which recommends targeting a respiratory rate range of 1 breath every 2–3 s (20–30 breaths/min) for children, accounting for age and clinical condition 1. When assessing a child's respiratory rate, it is essential to count for a full minute while the child is calm and at rest, as activity or distress can temporarily increase breathing rate.
Key Considerations
- Rates consistently above 30 breaths per minute may indicate respiratory distress, infection, or other medical concerns.
- Rates below 15 breaths per minute could signal respiratory depression.
- Measuring respiratory rate by observing the rise and fall of the chest or abdomen rather than listening to breaths provides a more accurate count.
- Regular monitoring of respiratory rate, along with other vital signs, helps establish a baseline for the individual child and allows for early detection of potential health issues.
Evidence-Based Recommendations
The American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care recommend targeting a respiratory rate range of 20-30 breaths per minute for children 1. Although other studies provide reference ranges for respiratory rates in children, such as the WHO cutoffs 1, the most recent and highest quality study available supports the range of 20-30 breaths per minute.
Clinical Implications
In clinical practice, it is crucial to prioritize the most recent and highest quality evidence when assessing and managing pediatric patients. By targeting a respiratory rate range of 20-30 breaths per minute, healthcare providers can help ensure the best possible outcomes for children, in terms of morbidity, mortality, and quality of life.
From the Research
Normal Respiratory Rate for a 5-Year-Old Child
The normal respiratory rate for a child can vary based on age. According to the studies:
- A study published in 1992 2 found that respiratory rate is inversely related to age, but it does not provide a specific range for a 5-year-old child.
- A study published in 1994 3 focused on infants and young children up to 3 years old and does not provide information for a 5-year-old child.
- A systematic review published in 2011 4 derived new centile charts for heart rate and respiratory rate in children from birth to 18 years of age. The charts show a decline in respiratory rate from birth to early adolescence. However, the study does not provide a specific normal range for a 5-year-old child.
- A study published in 1995 5 used a cutoff criterion for rapid breathing of 40 breaths/minute for children 1 to 5 years old, but this is for the diagnosis of pneumonia, not for determining normal respiratory rate.
- A study published in 2020 6 developed centile charts for respiratory rate in children from birth to 13 years of age using an optical sensor. The awake median respiratory rate was 25.4 at 3 years of age, but the study does not provide a specific value for a 5-year-old child.
Key Findings
- Respiratory rate decreases with age 2, 3, 4, 6.
- There is a wide range of normal respiratory rates in children 2.
- Sleep state can impact respiratory rate in young children 6.
- Existing reference ranges for respiratory rate may not be accurate 4.
Respiratory Rate Ranges
- The 2011 systematic review 4 found that the median respiratory rate decreases from 44 breaths per minute at birth to 26 breaths per minute at 2 years of age.
- The 2020 study 6 found that the awake median respiratory rate was 59.3 at birth and 25.4 at 3 years of age.
- The 1995 study 5 used a cutoff criterion of 40 breaths/minute for children 1 to 5 years old, but this is not a normal range.