From the Guidelines
The normal respiratory rate for a 5-year-old child is typically between 20-30 breaths per minute when at rest, as recommended by the 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. This rate is higher than in adults because children have smaller lungs and airways, requiring more frequent breathing to maintain adequate oxygen levels. When assessing a child's respiratory rate, count for a full minute while the child is calm and not crying or active, as these states can artificially elevate the rate. Some key points to consider when evaluating respiratory rate in children include:
- Respiratory rates gradually decrease as children age, with newborns having the highest rates (30-60 breaths per minute) and adults having the lowest (12-20 breaths per minute) 1.
- A respiratory rate consistently above 30 breaths per minute in a 5-year-old may indicate respiratory distress or illness.
- Other signs of respiratory problems include nasal flaring, retractions (visible pulling in of the chest between or below the ribs), grunting, or bluish discoloration of the lips or skin.
- If you observe these symptoms along with an elevated respiratory rate, seek medical attention promptly. It's also important to note that reference ranges for normal respiratory rates can be affected by factors such as altitude, and may not be based on evidence for all populations 1. However, the American Heart Association guidelines provide a clear recommendation for the normal respiratory rate range in children, which should be followed in clinical practice 1.
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.