What is a normal respiratory rate?

From the Guidelines

The normal respiratory rate for children varies by age, with rates of ≥60 breaths per min for children who are <2 months of age, ≥50 breaths per min for children who are between 2 months and 11 months of age, and ≥40 breaths per min for children who are 12–59 months of age, as defined by the WHO 1. When assessing respiratory rate, it is essential to count for a full minute while the person is at rest and unaware they're being monitored, as awareness can alter breathing patterns.

Key Considerations

• Respiratory rate is a critical factor in diagnosing pneumonia in children under 2 years of age, particularly febrile children 1.
• Manual measurement of respiratory rate can be imprecise and is affected by intra-observer variation, requiring focused concentration 1.
• Increased rates (tachypnea) can signal respiratory infections, anxiety, or compensation for metabolic acidosis, while decreased rates (bradypnea) might indicate medication effects, neurological issues, or metabolic alkalosis.

Age-Specific Respiratory Rates

• 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 It is crucial to evaluate the respiratory rate alongside other vital signs and clinical symptoms for proper assessment of a person's overall condition, as an abnormal respiratory rate may indicate respiratory distress, metabolic problems, or other medical conditions 1.

From the Research

Normal Respiratory Rate

• The normal respiratory rate is not explicitly defined in the provided studies, but we can look at the acceptable ranges for clinical purposes:
  • A study published in 2019 2 found that 13 out of 24 respiratory rate studies showed agreement within industry standards of ±3 breaths per minute.
  • Another study published in 2024 3 considered respiratory rate to be acceptable if it was within ±10% of the reference standard or 3 breaths per minute.
• The distribution of recorded respiratory rates was found to be right skewed, with values clustered at 18 and 20 breaths per minute, in a study published in 2017 4.
• Respiratory rate is an important vital sign, and its measurement can be used in conjunction with other signs, such as oxygen saturation, to provide a holistic overview of respiratory functions 5.
• In very preterm infants requiring respiratory support at birth, the target values for respiratory rate and oxygen saturation may not be reached quickly or reliably 6.

Factors Affecting Respiratory Rate

• The accuracy of respiratory rate measurement can be affected by various factors, including the method of measurement and the population being studied 2, 3.
• Respiratory rate can be influenced by physiological conditions, such as cardiopulmonary compromise, but the variation in respiratory rate may not always be accurately reflected in recorded values 4.
• The use of telehealth portals and contactless monitoring systems can provide accurate measurements of respiratory rate, but the accuracy of these systems should be validated against reference standards 3.