Pediatric respiratory rate chart by age
A quick normal respiratory rate chart for newborns, infants, toddlers, children, and adolescents. Use it to frame a bedside count, then interpret the result with work of breathing and oxygen status.
Use the number with the exam
Quick answer
- Respiratory rate normally falls as children grow, with the steepest decline during infancy and toddler years.
- Count breaths for a full minute when the child is young, irregular, sleeping, or clinically concerning.
- A high respiratory rate is more concerning when paired with retractions, grunting, nasal flaring, hypoxia, poor perfusion, or altered mental status.
- Use this chart for quick orientation, then use respiratory scores or local pathways when a child is symptomatic.
Normal pediatric respiratory rate chart
These are broad PALS-style age bands used throughout Pedscalc for quick bedside orientation. Source ranges vary, and symptomatic children should be interpreted through local pathways.
| Age band | Normal RR | Counting note |
|---|---|---|
| Neonate (0–28 days) | 30-53 breaths/min | Count for a full minute; periodic breathing can make short counts misleading. |
| Infant (1–12 months) | 30-53 breaths/min | RR can rise with fever, feeding effort, bronchiolitis, or crying. |
| Toddler (1–2 years) | 22-37 breaths/min | Use a calm resting count when possible; distress can change the number quickly. |
| Preschool (3–5 years) | 20-28 breaths/min | Pair the count with work of breathing, wheeze, retractions, and oxygen status. |
| School‑age (6–12 years) | 18-25 breaths/min | Trend after bronchodilators, antipyretics, fluids, or pain control when relevant. |
| Adolescent (≥13 years) | 12-20 breaths/min | Interpret with activity level, fever, anxiety, pain, and oxygenation. |
Need heart rate and blood pressure too? Use the pediatric vital signs chart by age.
How to count respiratory rate
- Watch the chest or abdomen before touching the child when possible; interaction can change the count.
- Count one rise and fall as one breath, and use a full 60 seconds for infants or irregular breathing.
- Record context: asleep, awake, crying, febrile, feeding, post-treatment, oxygen support, or recent activity.
- Repeat unexpected values after the child settles or after treatment, and document the trend.
- Do not interpret RR alone; pair it with effort, breath sounds, oxygen saturation, color, perfusion, and mental status.
How to interpret a high respiratory rate
Tachypnea can come from fever, pain, anxiety, dehydration, acidosis, asthma, pneumonia, bronchiolitis, croup, sepsis, or compensation for another illness. The risk depends on the full pattern, not the number alone.
- A high RR with normal work of breathing may need reassessment after fever or agitation improves.
- A high RR with retractions, grunting, hypoxia, or fatigue should prompt respiratory escalation.
- A falling RR in a tired child can be dangerous if effort, mental status, or oxygenation is worsening.
Respiratory red flags
- Retractions, grunting, nasal flaring, head bobbing, tripod positioning, or inability to speak/feed normally.
- Cyanosis, persistent hypoxia, apnea, recurrent pauses, or exhaustion.
- Fast breathing with poor perfusion, lethargy, dehydration, sepsis concern, or altered mental status.
- Respiratory rate that remains markedly abnormal after fever, pain, anxiety, or bronchodilator response is addressed.
- Any caregiver concern that the child is breathing differently than usual, especially in infants.
When to use a respiratory score
Use a respiratory score when you need a structured severity snapshot or trend after treatment. Choose the tool that matches the presentation and your local pathway.
- Pediatric asthma score for asthma or wheeze pathways.
- Wang bronchiolitis score when respiratory rate, wheeze, retractions, and general condition are needed.
- RDAI bronchiolitis score when your pathway focuses on wheeze and retractions.
- Bronchiolitis severity bands when you need a practical pathway-style severity band.
Related tools and references
Frequently asked questions
Normal pediatric respiratory rate depends on age. This chart uses 30-53 breaths/min for newborns and infants, 22-37 for toddlers, 20-28 for preschool children, 18-25 for school-age children, and 12-20 for adolescents.
Count for a full minute when possible, especially in infants, sleeping children, irregular breathing, or illness. Watch the chest or abdomen and count one rise and fall as one breath.
Yes. Fever, pain, anxiety, crying, dehydration, and respiratory disease can raise respiratory rate. Recheck after the child settles or after treatment, but escalate if work of breathing or appearance is concerning.
No. Respiratory rate is one sign. Retractions, grunting, nasal flaring, cyanosis, hypoxia, poor feeding, fatigue, and altered mental status help determine whether the child is in distress.
Use the pediatric vital signs calculator for broad age-band context. If the child has wheeze or bronchiolitis, use the pediatric asthma score, Wang score, RDAI, or bronchiolitis severity bands as appropriate for your pathway.