Gina Johnson
A newborn's normal breathing rate is about 40 to 60 times per minute, which may slow to 30 to 40 times per minute when sleeping. It is normal for a newborn baby to take slight pauses in their breathing for a few seconds, or to breathe rapidly for a short period. However, if a child's breathing pauses while they're asleep, that might be a sign of sleep apnea, which can occur in children between 2 and 8 years old. If your child seems to be having a hard time breathing, or you notice abnormal behaviours, it may be time to seek emergency care.
| Characteristics | Values |
|---|---|
| Normal breathing rate | 40-60 times per minute |
| Normal sleeping breathing rate | 30-40 times per minute |
| Normal breathing rate (1-5 years old) | Less than 40 breaths per minute |
| Signs of respiratory distress | Increase in breathing rate, increased heart rate, colour changes, grunting, nose flaring, sweating, wheezing, stridor, accessory muscle use |
| Signs of working hard to breathe | Drawing in the muscles below the ribs, between the ribs, and in the neck sinking in with each attempt to inhale |
| Signs of infection | Fever, congestion |
| Signs of asthma | Peak flow reading below 50% |
| Signs of sleep apnea | Snoring, choking, pauses in breathing |
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What You'll Learn
Sleep apnea
It is normal for newborns to breathe faster for a few seconds and then slow down their breathing, especially when sleeping. This type of irregular breathing is normal and does not require treatment. If irregular breathing persists past the age of six months, it is advised to consult a pediatrician.
Breathing issues are common in children, especially if they attend daycare or have siblings. It is normal for them to get as many as 12 infections a year. However, if your child seems to be having a hard time breathing, or you notice abnormal behaviours, it may be time to seek emergency care.
Children with sleep apnea may exhibit a range of symptoms, including loud snoring, gasping for air, or brief pauses in breathing during sleep. It is important for parents to pay attention to behavioural changes, as sleep apnea can sometimes present as ADHD or ADD and be misdiagnosed. If you suspect your child may have sleep apnea, it is recommended to reach out to a pediatrician, who may refer you to a pediatric ENT.
Treatments for sleep apnea in children vary depending on the severity of the condition. Mild sleep apnea can be treated with oral medication, such as montelukast, or nasal steroid or antihistamine sprays. For moderate to severe sleep apnea, surgery to remove part or all of the tonsils and adenoids may be recommended. Continuous positive airway pressure (CPAP) machines can also be used to maintain an open airway during sleep.
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Signs of respiratory distress
It is common for newborns to have irregular breathing patterns, including slight pauses and rapid breathing for a few seconds. This is normal and does not require treatment. However, if irregular breathing persists past six months, it is important to consult a pediatrician.
- Increased breathing rate: For children aged 1 to 5, a breathing rate of more than 40 breaths per minute is considered abnormal.
- Working hard to breathe: This can be observed through retractions, where the neck, areas below the ribs, and the areas between the ribs sink with each inhalation attempt.
- Color changes: A bluish tint around the mouth, inside the lips, or on the fingernails indicates inadequate oxygenation, known as cyanosis. The skin may also appear pale or gray.
- Grunting: A grunting sound during exhalation is the body's attempt to keep air in the lungs.
- Nasal flaring: Widening of the nostrils during breathing indicates an increased demand for air.
- Wheezing: This often signals a constriction or blockage in the small airways of the lungs, which can be triggered by a viral infection.
- Stridor: A distinctive, high-pitched sound during breathing due to turbulent airflow in the upper airways.
- Sternal recession: Inward movement of the space between the ribs and sternum during breathing, indicating that the body is exerting extra effort to draw air into the lungs.
- Fatigue: The child may show signs of fatigue as the body prioritises energy expenditure for breathing.
If you notice any of these signs of respiratory distress in your child, it is important to seek medical attention promptly. Trust your instincts, and if you are concerned about your child's breathing, don't hesitate to consult a healthcare professional.
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Normal breathing rates for toddlers
It is common for newborns to breathe faster for a few seconds and then slow down, especially during sleep. This type of irregular breathing is normal and usually resolves by the time they are six weeks old. However, if irregular breathing persists past six months of age, it is important to consult a pediatrician to ensure your child's breathing is healthy.
For toddlers aged one to five years old, a normal breathing rate is up to 40 breaths per minute. If your toddler exceeds this range, it may be an indication of an underlying health issue. It is important to monitor their breathing rate and seek medical advice if you have any concerns.
Breathing issues are common in toddlers, especially if they attend daycare or have siblings. They can be prone to frequent infections, which may impact their breathing. Additionally, conditions like sleep apnea can cause pauses in breathing during sleep, and this can occur in children between the ages of two and eight.
It is important to be vigilant about your toddler's breathing patterns and overall health. If you notice any signs of breathing difficulties, such as wheezing, coughing, or increased mucus production, don't hesitate to seek medical advice. Trust your instincts, and if you feel that your toddler is struggling to breathe or exhibiting abnormal behaviours, it is always best to err on the side of caution and consult a healthcare professional.
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Asthma and other respiratory conditions
Asthma is a respiratory condition that affects about 7.5 million children in the United States. It can be difficult to diagnose in children, especially those younger than six years old, as symptoms can be similar to other illnesses. Asthma symptoms in children include coughing, wheezing, chest tightness, and breathlessness. Children with asthma may also experience a combination of these symptoms, which can make asthma more likely.
Coughing is a common symptom in children, but there are certain indicators that it could be related to asthma. Asthma-related coughing often occurs at night, in the early morning, after exercise, or when the child is excited or laughing. A cough related to asthma may also persist for a long time and not go away.
Wheezing is another symptom of asthma and is a continuous high-pitched whistling sound that can be heard when a child breathes. It is different from other chesty noises and is often hard to hear, even for medical professionals.
Chest tightness can be another sign of asthma, but it may not be easy to notice. Children with chest tightness may rub their tummy or chest and complain of a "tummy ache" or "sore tummy".
Breathlessness is another symptom of asthma. While it is normal for children to get a bit breathless when playing or running around, breathlessness related to asthma may be indicated by faster breathing or the child having to try harder to breathe.
If you suspect your child has asthma, it is important to see a healthcare provider. Early treatment can help control symptoms and possibly prevent asthma attacks. A pediatrician may diagnose asthma based on a child's medical history, symptoms, and a physical examination. They may also refer the child to a specialist, such as a pediatric pulmonologist or pediatric allergist.
In addition to asthma, there are other respiratory conditions that can affect children. Bronchiolitis is a common condition in children under two years old, usually starting as a runny nose and cough, with breathing difficulties worsening over a few days. Pneumonia is another respiratory condition that can be life-threatening. Children with asthma or other chronic conditions are at a higher risk of developing pneumonia.
If your child is having difficulty breathing, it is important to seek emergency medical care.
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When to seek emergency care
While it is normal for newborns to breathe faster for a few seconds and then slow down their breathing, especially while sleeping, if your child seems to be having a hard time breathing or you notice abnormal behaviours, it may be time to seek emergency care.
If your child has stopped breathing and is unresponsive, immediately begin CPR and call 911. If your child ceases breathing for 15 seconds or more and then resumes breathing, visit the pediatric ER. If your child is struggling to breathe, wheezing, or making noises while breathing, this could indicate a breathing problem. If your child is working too hard to breathe, this may be a sign of respiratory distress. You may notice the muscles below their lower ribs, at their neck, or between their ribs sinking in with each attempt to inhale.
If your child has had an upper respiratory condition for more than five days and is not getting better, visit your doctor. Pneumonia is a common lung infection that can be life-threatening. Children with asthma, recent hospitalisation, frequent antibiotic use, or another chronic condition are at a higher risk for developing pneumonia. If your child is recovering from a choking episode, it is a good idea to visit the pediatric ER to ensure there are no long-term consequences.
If your child is not eating or drinking enough, or is not going to the bathroom regularly, seek medical attention.
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Frequently asked questions
A normal breathing rate for a child between 1 and 5 years old is fewer than 40 breaths per minute.
Slow breathing during sleep could be a sign of sleep apnea, which affects 2-3% of children. It can be caused by enlarged tonsils or adenoids, a small or constricted airway, or a misaligned jaw. Other symptoms include snoring and daytime drowsiness.
Signs of respiratory distress include an increased breathing rate, increased heart rate, grunting, and colour changes such as a bluish tint around the mouth or lips, or pale or grey skin.
If your child is showing any signs of respiratory distress, you should seek urgent medical attention.
