Respiratory Rate Guidelines for Infants

Definition and Measurement

According to the World Health Organization (WHO), tachypnea (abnormally fast breathing) in infants less than 2 months of age is defined as ≥60 breaths per minute 1
Manual measurement of respiratory rate can be imprecise and is affected by intra-observer variation, requiring focused concentration, as noted by the World Health Organization 1
Measurement is more difficult with a crying, irritable, or moving child, as stated by the World Health Organization 1
Inappropriate reference ranges for normal respiratory rates can lead to inaccurate determination of tachypnea and, consequently, inaccurate pneumonia diagnoses, according to the World Health Organization 1

A respiratory rate ≥60 breaths per minute in an infant less than 2 months old is considered tachypnea and may indicate respiratory distress, as defined by the World Health Organization 1

The normal respiratory frequency for infants under 1 year is approximately 20 to 60 breaths per minute, with a lower limit of 20 breaths per minute 2, 3, 4
Bradipnea is defined as a respiratory frequency <20 breaths per minute in infants under 1 year, which is an important criterion for detecting risk of serious injury 2, 3, 4

A respiratory frequency <20 breaths per minute in infants under 1 year should be considered a sign of alarm that reflects risk of serious injury and requires immediate medical attention 2, 3, 4
Respiratory frequency is one of the easiest vital signs to measure in infants, even in field conditions 3, 4
Tachypnea (≥60 breaths per minute) is a useful indicator for the diagnosis of lower respiratory infections in infants 5