Because heart rate generally decreases as body size increases, babies have the highest pulse. Heart rate slows down as a child grows. Knowing what a normal pulse rate is and how to check your child’s pulse can help you avoid unnecessary worry about your child’s heart rate. It can also help you identify a slow or fast pulse when your child is sick and let you know when to seek medical attention.
How to Take Your Child’s Pulse
Your heart rate, also called your pulse, is the number of times your heart beats every minute. You can measure your child’s pulse by placing your finger on their wrist under the thumb, over the middle of the chest, the side of the neck, or the top of the foot. These sites are areas of the body where an artery lies just under the skin. For example, the carotid artery is in the neck and the radial artery is in the wrist. Use a clock with a second hand, a stopwatch, or the timer on a cell phone to track the time. You might also want to use a phone app that measures the pulse. These often require you to place a finger on the camera lens for the measurement, so they may not be a good choice for young children who have a hard time holding still. Alternatively, you can count the number of beats you feel in 30 seconds and then multiply that number by two.
Resting Pulse and Target Heart Rate
Before looking at what is considered a normal pulse rate, keep in mind that health professionals talk about a couple of different types of heart rates.
The resting pulse rate is your heart rate when you are not exercising, such as when you are watching a movie or reading a book. This is what you want to measure in your children. The target heart rate is the ideal level your heart rate should reach while exercising. It is useful when you want to make sure you are getting an effective workout. The common calculation for determining the target heart rate in adults (220 beats per minute minus your age) is not accurate for children and should not be used. Your child’s pediatrician can determine an accurate target heart for your child if such a calculation is necessary to assess rate or rhythm anomalies.
Normal Heart Rate
A child’s resting pulse rate should be measured when they are at rest and not crying, running, or playing. Listed are the normal ranges of heart rates in children from birth to 18 years of age based on a large review study published in the Lancet. These measurements are taken from children at rest and in infants who are awake and healthy. The median number is listed as the “resting heart rate” and represents the middle heart rate of the whole sample. It’s best to talk with your pediatrician if you have concerns about your child’s pulse. There are some inconsistencies among various reference ranges for pediatric heart rate. Your pediatrician can give you a more accurate normal rate specifically for your child. Use this as a guide, but not a hard and fast rule. As you can see, younger children normally have faster heart rates than teenagers. On the other hand, very athletic teens can have resting pulse rates as low as 40 to 50 beats per minute. This is because they are so fit that their heart does not have to work as hard to move blood through the body.
Slow and Fast Heart Rates
A child’s pulse rate can be normal, fast (tachycardia), or slow (bradycardia). In some forms of tachycardia, like supraventricular tachycardia (SVT), the heart rate can rise above 220 beats per minute. In contrast, a child with bradycardia may have a heart rate of less than 50 beats per minute. It’s also important to talk to your pediatrician if your child always seems to be at either the upper or lower limits of normal. For example, tell your child’s doctor if:
DizzinessExtreme irritabilityFainting (syncope)
Seek medical attention right away in this situation.
Your child is at the low end of the age range for their pulse rate, even when running around and playing. They are always at the upper end of normal for their pulse rate, even when sleeping.
A heart rate above the upper limit of normal may be a sign of an underlying heart condition. It could also be a clue to other problems in the body, such as an infection or a metabolic condition. Any type of abnormal heart rate–whether in the rate or rhythm–is called arrhythmia. Not all arrhythmias are a cause for concern. Some are harmless, but others may require medical treatment. It’s a good idea to contact your pediatrician if you think your child’s pulse feels erratic or unsteady, especially if it happens often or lasts a long time.
Evaluation of an Abnormal Heart Rate
If your pediatrician is concerned about your child’s heart rate, they may order tests to see if there is an underlying heart abnormality. For example, in addition to your child’s pulse, your doctor may also check their blood pressure and order an electrocardiogram (ECG, also called an EKG). The ECG allows your doctor to not only verify your child’s heart rate, but also the rhythm, or electrical activity, of the heart. It can also provide clues on whether the heart is enlarged or working too hard. In addition to heart problems, your doctor may also do blood tests, such as a complete blood count or a thyroid test, to check for underlying infections and conditions like anemia or hyperthyroidism that can affect your child’s heart rate.
Other Causes of a High Heart Rate
Sometimes the culprit behind a child’s fast heart rate is much easier to fix. For example, one controllable factor is caffeine. A child may develop a high resting heart rate if they consume coffee, energy drinks, or several sodas throughout the day. The side effects of some medications can also affect a child’s resting heart rate. While you might expect that a stimulant for ADHD might raise your child’s heart rate, you may be surprised to learn that an over-the-counter decongestant can do so as well. A high resting heart rate can also be associated with pain, dehydration, or a fever. If the high heart rate is attributed to these factors, the reversal of those conditions should bring the heart rate back to normal.
A Word From Verywell
Understanding the normal range for your child’s heart rate and factors that can affect it allow you to make informed decisions when deciding whether to be concerned about an abnormality. In children especially, most of the time a heart rhythm or rate that is abnormal now and then is not a reason for worry. Even those that require treatment have very good outcomes. Be sure to reach out to your pediatrician if you have any questions or concerns about your child’s heart rate. There was an error. Please try again.
