Pulse Rate Basics For Newborns: Understanding The Normal Range

A newborn baby's pulse is a lot faster than an adult's, with a normal rate of 100 to 200 beats per minute when awake and 90 to 160 beats per minute when sleeping. A newborn's heart rate can be measured by checking their brachial pulse, which can be found by bending their arm so that their hand is near their ear and using two fingers to feel for the pulse on the inner side of the arm between the shoulder and elbow.

How to check a newborn's pulse

A newborn baby's pulse is 100 to 200 beats per minute when awake and 90 to 160 beats per minute when sleeping. Checking a newborn's pulse can be tricky because they have a lot of fat under their skin and are likely to move around. Here is a step-by-step guide on how to check a newborn's pulse:

Prepare the Baby:

Ensure the baby is relaxed and has not been crying, running, or jumping around for at least 5 minutes before taking their pulse.

Locate the Brachial Pulse:

• The best spot to feel a newborn's pulse is on the upper arm, known as the brachial pulse.
• Lay the baby on their back with one arm bent so that their hand is up by their ear.
• The brachial artery runs along the humerus (upper arm bone).

Feel for the Pulse:

• Use your index and middle fingers to gently press on the inner side of the baby's bent arm, between the shoulder and elbow.
• Do not use your thumb for this step.

Count the Beats:

• Once you locate the pulse, start counting the beats.
• Count the beats for 15 seconds, then multiply that number by 4 to get the beats per minute.

Alternative Method:

• If you cannot locate the brachial pulse, try checking the femoral pulse.
• The femoral pulse is the pulsation of the femoral artery, which supplies blood to the lower limbs.
• You can feel this pulse on the front of the baby's body where the thigh meets the trunk.

When to Seek Help:

• If you cannot feel a pulse or the pulse is very slow and irregular, call for emergency medical assistance immediately.
• They can guide you through performing cardiopulmonary resuscitation (CPR) if necessary.

Checking a newborn's pulse requires practice and skill, but it is a valuable skill to have, especially if your baby ever falls ill or gets injured.

Normal pulse rates for newborns

A newborn baby's pulse is typically between 100 and 200 beats per minute when awake, and 90 to 160 beats per minute when sleeping.

Checking a newborn's pulse requires skill and practice. The traditional method of taking a person's pulse is to feel it at the wrist, but most babies have chubby wrists, so feeling the pulse there is difficult. Instead, you can try to find the brachial pulse, which is the pulsation of the brachial artery, located along the humerus (the arm bone). To do this, bend your baby's arm so that their hand is near their ear, and use two fingers to feel for the pulse on the inner side of the arm between the shoulder and elbow.

If you are unable to find the brachial pulse, you can try to find the femoral pulse, which is the pulsation of the femoral artery, the large artery supplying the lower limbs. To find this, feel the front of your baby's body where the thigh meets the trunk.

If you are unable to find a pulse and your baby is unresponsive, call 911 and they can guide you on performing cardiopulmonary resuscitation (CPR).

What to do if you can't find a pulse

A newborn baby's normal pulse rate is 100 to 200 beats per minute when awake and 90 to 160 beats per minute when sleeping. If you can't find a pulse on a newborn, it is important to stay calm but act quickly. Here is what you should do:

Check for Breathing:

First, check if the newborn is breathing. Observe the chest for any movement and listen for any sounds of breathing. If the baby is not breathing, move on to step 2.

Call for Help:

If the newborn is not breathing, call for emergency medical assistance immediately. In many places, you can dial 911 for emergency services. Explain the situation and follow any instructions provided by the operator.

Check the Brachial Pulse:

While waiting for emergency services to arrive, try to locate the brachial pulse. This is the pulsation of the brachial artery, which runs along the upper arm bone (humerus). To find it, bend the baby's arm so that the hand is near the ear. Use two fingers to feel for the pulse on the inner side of the arm between the shoulder and elbow. Do not spend more than 10 seconds trying to locate the pulse.

Check the Femoral Pulse:

If you cannot find the brachial pulse, move on to checking the femoral pulse. This is the pulsation of the femoral artery, the large artery supplying blood to the lower limbs. You can feel the femoral pulse on the front of the baby's body, where the thigh meets the trunk. Again, do not spend more than 10 seconds trying to locate the pulse.

Begin CPR:

If you are unable to find a pulse and the baby is not breathing, begin cardiopulmonary resuscitation (CPR). CPR can help restore blood circulation and breathing. Place two fingers in the centre of the baby's chest and push down firmly and quickly. Aim for a rate of 100 to 120 compressions per minute. If you are unfamiliar with CPR, the emergency operator can guide you through the process.

It is important to remember that taking a newborn's pulse can be challenging due to their fat under the skin and their constant movement. It requires skill and practice. Knowing how to take a baby's pulse and perform CPR can be lifesaving, so it is valuable to educate yourself on these procedures.

When to call emergency services

A newborn's normal pulse rate is 70 to 190 beats per minute. However, if you notice any of the following symptoms, you should call the emergency services:

• Your baby is having trouble breathing. Look for muscles pulling in between the ribs or the nose puffing out with each breath.
• Your baby has pale or grey skin, or blue lips.
• Your baby is choking and requires the Heimlich maneuver.
• Your baby is drowning. Pull your child out of the water and start CPR, then call emergency services.
• Your baby is actively receiving CPR or other life-saving interventions.
• Your baby is profusely bleeding and requires constant pressure.
• Your baby is having a life-threatening allergic reaction.
• Your baby has a fever of 100.4 F or higher and is under 3 months old.
• Your baby has a stiff neck, feels disoriented, is lethargic, refuses to eat, or cries more when held.
• Your baby's breathing has changed pace or pattern, with more than 60 breaths per minute, or stops for longer than 20 seconds at a time (apnea).
• Your baby's nostrils are flaring, or their head is bobbing up and down.
• Your baby's skin is sucking in between the ribs, breastbone, or clavicles with each breath.
• Your baby is grunting with each breath.
• Your baby's lips or skin are turning bluish, purple, or grey.
• Your baby is wheezing or making a harsh vibrating or squeaking noise while breathing.
• Your baby is struggling to breathe after a bee sting, potential poisoning, exposure to an allergenic food, or if you suspect they have swallowed an object blocking their airway.
• Your baby is having a seizure, especially if it is their first, it lasts for more than a few minutes, you notice signs of breathing difficulty, it was caused by potential poisoning, or your baby loses consciousness during the episode.
• Your baby has a head injury and is vomiting, there is liquid oozing from their nose or ears, their pupils are of unequal size, or they are having seizure-like convulsions.
• Your baby has lost consciousness.
• Your baby has a deep bleeding cut or is vomiting blood, or there is blood in their stool.
• Your baby has less than three wet diapers per day, a lack of tears when crying, a sunken spot on the top of their head, or dry skin, lips, or tongue.
• Your baby has a red or purple rash that appears suddenly, especially tiny purple or dark red dots, which could indicate a bacterial infection in the bloodstream.
• Your baby is showing signs of heat injury, such as little urination or fewer wet diapers.
• Your baby is showing signs of hypothermia, such as uncontrollable shivering, sluggish behaviour, or slurring words.

How to check your own pulse

A newborn baby's heart rate is considered normal at 100 to 200 beats per minute when awake, and 90 to 160 beats per minute when sleeping. This is much higher than the normal resting heart rate for adults, which is about 60 to 100 beats per minute.

• Place your left hand on a table in front of you, palm facing up.
• With the index and middle fingers of your right hand, draw a line from the base of your left thumb to just below the crease in your wrist. Your fingers should be placed just to the left of the large tendon that pops up when you bend your wrist towards you.
• Apply gentle pressure. If you press too hard, you might not be able to feel the pulse.
• Wait for several seconds and make small adjustments to the placement of your fingers until you find your pulse.
• Notice whether your pulse is regular or irregular. An irregular pulse is a tell-tale sign of AFib or other heart rhythm disturbances.
• To calculate your pulse rate, use a watch with a second hand and place it on your right wrist or on the table next to your left hand.
• Count the number of beats for 20 seconds and multiply this number by 3 to get your heart rate, or simply count the beats for a full 60 seconds.

When to Check a Baby's Pulse:

You may need to check a baby's pulse to ensure their heart is beating regularly if you notice any of the following:

• Fast breathing
• Blue lips, or pale or grey skin
• Unresponsiveness, and you're unable to wake them
• They have fallen or been injured

Where to Check a Baby's Pulse:

• Brachial pulse: Bend the baby's arm so that their hand is near their ear. Use two fingers to feel for the pulse on the inner side of the arm between the shoulder and elbow.
• Femoral pulse: If you can't find the brachial pulse, try feeling for the femoral pulse on the front of the baby's body, where the thigh meets the trunk.

How to Calculate a Baby's Pulse:

Count the beats for 15 seconds and multiply by 4 to get the pulse per minute.

Alternative Methods:

• Pulse oximeters: These devices give a readout of the heart rate and oxygen saturation. However, they need to be specially made to fit a baby's tiny fingers.
• Smartphone apps: Press a finger against the camera lens to get a pulse reading. This works best when the child is still and is more suitable for older, cooperative children.
• Fitness devices and smartwatches.

Frequently asked questions