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# Vital signs in children: how they change with age

- Topic

The younger the child, the faster the pulse and breathing and the lower the blood pressure; normal depends on age.

Updated 2026-11-01

## Key points

- The younger the child, the higher the heart and respiratory rates and the lower the blood pressure.
- In children hypotension is a late sign of shock; tachycardia and prolonged capillary refill come earlier.
- Breaths are counted for a full minute in infants, who breathe irregularly.
- Fever in infants: rectal 38 °C or higher; under three months it is assessed at once.
- The cuff must suit the child's arm; an adult cuff gives falsely low readings.

## What it is

Normal vital signs change with age: the newborn has the highest heart and respiratory rates and the lowest blood pressure, approaching adult values in adolescence. Reading a child's vital sign without knowing their age leads to errors. Tachycardia and tachypnea are early signs of serious illness; hypotension is late.

## Key facts

- Normal temperature in children: 36.4 to 37.5 °C.
- Normal oxygen saturation at any age: 95 to 100%.

## Step by step

- Measure with the child calm, ideally held by the caregiver; count breathing first, before disturbing the child.
- Count breaths by watching the abdomen for a full minute.
- In infants count the apical pulse with the stethoscope for one minute; in older children, the radial pulse.
- Temperature: rectal or axillary in infants; axillary, tympanic or oral depending on age.
- Choose a cuff covering about two thirds of the upper arm and measure blood pressure.
- Read each value against the table for age and record the child's state (crying, asleep, febrile).

## Reference values by age (OpenStax, Fundamentals of Nursing, table 7.1). These are reference ranges, not treatment thresholds.

| Age | Heart rate (bpm) | Respiratory rate (breaths/min) | Systolic pressure (mmHg) |
| --- | --- | --- | --- |
| Newborn | 100 to 205 | 30 to 60 | 67 to 84 |
| Infant (1 to 12 months) | 100 to 180 | 30 to 53 | 70 at birth to 90 at one year |
| Toddler (1 to 3 years) | 98 to 140 | 22 to 37 | 86 to 106 |
| Preschool (3 to 5 years) | 80 to 120 | 20 to 28 | 89 to 112 |
| School age (6 to 9 years) | 75 to 118 | 18 to 25 | 97 to 115 |
| Preadolescent (10 to 12 years) | 75 to 118 | 18 to 25 | 102 to 120 |
| Adolescent (12 to 17 years) | 60 to 100 | 12 to 20 | 110 to 131 |
| Adult | 60 to 100 | 12 to 20 | 90 to 120 |

## Test yourself

Think of the answer, then tap the question to see it.

## Why is hypotension a late sign of shock in children?

Because children compensate with strong tachycardia and vasoconstriction and hold their pressure until a lot of volume is lost.

## What is the normal respiratory rate of a newborn?

Between 30 and 60 breaths per minute, depending on the reference table used.

## Why is breathing counted first in an infant?

Because crying and handling raise the respiratory rate; it is counted while the infant is calm.

## What happens if an adult cuff is used on a child?

The pressure reads falsely low because the cuff is too large for the arm.

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## Related

- [Vital signs: what they are and how to record them](https://durgical.com/en/clinical-exam/vital-signs-what-they-are-and-how-to-record-them/)
- [Pediatric history: perinatal, growth, development and vaccines](https://durgical.com/en/clinical-exam/pediatric-history-perinatal-growth-development-and-vaccines/)
- [Pain assessment and pain scales](https://durgical.com/en/clinical-exam/pain-assessment-and-pain-scales/)
- [Capillary refill time](https://durgical.com/en/clinical-exam/capillary-refill-time/)

## Related conditions

- [Bronchiolitis (RSV)](https://durgical.com/en/conditions/bronchiolitis/)
- [Dehydration in children (acute diarrhoeal disease)](https://durgical.com/en/conditions/dehydration-in-children/)

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Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Sources: [7.1 Indicators of Physiologic Functioning - Fundamentals of Nursing | OpenStax](https://openstax.org/books/fundamentals-nursing/pages/7-1-indicators-of-physiologic-functioning) (OpenStax, Rice University, 2024); [Fever: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003090.htm) (U.S. National Library of Medicine (MedlinePlus), 2025); [Dehydration in Children - Pediatrics - MSD Manual Professional Edition](https://www.msdmanuals.com/professional/pediatrics/dehydration-and-fluid-therapy-in-children/dehydration-in-children) (Merck & Co. (MSD Manual Professional Edition), 2025).

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