Normal Respiratory Rate by Age

Normal respiratory rate at a glance

Your respiratory rate is the number of breaths you take per minute. It is one of the four classic vital signs, alongside heart rate, blood pressure and temperature – and it is often the first to change when someone becomes unwell. Yet it is also the vital sign most often skipped or estimated, because counting breaths properly takes a full minute.

• A normal respiratory rate for an adult at rest is about 12 to 18 breaths per minute (MedlinePlus). Many hospital early-warning systems treat 12–20 as normal.
• Babies and young children breathe much faster. A healthy newborn's median rate is about 43 breaths per minute; by adolescence it is about 16.
• A raised rate (tachypnoea) at rest is an important warning sign in fever, infection, lung and heart conditions.
• A very slow rate (bradypnoea) can follow sedating medicines, opioids or alcohol, or reflect serious illness.

The checker above compares a breathing rate with the age-specific centiles from the largest systematic review of children's vital signs (Fleming and colleagues, *The Lancet*, 2011) or with the adult range. Choose an age group, enter breaths per minute, and see where the value sits.

Normal respiratory rate by age

How to read this chart: the median is the typical rate for a healthy child of that age at rest. The 10th to 90th centiles cover the middle 80% of healthy children. Values below the 1st or above the 99th centile are unusual in healthy children and deserve attention, especially with other symptoms.

The Fleming review pooled data from 69 studies and 3,881 healthy children from birth to 18 years. It found that respiratory rate falls steeply in the first two years of life and then more gradually, and that many older textbook ranges did not match the evidence well – which is why centile charts are increasingly preferred over single cut-offs.

Adults

These bands mirror the respiratory-rate thresholds in the UK National Early Warning Score 2 (NEWS2), which allocates points for a rate of 8 or less, 9–11, 21–24 and 25 or more. A rate of 22 or more is also one of the three bedside criteria in the qSOFA score used to identify adults with suspected infection at risk of poor outcomes in the Sepsis-3 definitions.

How to measure respiratory rate correctly

Counting breaths sounds simple, but small errors matter because the normal range is narrow. Studies of hospital charts have repeatedly found values clustered suspiciously at 18 or 20, suggesting estimates rather than counts.

1. Count at rest. Wait until the person has been sitting or lying quietly for a few minutes. Exercise, talking, crying and anxiety all raise the rate.
2. Do not announce it. People change their breathing when they know it is being watched. A common technique is to keep your fingers on the wrist as if still taking the pulse.
3. Count one breath as one rise and fall of the chest or abdomen.
4. Count for a full 60 seconds. Counting for 15 or 30 seconds and multiplying introduces large errors at low rates.
5. For babies, watch the abdomen. Infants breathe mainly with the diaphragm, so the tummy moves more than the chest. Count while the baby is calm or asleep, ideally not straight after feeding or crying.
6. Note the pattern as well as the number: depth, regularity, effort and noises.

How breathing is controlled

Breathing is controlled automatically by the respiratory centres in the brainstem. They respond mainly to the level of carbon dioxide in the blood, sensed as changes in acidity: when CO₂ rises, you breathe faster and deeper; when it falls, breathing slows. Oxygen sensors in the carotid arteries add a backup signal when oxygen falls significantly. You can override the automatic system for a while – holding your breath, speaking, singing – but it always reasserts itself.

This explains several observations. People with metabolic acidosis breathe hard to blow off CO₂ and correct their blood acidity. Opioids and sedatives blunt the brainstem's response to CO₂, slowing breathing. Anxiety can make people over-breathe, lowering CO₂ enough to cause tingling fingers and light-headedness. And in long-standing lung disease, the system can reset so that people tolerate higher CO₂ levels.

What changes the respiratory rate

Fast breathing (tachypnoea)

A raised resting respiratory rate is a sensitive but non-specific sign of illness. Common causes include:

• Infections – pneumonia, bronchiolitis in infants, sepsis anywhere in the body.
• Lung conditions – asthma attacks, COPD flare-ups, pulmonary embolism, collapsed lung.
• Heart conditions – heart failure, arrhythmias.
• Metabolic causes – diabetic ketoacidosis, kidney failure, some poisonings, in which the body breathes faster to blow off acid.
• Fever, pain and anxiety, which raise the rate without lung disease.
• Anaemia, which reduces oxygen-carrying capacity.

In children, a raised respiratory rate is one of the most useful signs of pneumonia, and the World Health Organization's community guidance uses age-specific fast-breathing thresholds for this reason.

Slow breathing (bradypnoea)

A slow rate is less common and can be serious. Causes include:

• Opioid medicines, sedatives and alcohol – especially in combination.
• Head injury or raised pressure in the skull.
• Severe hypothermia.
• Severe hypothyroidism.
• Exhaustion in someone who has been working hard to breathe, for example a child in a prolonged asthma attack – a dangerous sign.
• Sleep: a slightly lower rate during sleep is normal.

Breathing patterns: more than the number

Clinicians look at how someone is breathing as well as how fast. Some recognised patterns:

A normal rate with a worrying pattern – for example a child with a rate in the normal range but obvious recession and grunting – still needs assessment.

Breathing during exercise

During exercise, breathing rate and depth both increase to deliver more oxygen and remove carbon dioxide. A healthy adult's rate can rise to 30–40 breaths per minute or more during hard exercise and return towards resting levels within minutes of stopping. Fitness changes the response: trained athletes tend to breathe more deeply and recover faster. Becoming breathless with less effort than usual, or taking much longer than usual to recover, is a change worth discussing with a clinician, particularly if it comes with chest pain, palpitations or ankle swelling.

Respiratory rate during sleep

Breathing slows slightly and becomes more regular in deep sleep, and less regular in dream (REM) sleep. Sleep-related breathing disorders are about pauses and airflow, not just rate: in obstructive sleep apnoea, the airway repeatedly narrows or closes, causing loud snoring, gasps and pauses, with daytime sleepiness. If a bed partner notices pauses in breathing or you wake unrefreshed despite enough time in bed, a sleep assessment may help.

Why respiratory rate matters so much

Respiratory rate is one of the best single predictors of serious deterioration in hospital patients. Studies of patients who had cardiac arrests or were admitted to intensive care have found that a rising respiratory rate was often present hours beforehand, sometimes while other vital signs were still normal. That is why early warning scores give it substantial weight, and why nurses and doctors are encouraged to count it carefully rather than estimate it. At home, the same principle applies: in someone who is unwell, faster breathing at rest – or breathing that seems to be taking more effort – is a reason to seek advice sooner rather than later.

Warning signs that need urgent help

Call emergency services or seek urgent care if someone has:

• Breathing that is very fast, very slow, irregular, or stops for more than a few seconds (in babies, pauses of more than about 20 seconds).
• Struggling to breathe – using neck or tummy muscles, nostrils flaring, grunting, the skin pulling in between or below the ribs (recession).
• Blue or grey lips, tongue or skin, or unusually pale or mottled skin.
• Drowsiness, confusion or being hard to wake.
• Unable to speak in full sentences, or a baby too breathless to feed.
• Chest pain with breathlessness.

Trust your instincts with babies and young children: if a child's breathing worries you, get them checked.

Respiratory rate in early warning scores

Hospitals use early warning scores to spot patients who are deteriorating. In NEWS2, the respiratory rate is scored alongside oxygen saturation, oxygen use, blood pressure, pulse, level of consciousness and temperature. The respiratory-rate component scores:

Higher total scores trigger more urgent clinical review. Paediatric early-warning systems use age-specific bands for the same purpose.

Respiratory rate in older adults

Healthy older adults have resting rates similar to younger adults, perhaps slightly higher. In older people, a raised respiratory rate is often one of the earliest signs of infection, sometimes before fever develops, and confusion may be the only other symptom.

Respiratory rate and oxygen saturation

Pulse oximeters measure oxygen saturation (SpO₂), not breathing rate. A person can maintain a normal SpO₂ by breathing faster, so a normal oximeter reading does not mean breathing is normal. Both should be checked together. Some wearable devices and smartwatches estimate respiratory rate during sleep; these estimates can be useful for spotting trends but are not as accurate as a careful manual count.