An infant is typically defined as a child from birth up to one year of age. Knowing how to assess an infant’s pulse is an important skill, providing immediate insight into their circulatory status. This knowledge is particularly useful for parents and caregivers to monitor for potential changes in health or in emergency situations. This guidance offers a practical, safe approach to finding and interpreting this vital sign.
Primary Location: The Brachial Pulse
The preferred and most reliable location for checking an infant’s pulse is the brachial artery, which runs along the inner side of the upper arm. This site is favored because the artery is large and relatively superficial, making it easier to feel in the small, soft limbs of a baby. Other common pulse points, such as the radial pulse at the wrist or the carotid pulse in the neck, are often too small or difficult to access reliably in infants.
To accurately locate the pulse, the infant should be lying on their back with one arm gently extended alongside their body. The brachial artery is situated on the inside of the upper arm, running between the elbow and the shoulder. Specifically, you should target the groove found in the middle of the upper arm, approximately halfway between the elbow and armpit.
While the brachial pulse is the standard, the femoral pulse in the groin can serve as an acceptable secondary alternative. Feeling for the pulse requires compressing the artery against the underlying bone, which, in the case of the brachial artery, is the humerus.
Safe Technique for Pulse Assessment
The actual mechanics of checking the pulse are just as important as knowing the correct location. You should always use the pads of your index and middle fingers to palpate the artery. Avoid using your thumb, as the thumb has its own strong pulse, which can easily be mistaken for the infant’s heartbeat, leading to an inaccurate reading.
Apply a gentle, yet firm, pressure to the chosen site, pressing the artery lightly against the bone without occluding the artery completely. The infant should be calm and still for the most accurate baseline reading; if they are crying or moving, their heart rate will be artificially elevated. The check should be performed directly on the skin, as clothing can interfere with the sensation of the pulse.
Once the pulse is located, count the beats for a minimum of 15 seconds, and then multiply that number by four to calculate the beats per minute (BPM). In situations where an infant appears distressed or unwell, counting the beats for a full 60 seconds is recommended to gain a more precise measurement. The time spent checking for a pulse in an emergency should be brief, ideally no more than 10 seconds.
Interpreting Infant Pulse Rates
An infant’s normal heart rate is significantly faster than an adult’s and varies depending on their exact age and activity level. For a newborn up to one month old, a resting heart rate may range between 70 and 190 beats per minute (BPM). Infants between one and eleven months typically have a resting rate between 80 and 160 BPM.
These rates can increase substantially when the baby is active, crying, or has a fever. Observing the infant’s state is necessary for proper context, as a rate of 160 BPM in a sleeping baby is different from the same rate in a crying baby. A heart rate that is consistently outside the normal range for their age may signal an underlying health issue.
Caregivers should seek immediate medical attention if the infant’s pulse rate is consistently below 60 BPM (bradycardia), especially if it is accompanied by other symptoms like lethargy, difficulty breathing, or pale and bluish skin. A very slow pulse requires prompt evaluation. Likewise, a persistently very fast rate (tachycardia), along with signs like trouble breathing or an inability to wake the baby, also warrants an emergency medical consultation.