Monitoring an infant’s pulse is a fundamental skill for gauging their well-being, especially during illness or emergencies. Due to the rapid heart rate and different anatomical proportions of babies compared to adults, the location and method for checking their pulse must be adjusted. Learning the proper technique provides parents and caregivers with a reliable way to assess circulation outside of a clinical setting.
Locating the Brachial Artery
The most reliable location to check an infant’s pulse is the brachial artery, situated on the inner side of the upper arm. This artery runs between the shoulder and the elbow, offering a strong and consistent signal. This site is preferred over the wrist’s radial artery because the blood vessels in an infant’s extremities are small and difficult to feel. Checking the neck’s carotid artery is avoided due to short necks, which makes the artery hard to isolate and risks accidentally compressing the trachea.
To find the brachial pulse, gently turn the baby’s arm outward so the palm is facing up, allowing access to the soft tissue of the inner bicep. Place your index and middle fingers roughly midway between the shoulder and the elbow. The artery is close to the surface and can be felt when pressed lightly against the humerus bone.
Proper Technique for Pulse Assessment
Once the location is established, the method for palpating the pulse requires care and precision. Always use the pads of your index and middle fingers to feel for the rhythmic throbbing of the artery. Avoid using your thumb, as it has its own detectable pulse that can easily be mistaken for the infant’s heartbeat.
Pressing too firmly can compress the artery entirely, making the pulse impossible to detect, leading to an incorrect assessment. Conversely, pressing too softly may not be enough to sense the pulse, especially if the baby has weak circulation. Apply only enough gentle pressure to feel the distinct beat against the bone beneath your fingertips.
The duration of the count depends on the situation. In an emergency, you are simply assessing for the presence of a pulse, which should take no more than 10 seconds. For a routine check, count the beats for a full 60 seconds to ensure the highest accuracy. A more common method is to count the beats felt over 15 seconds and then multiply that number by four to calculate the beats per minute. Try to perform the assessment when the baby is calm and resting, as crying or movement can interfere with your ability to locate and count the pulse accurately.
Understanding Normal Infant Heart Rates
Infants have a much faster heart rate than older children and adults, which reflects their higher metabolic rate and smaller heart size. A newborn (zero to one month old) typically has a resting heart rate ranging from 70 to 190 beats per minute (bpm). For an older infant (one to 11 months), the normal resting range is slightly lower, generally falling between 80 and 160 bpm.
These numbers represent a wide range because an infant’s heart rate fluctuates dramatically based on activity level. The rate naturally increases during excitement, feeding, or crying, and decreases while they are sleeping. A pulse rate below 60 bpm in a non-sleeping infant is considered too slow and requires immediate attention.
If the pulse rate is consistently too high or too low, or if the rhythm feels irregular, contact a healthcare provider. Seek immediate medical attention if an abnormal heart rate is accompanied by symptoms such as extreme lethargy, difficulty breathing, or a change in skin color, such as paleness or blue lips. These signs can indicate a problem with circulation or oxygenation that needs prompt medical intervention.