How to Take Your Child's Pulse

A person's pulse, or heart rate, is the number of times the heart beats per minute. Taking someone's pulse can tell doctors important things about his or her health.

Heart rate can vary depending on things like a person's age and level of stress or activity at the time the pulse is taken. It's normal for a heart rate to be irregular — meaning that the heart will slow down or speed up from time to time. But when it beats faster than what's considered normal for an extended length of time, it could signal a problem.

What's a Normal Heart Rate?

A child's hearts normally beat faster than an adult's. A healthy adult heart rate can range from 60 to 100 beats per minute during rest.

Kids' heart rates can be as low as 60 beats per minute during sleep and as high as 220 beats per minute during strenuous physical activity. It's normal for athletic kids to have slower resting heart rates, often in the 40s or 50s.

Before taking your child's pulse, check with your doctor to see what range is considered normal for your child.

When to Take a Child's Pulse

Usually, there's no need to take your child's pulse. Your doctor will check your child's heart rate at well checkups.

But if your child has a medical condition that requires you to monitor his or her heart rate, your doctor may have told you when to take a pulse. You might need to do it regularly, or only on occasion. If you're not sure, ask your doctor.

You also should take a pulse if your child ever complains of a "racing" heart or palpitations — when it feels like the heart is "skipping" a beat. Some kids say this feels like a buzzing, beeping, vibrating, or fluttering feeling in their chest. (Oftentimes, though, these feelings are nothing serious and sometimes not even related to the heart. Muscles in the neck or chest can sometimes twinge or spasm, making someone think it's the heart skipping or racing.)

Other times to check a pulse include if your child:

• faints
• has chest pain
• has trouble breathing that is not caused by asthma
• has skin that suddenly turns pale or grey, or has lips that are blue

If your child has any of the symptoms above, begin taking the pulse right away. Make note of the activity that caused the symptoms and be sure to tell the doctor.

How Do I Take a Pulse?

To take your child's pulse, you will need a watch with a minute hand, or a stopwatch with the minutes and seconds displayed (this is usually easier to use). Find a quiet place where your child can sit or lie comfortably.

If your child has just been active (running, jumping, crying, etc.), wait at least 5 minutes to allow the heart time to slow down and return to a normal beat.

To feel a pulse, you press two fingers — your index ("pointer") and middle fingers — onto a major artery in the body. Press gently. Never press with your thumb, as it has a pulse all its own and can throw off a reading. When you've located the pulse, you will feel a throbbing sensation.

There are several areas on the body to read a pulse, but in kids these are generally the easiest places:

• On the neck (carotid artery pulse). The carotid artery runs along either side of the throat (windpipe). Run your fingers about halfway down the neck and press gently to the left or right side of the windpipe (carefully avoiding the Adam's apple in teen boys). Press gently. You should feel the pulse. If not, try again or on the other side.
• On the wrist (radial pulse). This is the spot where most adults have their pulse taken. It can work well in kids, too. To find the right spot, place a finger at the base of your child's thumb and slide it straight down to the wrist. On the wrist, press gently to feel for the pulse. This works best if your child's hand is lying flat or bent slightly backward.
• In the armpit (axillary pulse). Press your fingertips into the armpit, feeling around for the arm bone. When you feel the arm bone beneath your fingers, you should also feel the pulse. This method works well for infants.
• In the crease of the elbow (brachial pulse). This location works best for infants. Place your infant on his or her back with one arm flat along the baby's side (elbow crease facing up). In the crease of the elbow, gently place your fingers on the inside of the arm (the pinky side). Feel around for a pulse.

Once you've located the pulse (feeling a "throbbing" or "beating" sensation on your fingers), begin counting the beats within a 30-second timeframe. After 30 seconds, stop. Take the number of beats (for example, 45 beats in a 30-second period) and double it. So:

• 45 x 2 = 90 beats per minute. The heart rate for your child would be 90, which is within the normal range for most kids. (This is just an example; your child's heart rate may be different.)

If you don't feel comfortable taking a pulse this way, or have difficulty, there is another option. Many smartphone apps can give pulse readings simply by pressing a finger over the camera lens. For a good reading, your child needs to be very still, so this method works best in older kids who are more cooperative. Before using one of these, ask your doctor if it's a good idea or if he or she recommends a particular heart rate app.

When to Call the Doctor

If your child's heart rate is within the normal range, you don't need to call the doctor (unless your doctor asked you to call with the reading, in which case you should call to report that it's normal). There's also no need to call if the heart rate slowed down or sped up while you were taking the pulse. Some variation in speed is normal.

If your child's heart rate is above the normal range, or too fast to count, wait a little while and recheck it. It may return to a normal rate. If it's still too high, call your doctor. If your child is having other symptoms in addition to a high heart rate, call 911 or drive your child to the nearest ER.

If you have any other questions about taking a child's pulse, call your doctor.