Feeling and counting your baby's pulse can tell you about their heartbeat. Babies have a lot of fat under the skin and don't cooperate when you're trying to take their pulse. Taking a baby's pulse requires skill and practice. You should know the brachial pulse location (near the elbow) and practice feeling your baby's pulse. It will be valuable if your baby's ever sick or injured.
What Is Brachial Pulse?
The traditional method of taking a person's pulse is to feel it at the wrist. The radial artery runs close to the skin at this place and is easy to feel. But most babies have chubby wrists. Feeling the pulse here is difficult, especially if your baby is moving their wrist.
The brachial pulse is the pulsation of the brachial artery, which runs along the humerus (the arm bone). Bend your baby's arm so that the hand is near the ear. Use two fingers to feel for the pulse on the inner side of the arm between the shoulder and elbow.
How to Check an Infant's Pulse
You may need to feel an infant's pulse to make sure their heart is beating regularly. This is most likely if:
- Your baby is sick
- Your baby's breathing is fast
- Your baby has blue lips, or pale or gray skin
- You find your baby unresponsive, and you're unable to wake them
- Your baby has had a fall or been injured in some way
The pulse is a sign of life. Feeling a baby's pulse is a way to make sure that their heart is beating. If you cannot feel the pulse, or it is slow and irregular, you should call for help and begin cardiopulmonary resuscitation (CPR).
In such situations, when a baby is unresponsive, try to feel the brachial pulse. If you can't, try the femoral pulse. This is the pulsation of the femoral artery, the large artery supplying the lower limbs. You can feel the femoral pulse on your baby's front, where the thigh meets the trunk. Do not try for more than 10 seconds to locate a pulse. If you can't find a pulse in that time, you should begin CPR.
To count your baby's pulse, you will need a clock or watch with a second hand. Feel for the brachial or femoral pulse and count it for 15 seconds. Multiply the beats counted in 15 seconds by 4 to get the pulse per minute.
Other Ways of Taking a Baby's Pulse
Several electronic methods to take a pulse are now available. Pulse oximeters give a readout of the heart rate along with the oxygen saturation. These devices are inexpensive and easy to use. But babies need machines specially made to fit their tiny fingers.
Smartphone apps are available that can count the pulse if you press a finger against the camera lens. This method works best if the child is still. It's best for older children who can cooperate. You can use it with a sleeping or unconscious child.
Fitness devices and smartwatches can also count the pulse.
Normal Pulse Rate for Infants
Your first feel of your baby's pulse may startle you because it's so fast. A newborn baby's pulse is 100 to 200 beats a minute when awake and 90 to 160 beats a minute when sleeping. Infants in the first year have pulse rates of 100 to 180 beats per minute when awake and 90 to 160 beats a minute when sleeping.
The pulse rate in a child is affected by:
- Body temperature (fever)
- Some medicines
- Congenital heart disease (CHD)
Irregular Pulse Rate
Tachycardia. A very high pulse rate is called tachycardia. The common causes are fever, anemia, dehydration, and other diseases. Sometimes, the heart itself is beating too fast. The frequent disorders are supraventricular tachycardia (SVT) and ventricular tachycardia. These are both dangerous conditions.
When the heartbeat is very fast in SVT, the chambers do not get time to fill before the muscle begins contracting. The pumping of blood is inefficient, and the body may not get enough blood and oxygen supply. Dangerous blood clots may also form. SVT lasts from a few seconds to several hours.
Normally, the rhythm of the heart is set by the sinoatrial node, which sends electrical impulses to the atrium and then the ventricle. In ventricular tachycardia, the ventricles contract by themselves at a very high rate. They may or may not have filled with blood before contracting. The blood supply with each pulse is irregular. Ventricular tachycardia can cause sudden cardiac arrest (stoppage of the heart). Timely detection of this condition can be lifesaving.
Bradycardia. A pulse rate slower than normal for your child's age is called bradycardia. The two common types are sinus bradycardia and heart block.
Sinus bradycardia is caused by slower electrical discharges from the sino-atrial node in the heart. The heartbeat is slow but regular, and the sequence of atrial and ventricular contraction is maintained. Sinus bradycardia often happens in premature infants. Breathing problems, some medicines, and lowered body temperature (hypothermia) can also cause bradycardia.
Heart block is the stoppage of electrical signals from the sinus and atria to the ventricles. When the ventricles do not get signals, they start beating at their own pace. This pace is slower than the sinus rhythm. Since coordination is lost, the filling of the ventricles before they contract is hit and miss.
Irregular Heart Rate — Symptoms
Older children complain of chest pain, a fluttering feeling in the chest, or lightheadedness. But infants are unable to complain. They appear pale and fussy, do not feed well, and may seem to lack energy. If your baby has some of these symptoms and you find their pulse is irregular, you should consult your pediatrician.
Most often, your baby will not complain and will seem normal. You may detect the abnormal heart rate when you take your child's pulse. Detecting such abnormalities could save your child from serious complications.
Your pediatrician will examine your baby for any signs of illness. An electrocardiogram may show a disturbance in the heart rhythm. Conditions like SVT and ventricular tachycardia may come and go, so your child may be given a wearable monitor.
Knowing how to take your baby's pulse is an important skill. You may be able to help your pediatrician detect a serious heart disease. Knowing how to take a baby's pulse and perform CPR as indicated by the heart rate can save their life.