How to Take an Infant's Pulse

Co-authored by Joel Warsh, MD

Last Updated: December 5, 2021 References

Heart rate, which is also known as pulse rate is defined as the number of times the heart beats in one full minute. Infants generally have higher pulse rates than adults; they're heart rates generally fall between 140 and 160 beats per minute, even at rest.^{[1]
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Research source
Fundamentals of Nursing 6th Edition Volume 1 by Potter and Perry (2005), Vital Signs, pages 637-44.} Infants have higher pulse rates because their bodies are growing rapidly, which causes their metabolism to be high. When a person or infant has a fast metabolism, the body requires more oxygen to pump out the carbon dioxide in the body; this is achieved by an increase in the heart rate.

Method 1

Method 1 of 3:

Taking an Infant's Pulse Rate

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1
Find the areas where the infant's pulse is strongest. An infant's pulse is stronger in the apical area, or left part, of the chest near the heart.^{[2]
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Research source
Fundamentals of Nursing 6th Edition Volume 1 by Potter and Perry (2005), Vital Signs, pages 637-44.} You can choose any of the two in taking an infant's pulse.
- It is also strong in the brachial area, or the inner bend of the arm at the back of the elbow.
Infants have weaker immune systems than adults. Because of this, is it important that you rinse your hands with warm water and antibacterial soap. This will help to prevent you from transmitting any harmful microorganisms to the infant.

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3
Prepare the necessary materials. When taking an infant's pulse rate, it is helpful to use a stethoscope to allow you to hear the pulse. A stethoscope can be purchased at your local pharmacy. You will also need:
- A watch that counts seconds.
- Pen and paper.
4
Place the infant on his or her back. Doing this will help to keep the infant's pulse rate from increasing, which could throw off the accuracy of your results. You can place the child between two pillows so that she cannot roll away, or you can ask someone to hold the infant on her back while you take the reading.^{[3]
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Research source
Circulatory Response to the Upright Posture by James J. Smith (1990, September 24), page 15-16.}
- When an infant is placed in a vertical position, blood flows to the lower extremities due to the force of gravity, which causes the heart to beat faster. The heart beats faster because the heart has to work harder to pump blood to the different parts of the body.^{[4]
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  Research source
  Circulatory Response to the Upright Posture by James J. Smith (1990, September 24), page 15-16.}
5
Make sure that the infant is not crying before taking the pulse. Extreme emotions activate the sympathetic nervous system (a part of the brain that increases vital signs such as the heart rate, breathing and blood pressure). As a result, if the infant is unhappy, the heart rate will increase suddenly.^{[5]
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Fundamental Nursing Skills and Concepts by Barbara Kuhn Timby (2009), page 195.}
- If the infant begins to cry, soothe her and wait for her to calm down before you try taking her pulse.
6
Locate the apical pulse. If the baby is wearing a dress or shirt with Velcro straps or ties, undo these so that you can expose the baby's chest without removing the entire dress. To find the apical pulse^{[6]
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Research source
Fundamentals of Nursing 6th Edition Volume 1 by Potter and Perry (2005), Vital Signs, pages 637-44.}:
- Place your pointer finger on the middle part of the baby's left clavicle, or collarbone (this is the long bone in the chest that is near the shoulder blade).
- Glide your finger down slowly to locate the first intercostal space (this refers to the space between each rib).
- Move down to the second and third intercostal space, until you reach the fourth space. This is where you should be able to feel the apical pulse most strongly. This spot is known as the spot of maximal impulse.
7
Place your stethoscope on the baby's chest. Warm the stethoscope up by placing the large metal circle (this is known as the diaphragm) in the palm of your hand for at least 10 seconds.
- Warning up the diaphragm will help to keep the infant from being startled by the cold metal and beginning to cry.
8
Listen for the pulse. Insert the earpieces of the stethoscope and place the diaphragm on to the apical pulse, or the fourth intercostal space. Again, this should be the fourth space you find between the ribs when you run your finger down from the baby's left collarbone.
- You should hear a loud “lub-dub” sound when you put your stethoscope over the apical pulse. The “lub-dub” sound is considered one whole beat.
9
Count the heart rate of the infant for one full minute for accurate results. The count should start when the “dub” sound is heard.^{[7]
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Research source
Fundamentals of Nursing 6th Edition Volume 1 by Potter and Perry (2005), Vital Signs, pages 637-44.}
- Get the pen and paper and record the number of pulses or heartbeats you hear in the space of 60 seconds.
- Wash your hands thoroughly when you are done recording the pulse rate.

Method 2

Method 2 of 3:

Finding the Brachial Pulse

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As mentioned above, you should always wash your hands when taking an infant's pulse in order to avoid passing any microorganisms on to the infant.
2
Gather your supplies. You will not need a stethoscope to listen to the brachial pulse, as it is not as loud as the apical pulse so you will most likely not be able to hear it. Instead, you will use your pointer and middle finger to feel the pulse.^{[8]
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Research source
Fundamentals of Nursing 6th Edition Volume 1 by Potter and Perry (2005), Vital Signs, pages 637-44.} You will also need:
- A watch that counts seconds
- A pen and paper
3
Hold the infant so he or she is on his or her back. Again, as mentioned above, it is important to take the infant's pulse when she is lying on her back because when an infant is held in a vertical position, her heart rate tends to increase. .^{[9]
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Research source
Circulatory Response to the Upright Posture by James J. Smith (1990, September 24), page 15-16.}
- This is because her heart is working harder to pump blood down into the lower extremities and back out again.
4
Soothe the child if he or she is crying. Make sure that the infant is not crying before taking the pulse as extreme emotions activate the sympathetic nervous system. The sympathetic nervous system, when activated, will increase the heart rate.^{[10]
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Research source
Fundamental Nursing Skills and Concepts by Barbara Kuhn Timby (2009), page 195.}
- Do your best to soothe the infant and make sure that she is calm before you take a measurement of her pulse, otherwise you may not get an accurate reading.
You can do this by rubbing your hands together. If you have cold hands, placing them on the infant's sensitive skin may cause her to become startled, in which case she may begin to cry.
6
Use your fingers to find the pulse. Put your point and middle finger on the infant's inner bend of the upper arm at the back of the elbow. Press your fingers firmly but gently against the baby's skin to try to feel the pulse.
- Count the pulse rate of the infant for one full minute for accurate results. Get the pen and paper and record the number of times you feel the infant's pulse beat in the span of 60 seconds.
- Consider repeating this process for another 60 seconds to double-check your findings.

Method 3

Method 3 of 3:

Knowing When to Call a Doctor

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A fast heart rate is considered a pulse rate of more than 160 beats per minute at rest. A fast heart beat does not allow the heart to have sufficient time to fill before it contracts, so blood flow to the different parts of the body is compromised.^{[11]
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Trustworthy Source

American Heart Association
Leading nonprofit that funds medical research and public education

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A slow heart rate is considered less than 140 beats per minute at rest. If the heartbeat is slow, the heart is unable to supply enough blood to the different parts of the body.
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Seek medical attention if you hear a third heart sound. Normally, the heart makes two sounds during each beat: “lub”, which is considered the first heart sound (S1) and “dub”, which is the second heart sound (S2). A third heart sound (S3), is often described as a horse gallop sound, which makes the heartbeat sound like “lub du bub”.^{[12]
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Trustworthy Source

American Heart Association
Leading nonprofit that funds medical research and public education

Go to source}
- A third heart sound can be related to conditions such as congestive heart failure (the heart muscle does not pump enough blood), cardiomyopathy (weakening of the heart muscle) and valvular regurgitation (backflow of blood because of incompetent valves).^{[13]
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  Research source}
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Contact a doctor if you hear a fourth heart sound. This fourth sound, which is called S4, makes the heartbeat sound like “Be lub dup”—S1, then S4, then S2.^{[14]
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Research source}
- A fourth heart sound can be related to conditions such as the stenosis of heart blood vessels (narrowing of blood vessels), ischemia (lack of oxygen supply to the heart), cardiomyopathy (weakening of heart muscle) and valvular regurgitation.

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Question

Where can you find an infant's pulse?

Joel Warsh, MD
Board Certified Pediatrician
Dr. Joel Warsh is a board certified Pediatrician and the Owner & Founder of Integrative Pediatrics and Medicine in Los Angeles, California. With over a decade of experience, Dr. Warsh specializes in holistic and integrative medicine. He holds a Bachelor’s degree in Kinesiology and Health Sciences, a Master’s degree in Epidemiology and Community Health, and a Doctor of Medicine (MD) from Thomas Jefferson Medical College, where he was elected president of the Jefferson Pediatric Society. Dr. Warsh then completed his Pediatric Residency at Children’s Hospital of Los Angeles (CHLA), where he received the George Donnell Society Research Fellow.

Joel Warsh, MD

Board Certified Pediatrician

Expert Answer

To take an infant's pulse, you can listen to the heart, you could take it on the arm, or you could do it on the neck. It's pretty much the same places it would be on an adult.

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Question

What is a normal pulse for an infant?

Joel Warsh, MD
Board Certified Pediatrician
Dr. Joel Warsh is a board certified Pediatrician and the Owner & Founder of Integrative Pediatrics and Medicine in Los Angeles, California. With over a decade of experience, Dr. Warsh specializes in holistic and integrative medicine. He holds a Bachelor’s degree in Kinesiology and Health Sciences, a Master’s degree in Epidemiology and Community Health, and a Doctor of Medicine (MD) from Thomas Jefferson Medical College, where he was elected president of the Jefferson Pediatric Society. Dr. Warsh then completed his Pediatric Residency at Children’s Hospital of Los Angeles (CHLA), where he received the George Donnell Society Research Fellow.

Joel Warsh, MD

Board Certified Pediatrician

Expert Answer

An infant's heart rate is usually around 150 when they're first born. It goes down from there, so depending on their age, a normal heart rate would be about 100-150.

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