Normal physical findings
Respiratory rate 40–60/min.
Irregular with pauses ≤5 s in REM sleep
Regular in non-REM sleep, rate 5–10 breaths/min slower than in REM sleep or when awake
Comfortable (no dyspnea)
No chest retractions (subcostal or intercostal)
No flaring of nostrils
Pulse rate 120–160 beats/min (but may go as low as 80 during sleep).
Sinus arrhythmia rare in the newborn.
Pulses easy to feel.
Femoral pulses may be decreased in the first 48 h.
Femoral pulses may be impalpable, reduced or delayed with coarctation of the aorta. In any infant with suspected heart disease, blood pressure should be measured in all four limbs. A difference of >15 mmHg between the upper (higher) and lower extremities is significant.
Bounding pulses are characteristic of a patent ductus arteriosus.
Interpreting the heart rate is best done in conjunction with the respiratory rate and oxygen saturation.