From the article you will learn what is the norm of pressure in children. What should it be in different periods child development, whether it depends on gender. When a change in blood pressure (abbreviated blood pressure) in children is normal, and when you need to seek help. How to correctly measure the pressure of a child.
Article publication date: 07/18/2017
Article last updated: 06/02/2019
Blood pressure is an indicator that depends on the age of a person. The lowest values are recorded in newborns (in the first 4 weeks), when blood pressure is in the range of 60–80 by 40–50 mm Hg. Art.
As the work of the vessels and the heart changes, associated with the transition to a pulmonary type of breathing, blood pressure also increases - during the first year it can reach a value of 90 to 70 mm Hg. Art., but more often lies in the lower limits.
Normal children's pressure from 1-2 to 8-9 years is about 100 per 70 mm Hg. Art. Then it gradually grows and by the age of 15 enters the "adult" boundaries.
Children also have fairly large pressure fluctuations, often up to 20–25 mm Hg. Art., which is associated with increased activity of the child.
Problems with blood pressure under the age of 18 are dealt with by neonatologists, district pediatricians and pediatric cardiologists.
Normal blood pressure in children
Immediately after birth, the child registers the most low level Blood pressure, which grows as quickly as possible (on average, up to 2 units per day) during the first weeks. In the future, the growth rate slows down.
In pediatric practice, unlike the adult population, there is no single normal level of pressure - indicators that are registered in 90-94% of children are taken beyond the boundaries.
A table by the age of the child, including physiological fluctuations:
| Age limits | Level, mm Hg Art. | |
|---|---|---|
| systolic | diastolic | |
| First 2 weeks - neonatal period | 60–96 | 40–50 |
| 2 to 4 weeks - neonatal period | 80–112 | 40–74 |
| From 1 to 12 months - the infant stage | 90–112 | 50–74 |
| 1 to 3 years - early childhood | 100–112 | 60–74 |
| 3 to 6 years old - preschool | 100–116 | 60–76 |
| 6 to 9 years old - early school stage | 100–122 | 60–78 |
| 9 to 12 - middle school age | 110–126 | 70–82 |
| From 12 to 15-17 - senior school period | 110–136 | 70–86 |
Also, normal blood pressure in children of different ages can be obtained using the formulas for calculating:
The physiological limits of fluctuations in the formulaic calculation system are up to 30 units in the direction of increase.
Speaking about the norm, it should be noted that it is always individual, especially in relation to childhood. Many factors will affect the level of pressure of the child:
- Place of residence (in a mountainous or tropical climate, a natural decrease in blood pressure is observed).
- The amount of salt in food (for children during the period breastfeeding mother's salt preferences).
- Time of birth (in children born prematurely, blood pressure is lower).
- activity (than more active child- the higher its pressure in the younger period, and with regular sports loads, older children develop a physiological decrease in blood pressure).
- Compliance with measurement technique.
- Growth (the higher the child, the higher the pressure).
In order to facilitate the use of tables with age and gender standards, pediatrics has a rule:
- consider acceptable blood pressure for the first 10 years, figures up to 110 per 70 mm Hg. Art.;
- after 10 years - up to 120 per 80 mm Hg. Art.
When this norm of blood pressure in children is violated, this is a reason to use formulas and tables to make sure that there is no pathology.
Sex differences
Not always present, but it must be taken into account that, depending on the sex of the child, there may be differences in blood pressure:
- from birth to the end of the first year, the level of pressure in girls and boys is the same;
- then, in girls, it gradually increases, reaching a maximum difference by 3–4 years;
- at the age of five years, the indicators are compared;
- from five to ten years, the pressure level of girls is again higher than that of boys;
- after 10 years of age, boys lead, this championship is maintained until the age of 17.
Why does blood pressure drop in children?
Low blood pressure may be physiological. This is due to the features of the function nervous system when its parasympathetic part is more active. In this variant, against the background of a decrease in blood pressure, there are no disturbances in the general well-being of the child.
Pathological decrease in blood pressure has its negative manifestations:
- Weakness.
- Decreased activity.
- Appetite problems.
- Dizziness.
- Different intensity of pain in the head.
- Tendency to collapse and faint.
- Vegetative disorders.
The reason for this condition is a violation of the pressure regulation system, which is aggravated by external factors:
- pathology of the course of pregnancy (somatic diseases in the mother, infections, the action of harmful agents, etc.);
- premature birth;
- increased intracranial cerebrospinal fluid pressure;
- chronic infectious and inflammatory foci;
- personal characteristics (emotional instability, hysteria);
- psycho-emotional stress;
- unfavorable socio-economic conditions;
- insufficient level of physical activity;
- violation of the mode of activity and rest;
- a period of high instability of hormone levels (11–14 years).
Increased intracranial pressure Why is the pressure rising?
Under certain conditions, an increase in pressure is a physiological norm. This is how it happens:
- in any stressful situation, when the emotional background is increased;
- during and immediately after intense physical activity;
- in cases of trauma.
A feature of this state is the temporary nature of the change in pressure.
In the case of pathological primary arterial hypertension in children, a moderate level of pressure increase (“mild hypertension”) is noted. High blood pressure numbers indicate a secondary genesis of pathology.
There are often no symptoms of pressure changes. This is an accidental finding during a routine inspection.
If high blood pressure figures are detected, it is necessary to prescribe the child an additional examination to clarify the cause:
| Cause group | Specific diseases |
|---|---|
| Damage to the kidney tissue | Glomerulonephritis - inflammatory changes in the glomeruli of the kidneys Glomerulosclerosis - transformation of kidney tissue into connective tissue Nephropathy of any origin Hydronephrosis - an increase in the pyelocaliceal system of the kidney with compression of the glomeruli and a gradual "shutdown" of the organ Underdevelopment of kidney tissue (hypoplasia) Benign and malignant neoplasms Alport's syndrome - a combined pathology of the kidneys, hearing and vision |
| Vascular changes | Malformations - shunting of blood between the arterial and venous system Developmental disorders of the aorta (coarctation, stenosis or underdevelopment of the abdominal part, open duct between the aorta and the pulmonary trunk) Vasculitis - inflammatory process in the wall of autoimmune vessels Narrowing of the renal arteries Takayasu's disease - vasculitis involving the aorta and large arteries |
| Endocrine diseases | hyperthyroidism Increased function of the adrenal cortex (hyperaldosteronism) |
| Damage to the nervous system | Tumor processes Infectious and inflammatory diseases Day-Riley disease is a pathology of the nervous system with vegetative manifestations |
| Medicinal action | Non-steroidal anti-inflammatory drugs Synthetic hormones of the adrenal cortex Appetite suppressants Tablet contraceptives Steroid drugs Amphetamine phencyclidine |
| Other reasons | Nicotine Alcohol Lead or mercury poisoning (heavy metals) |
Features of the measurement technique
Measurement of pressure in children has its own characteristics, if they are violated, there is a high risk of misinterpretation of the result.
Primary requirements:
- The width of the tonometer cuff is at least 40% of the circumference of the arm.
- The cuff should cover the arm by 80-100%.
- Take measurements on both hands.
- Multiplicity - at least two times.
- Control of blood pressure, in case of its change, is carried out at home in the morning and evening for one week.
- Do not measure immediately after feeding, active play or crying baby.
- The study should be done only in the supine or sitting position, after 20–30 minutes of rest.
Indications for daily measurement
In children, due to their increased activity and excitability, often to establish a diagnosis pathological change Blood pressure is measured during the day to avoid errors in diagnosis.
Indications for monitoring blood pressure at home for 24 hours.
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Did you have a premature baby? Of course, you are worried and ask a lot of questions, the answers to which, alas, you do not always get in a timely manner. Meanwhile, knowing the "weak" places of the baby, you can more easily cope with many situations - for example, feeding or bathing. Yes, and a small weight gain or some lag behind the crumbs in development from their peers will not cause concern.
In addition, remember that any medical forecast is by no means the final "verdict". Quite often, babies with seemingly favorable data die or lag behind in development, while children with gloomy prospects survive and grow up healthy against all odds.
So you want to know everything about premature babies? We will tell you about the features of physiology, development, nursing, feeding and restorative treatment of babies born much earlier than expected.
As defined by the World Health Organization (WHO)
A child is considered premature if he was born between 22 and 37 weeks of gestation (gestation) with a weight of 500 to 2500 grams and a height of 25 to 40 centimeters.
premature baby day
It is celebrated on November 17, which was established in 2009 by the European Foundation for the Care of Newborn Patients.
Degrees of prematurity
They are determined depending on the weight and the number of complete weeks of pregnancy (gestation) at the time of delivery.
I degree
The baby is born at 34-36 weeks and 6 days with a weight of 2001 to 2500 grams. The child is fully mature and self-sufficient. Therefore, as a rule, no special conditions are required. However, sometimes treatment and nursing is necessary - for example, with prolonged jaundice, trauma during childbirth, and some other conditions.
II degree
The baby is born at 31-33 weeks and 6 days with a weight of 1501 to 2000 grams. Usually, a baby quickly adapts to new living conditions with the provision of timely medical care, as well as the creation of appropriate conditions for care and feeding.
III degree
Very early delivery at 28-30 weeks of gestation with a baby weighing 1001 to 1500 grams. Many of these children survive, but in the future they need long-term rehabilitation treatment and observation by doctors of various specialties. Sometimes some babies have various diseases, congenital malformations or genetic abnormalities.
IV degree
Childbirth before 28 weeks of pregnancy with an extremely low birth weight of a child up to 1000 grams. The baby is immature and completely unprepared for new conditions. Every fifth baby is born alive, but the chance of survival is extremely low. Unfortunately, many children die before reaching the age of one month: of those born before 26 weeks - 80-90% of babies, at 27-28 weeks - 60-70%.
Moreover, such children usually have numerous serious illnesses and / or congenital malformations, which significantly worsens the prognosis. Parents are explained the further probable fate of the crumbs and the need for long-term nursing. The final decision on the management of a very premature baby is recommended to be made jointly with an obstetrician-gynecologist, neonatologist and parents.
Signs of prematurity
Depend on the number of completed weeks of pregnancy (gestational age) at the time of birth.
Moderate, or I-II degree of prematurity
Baby is mostly active, moves arms and legs, but his muscle tone is somewhat reduced.
Cardiovascular system of premature babies
In utero, the fetus has a special blood circulation. The fact is that the lungs do not participate in breathing, and oxygen enters the blood from the vessels of the placenta. Arterial blood, once in the blood vessels of the baby, mixes with venous blood and is again distributed throughout the body.
This process is possible due to holes, or shunts, between the chambers of the heart and large vessels.
In a full-term baby, after the first breath, auxiliary openings are closed. This is how the blood circulation of the newborn is established, ensuring the supply of arterial blood to the organs and tissues.
Due to the incomplete maturation of tissues in a premature baby, such a restructuring occurs much later. In addition, this process is also delayed due to an increase in the load on the heart and blood vessels: resuscitation (revival) in the delivery room, artificial lung ventilation, intravenous infusion of solutions.
A premature baby often has congenital heart defects that significantly worsen his condition.
A child born before the expected date is sensitive to external stimuli (touch, loud sound) with an increase in heart rate and an increase in blood pressure.
Endocrine system of a premature baby
Cortisol is insufficiently produced by the adrenal cortex, a hormone necessary to adapt the baby to life outside the womb and ensure an adequate response to stress (birth). With adrenal insufficiency, the child's condition deteriorates rapidly: blood pressure drops sharply and the amount of urine decreases, body temperature drops.
The function of the thyroid gland is temporarily reduced (transient hypothyroidism), which leads to a slowdown in the metabolism of the baby. The condition is manifested by a tendency to edema, prolonged jaundice, poor weight gain, and various respiratory disorders.
The sex glands produce hormones in insufficient quantities, so the sexual crisis is not pronounced:
- In girls, the mammary glands moderately enlarge and the labia swell, and spotting from the genitals is not pronounced or absent.
- In boys, the scrotum and penis may swell slightly.
Low blood sugar (hypoglycemia)
Often occurs in the first 3-5 days of life, due to several factors:
- Insufficient stores of glycogen - a form of storage of glucose in cells.
- Reduced production of enzymes by the pancreas, which reduces the breakdown and absorption of glucose from the intestines and stomach.
- Increased synthesis in the pancreas of insulin - a hormone that promotes the penetration of glucose into cells.
What is the danger of hypoglycemia? The maturation of the nervous tissue is disturbed, in the future, epileptic seizures (convulsions) and mental retardation may occur.
The immune system of preterm infants
There is also a positive moment in such work of the immune system: in some babies, the risk of developing allergic reactions after birth is somewhat reduced.
However, as they grow older, on the contrary, the child becomes more susceptible to
- Reduced levels of vitamin K, which is involved in the formation of proteins and some blood factors (for example, prothrombin) responsible for normal blood clotting.
- Reduced ability of platelets (blood cells) to stick together and form blood clots.
Jaundice in premature babies
In utero, the fetus develops fetal hemoglobin, carrying more oxygen to organs and tissues, which is necessary in conditions of mixed circulation.
After birth, fetal hemoglobin is rapidly degraded to form bilirubin- a toxic pigment that spreads throughout the body with blood, staining the skin and mucous crumbs yellow. Bilirubin binds to special proteins that are produced in the liver, then excreted from the body.
In a full-term baby bilirubin levels rarely reach high numbers and are excreted from the body within a few days or two weeks.
In a premature baby this process is delayed due to the immaturity of the liver, insufficient production of bile acids, narrow bile ducts of the liver and gallbladder.
An increase in the level of bilirubin is dangerous because, being a toxic substance, it leads to impaired respiration in cells and the formation of proteins. Most of all, bilirubin "loves" fat cells and nervous tissue.
Physiological weight loss
After birth, all babies "lose weight" for several reasons:
- During childbirth, the body's metabolism and energy consumption by tissues increase.
- Childbirth is stressful for the baby, leading to fluid loss through sweat and breathing.
- The original stool passes - meconium.
The child has nothing to compensate for the losses from the outside, since not enough colostrum and energy enter the body. The baby begins to consume its own "reserves" of brown fat accumulated during fetal development.
Weight recovery takes place at different times. In full-term children - by 7-10 days of life. With a moderate degree of prematurity - usually after the second week of life, with a deep - the third or fourth week. Numerous factors influence the process: the conditions of nursing and feeding, the presence or absence of diseases, and some other points.
urinary system
The exchange of salts and water in premature babies is unstable, so they are equally prone to both the formation of edema and dehydration. In addition, the kidney tissue in which urine is formed is also immature, further contributing to water retention in the body.
Therefore, premature babies often develop early swelling- even during fetal development, in the first hours or days of life. They are soft, spread throughout the body and disappear in the first or second week of life.
Late swelling occur in the second or third week of life, indicating nutritional problems, a decrease in the amount of protein in the body, or the presence of a disease in the child. Edema is dense to the touch, located in the lower third of the abdomen, feet, legs and pubis.
Taking into account the characteristics of organs and tissues, premature baby needs help to adapt to new conditions of life and survival.
Heart rate (HR) is one of the main characteristics of human health. The norm of heart rate in children by age has its own differences. This is due to the internal characteristics of the growing organism and the influence of external factors on it.
The rate of heart rate changes with the age of the child
Heart rate norms in children of different ages
A child's heart grows rapidly in the first year of life. At this time, the pulse is the highest. As you grow older, the heart system is formed, the vessels are strengthened, which leads to the stabilization of the heart rate and a decrease in this indicator.
Table "Age rate of heart rate in children"
| Age | Boundary indicators | Mean |
| In a newborn (from the first day to 30 days of life) | 110–170 | 138 |
| In an infant (from 1 to 6 months) | 107–165 | 135 |
| 6 months to 1 year | 104–163 | 132 |
| For 1-year-olds and up to 2 years | 92–155 | 123 |
| From 2 to 4 years | 90–141 | 116 |
| From 4 to 6 years | 88–127 | 108 |
| From 6 to 8 years old | 77–117 | 97 |
| 8 to 10 years old | 69–108 | 88 |
| 10 to 12 years old | 62–102 | 82 |
| From 12 to 14 years old | 54–97 | 77 |
Starting from the age of 15, in adolescents, the number of heartbeats is fixed within 75 beats per minute (limit values are 62–81 beats per 60 seconds), which is a normal indicator for an adult.
Deviations from the norm for no apparent reason, especially at rest, may be the result of disturbances in the work of the heart, blood vessels or other vital organs. In order to avoid serious complications, it is better to see a doctor.
Pulse rate in premature babies
Some organs and systems in babies born prematurely are not completely formed. In this case, the baby's body needs more time to adapt to environmental conditions. The child is more sensitive to external stimuli, which greatly increases the frequency of contractions of the heart muscle and blood pressure. That is why in premature babies, a pulse of 180 beats per minute is not considered a pathology, but is their age norm.
High heart rate in premature babies is normal
Normal heart rate in child athletes
The heart rate of a child who is constantly involved in sports in a calm state is lower than that of his peers. This is a normal phenomenon, which indicates the good work of the heart muscle and its health. The maximum heart rate in such children during training should not exceed the indicator, which is calculated by the formula - 220 beats minus age. The obtained values are present only during the first 10 minutes after physical exertion, and then return to normal. If the high pulse has not stabilized, we are talking about cardiac pathologies.
An increase in heart rate in children during exercise is normal.
The difference in heart rate between boys and girls
Pulse in children preschool age does not depend on gender. As they grow older (puberty), the development of the autonomic regulation of the heart in girls and boys is slightly different, as a result, the pulse of the beautiful half of humanity is 10–15 beats higher.
Girls have a slightly higher heart rate than boys.
Causes of heart rate deviation from the norm
Heartbeat, like pressure, can change during the day under the influence of external factors:
- heavy physical exercise;
- stressful situations;
- weather conditions (heat, high humidity).
Stressful situations can increase a child's heart rate
Changes in environment enhances the work of the heart, and increase its usual rhythm by almost 3 times. This condition is considered normal if short time values return to normal, and the baby's well-being does not suffer.
If palpitations are observed in children at rest, the cause may be:
- inflammatory processes in the respiratory organs;
- pathologies of the cardiovascular system;
- negative deviations in the endocrine system;
- diseases caused by a bacterial or viral infection;
- problems in blood formation (anemia).
Exhaustion of the body and severe overwork can also cause increased contraction of the heart muscle, which negatively affects blood pressure and the functioning of vital systems in general.
How to measure heart rate correctly
Measuring heart rate in children does not require special skills.
The main thing is to know the places on the body where the pulsation occurs best:
- in newborn babies and children under one year old - a large fontanel, chest;
- at one year old babies, older children, adolescents and adults - the neck (carotid artery), temple, wrist (above the wrist joint), elbow or groin.
To measure the heart rate, you will need a stopwatch (electronic clock). At the site of the pulsation, you need to place the index and middle fingers, note the time (60 seconds) during which to count the number of strokes.
When measuring heart rate, put your index and middle fingers on the place of the pulsation
When measuring heart rate, it is important to remember that any external factors can affect its performance. In sleep, the pulse is usually below the limit values, after squats it is 2–2.5 times higher than normal, and at temperature, the heart rate can go off scale.
In order for the measurement to show reliable results, you should follow some recommendations:
- It is necessary to measure the heart rate when the baby is at rest (sitting or lying down), preferably in the morning.
- The procedure is carried out for 3-4 days at the same time. This will provide more accurate data.
- The results obtained after physical exertion or an emotional outburst should be checked by re-measurement when the baby is in a calm state.
Heart rate control allows you to monitor the state of the child's body and helps to identify negative deviations in the work of vital systems in time. The main thing is to measure the pulse correctly and not to panic in case of deviations from fixed indicators, but to consult a doctor.
The rate of heart rate in children of different ages is very different. In babies of the first year of life, this indicator is the highest, but closer to adolescence, the pulse stabilizes, since the cardiovascular system has already been formed. Heart rate is influenced by both external (emotional stress, physical activity, weather conditions) and internal (pathologies of the cardiovascular system) factors. Therefore, it is important to constantly monitor the child's pulse in order to keep this indicator normal.
Few parents are prepared for the birth of their child. ahead of time. Most often, the birth of a premature baby becomes a difficult test for the whole family. This is because everyone is waiting for the birth of a plump, rosy-cheeked toddler, expecting to return from the maternity hospital in a maximum of 5 days, and in general, as a rule, they make optimistic plans for the future. Great amount information for future and young parents, including the Internet, television, printed publications, is dedicated to a normal pregnancy, childbirth without complications and caring for a healthy newborn. When something starts to go wrong, parents find themselves in an information vacuum, which sometimes exacerbates an already difficult situation.
For the first time in Russia, a resource has been created that is completely devoted to the problem of premature birth and prematurity. This resource was created by parents for parents who are expecting or have already given birth to a child prematurely. From our own experience, we have experienced a lack of information during the period of maintaining a pregnancy, nursing a baby in a maternity hospital and a perinatal center. We felt an acute shortage of funds for specialized care, which is so necessary for the full physical and mental maturation of the child outside the womb. Behind him is more than one month spent at the incubator, then at the crib in endless expectation, fear and hopes for recovery. As the baby grew, more and more information was needed about the care, development, education of a child born prematurely, which would be adapted to our situation and which is very difficult to find. Such experience gives us reason to believe that the information posted on our website will help young mothers and fathers be more prepared for the birth of their dearest baby, which means it is easier and more peaceful to survive this difficult period in life. Knowledge and experience will make you more confident and help you focus on the most important thing - the health and development of your baby.
As materials for creating the site, we used medical and pedagogical literature, reference books, practical guides, opinions of specialists in the field of obstetrics, gynecology and neonatology, child psychology and pedagogy, materials from foreign resources, as well as the invaluable experience of parents whom we met and became close friends thanks to our children.
We draw your attention to the fact that the materials presented here are not a “recipe” for you and your child, but are only intended to help you deal with the situation, dispel some doubts and orient yourself in your actions. mention of any medicines, equipment, brands, institutions, etc. is not an advertisement and cannot be used without the consent of experts.
We hope that we will be useful to you from the moment your baby is born and we will grow with you. If you have any questions, wishes or suggestions, This e-mail address is being protected from spambots. You need JavaScript enabled to view it !
Sincerely yours,
The cardiovascular system functions already in the prenatal period. It empowers the heart faster than others internal organs, adapt to new (extrauterine) conditions.
The intrauterine circulation of the fetus has its own characteristics and differs significantly from the circulation of the child. After birth, the foramen ovale, connecting the right and left atria, closes, and the ductus arteriosus, which in the fetus connects the pulmonary artery to the aortic arch, collapses. In some preterm infants, the ductus arteriosus closes later, at 1–3 months of age. Late closure of the ductus arteriosus contributes to the development of congestion in the lungs.
Blood pressure and pulse. Blood pressure in premature babies is lower than in full-term babies. According to E. Ch. Novikova, in the first month of life, the maximum pressure ranges from 50-80 mm Hg. Art., averaging 65 mm. According to other authors, the maximum pressure is even less (according to A.F. Zelensky, 40-47 mm according to Crosse, 46-60 mm). The minimum pressure averages 25 mm Hg. Art.
The pulse rate in healthy premature babies fluctuates over a fairly wide range (100-180 beats per minute). A decrease in heart rate (less than 100 beats per minute) is typical for children with intracranial trauma, and an increase (more than 180 beats per minute) in a child at rest is typical for premature babies with pneumonia, heart defects and other pathologies.
The pulse in premature babies is characterized by great lability. When crying, feeding, after a medical examination, it easily becomes more frequent. The pulse is best counted by heart contractions, during sleep or at the beginning of the examination, and always in a minute.
peripheral vessels. Premature infants are characterized by increased permeability and fragility of peripheral vessels, which, according to Ilppö, is 3.5 times greater than full-term infants. This is due to the poor development of elastic tissue in the vascular walls, and especially applies to the vessels of the brain. The result of increased permeability of cerebral vessels is the tendency of premature babies to hemorrhages in the brain. Vascular permeability increases significantly in the state of asphyxia.
Peripheral circulation. Premature babies are prone to hypostases (slow blood flow). A manifestation of this is the bluish or cherry coloration of the feet and hands, which is so often observed in them in the first weeks of life. Sometimes it is enough to put the child on its side, as the lower foot and hand become cherry or cyanotic. The Finkelstein symptom, also known as the Harlequin symptom, is much less common: when the child is on its side, the skin of the lower half of the body is hyperemic more sharply than the upper half, the border between them runs exactly along the midline.