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Reference Values for Children


Blood Pressure in Premature Infants, Normal
(Birth weight 600 to 1,750 g)
Day
600 to 999 g
1,000 to 1,249 g
S ( ± 2SD)
D ( ± 2SD)
S ( ± 2SD)
D ( ± 2SD)
1
37.9 (17.4)
23.2 (10.3)
44 (22.8)
22.5 (13.5)
3
44.9 (15.7)
30.6 (12.3)
48 (15.4)
36.5 (9.6)
7
50 (14.8)
30.4 (12.4)
57 (14)
42.5 (16.5)
14
50.2 (14.8)
37.4 (12)
53 (30)
28
61 (23.5)
45.8 (27.4)
57 (30)

Day
1,250 to 1,499 g
1,500 to 1,750 g
S (± 2SD)
D (± 2SD)
S (± 2SD)
D (± 2SD)
1
48 (18)
27 (12.4)
47 (15.8)
26 (15.6)
3
59 (21.1)
40 (13.7)
51 (18.2)
35 (10)
7
68 (14.8)
40 (11.3)
66 (23)
41 (24)
14
64 (21.2)
36 (24.2)
76 (34.8)
42 (20.3)
28
69 (31.4)
44 (26.2)
73 (5.6)
50 (9.9)
Blood pressure was obtained by the Dinamap method
S = systolic, D = diastolic, SD = standard deviation
Modified from Ingelfinger JR, Powers L, Epstein MF. Blood pressure norms in low-weight infants: birth through four weeks. Pediatr Res. 1983;17:319A.

Hypertension, Classification by Age Group
Age Group
Significant Hypertension
(mm Hg)
Severe Hypertension
(mm Hg)
Newborn (7 days)
systolic BP
≥96
≥106
Newborn (8 to 30 days)
systolic BP
≥104
≥110
Infant (<2 years)
systolic BP
≥112
≥118
diastolic BP
≥74
≥82
Children (3 to 5 years)
systolic BP
≥116
≥124
diastolic BP
≥76
≥84
Children (6 to 9 years)
systolic BP
≥122
≥130
diastolic BP
≥78
≥86
Children (10 to 12 years)
systolic BP
≥126
≥134
diastolic BP
≥82
≥90
Adolescents (13 to 15 years)
systolic BP
≥136
≥144
diastolic BP
≥86
≥92
Adolescents (16 to 18 years)
systolic BP
≥142
≥150
diastolic BP
≥92
≥98
Adapted from Horan MJ. Pediatrics. 1987;79:1-25.

Hypotension, Definitions by Age Group
Hypotension is a systolic blood pressure <5th percentile of normal for age, namely: 
·         <60 mm Hg in term neonates (0 to 28 days)
·         <70 mm Hg in infants (1 to 12 months)
·         <70 mm Hg + (2 x age in years) in children 1 to 10 years
·         <90 mm Hg in children ≥10 years of age


Normal Pediatric Heart Rates
Age
Mean Heart Rate
(beats/minute)
Heart Rate Range
(2nd to 98th percentile)
<1 day
123
93 to 154
1 to 2 days
123
91 to 159
3 to 6 days
129
91 to 166
1 to 3 weeks
148
107 to 182
1 to 2 months
149
121 to 179
3 to 5 months
141
106 to 186
6 to 11 months
134
109 to 169
1 to 2 years
119
89 to 151
3 to 4 years
108
73 to 137
5 to 7 years
100
65 to 133
8 to 11 years
91
62 to 130
12 to 15 years
85
60 to 119
Adapted from: The Harriet Lane Handbook. 12th ed. Greene MG, ed. St Louis, MO: Mosby Yearbook; 1991.

Normal QRS Axes (in degrees)
Age
Mean
Range
1 week to 1 month
+110
+30 to +180
1 to 3 months
+70
+10 to +125
3 months to 3 years
+60
+10 to +110
>3 years
+60
+20 to +120
Adults
+50
–30 to +105


Normal Respiratory Rates
Hour After Birth
Average Respiratory Rate
Range
1st hour
60 breaths/minute
20 to 100
2 to 6 hours
50 breaths/minute
20 to 80
>6 hours
30 to 40 breaths/minute
20 to 60

Age
(years)
Mean RR
(breaths/minute)
0 to 2
25 to 30
3 to 9
20 to 25
10 to 18
16 to 20



Normal Lab Values
Age
Serum Concentration
CHEMISTRY
Albumin
Premature 1 day
1.8 to 3 g/dL
Full-term <6 days
2.5 to 3.4 g/dL
8 days to 1 year
1.9 to 4.9 g/dL
1 to 3 years
3.4 to 4.2 g/dL
4 to 19 years
3.5 to 5.6 g/dL
Ammonia
All ages
19 to 60 mcg/dL
Amylase
1 to 19 years
30 to 100 units/L
Bilirubin, total
See nomogram for age-specific neonatal values
1 month to Adult
<1 mg/dL
Calcium, total
Cord blood
9 to 11.5 mg/dL
Newborn 3 to 24 hours
9 to 10.6 mg/dL
Newborn 24 to 48 hours
7 to 12 mg/dL
4 to 7 days
9 to 10.9 mg/dL
Child
8.8 to 10.8 mg/dL
Adolescent to Adult
8.4 to 10.2 mg/dL
Calcium, ionized, whole blood
Cord blood
5 to 6 mg/dL
Newborn 3 to 24 hours
4.3 to 5.1 mg/dL
Newborn 24 to 48 hours
4 to 4.7 mg/dL
≥2 days
4.8 to 4.92 mg/dL (2.24 to 2.46 mEq/L)
Carbon dioxide (PCO2)
Newborn
27 to 40 mm Hg
Infant
27 to 41 mm Hg
Child to Adult:
Male
35 to 48 mm Hg
Female
32 to 45 mm Hg
Chloride
95 to 105 mEq/L
Cholesterol
See following tables for age- and gender-specific values
Creatinine
0 to 4 years
0.03 to 0.5 mg/dL
(IDMS) Enzymatic
4 to 7 years
0.03 to 0.59 mg/dL
7 to 10 years
0.22 to 0.59 mg/dL
10 to 14 years
0.31 to 0.88 mg/dL
>14 years
0.5 to 1.06 mg/dL
Glucose
Cord blood
45 to 96 mg/dL
Premature
20 to 60 mg/dL
Neonate
30 to 60 mg/dL
Newborn 1 day
40 to 60 mg/dL
>1 day
50 to 90 mg/dL
Child
60 to 100 mg/dL
Adult
70 to 105 mg/dL
Iron
All ages
22 to 184 mcg/dL
Iron binding capacity, total
Infant
100 to 400 mcg/dL
≥1 year to Adult
250 to 400 mcg/dL
Lactic acid, lactate
1 to 12 months
10 to 21 mg/dL
1 to 7 years
7 to 14 mg/dL
7 to 15 years
5 to 8 mg/dL
Lead, whole blood
Child
<10 mcg/dL
Toxic
≥70 mcg/dL
Lipase
1 to 18 years
145 to 216 units/L
Magnesium
1.5 to 2.5 mEq/L
Osmolality, serum
Child to Adult
275 to 295 mOsm/kg
Phosphorus
Newborn 0 to 5 days
4.8 to 8.2 mg/dL
1 to 3 years
3.8 to 6.5 mg/dL
4 to 11 years
3.7 to 5.6 mg/dL
12 to 15 years
2.9 to 5.4 mg/dL
16 to 19 years
2.7 to 4.7 mg/dL
Potassium, plasma
Newborn
4.5 to 7.2 mEq/L
2 days to 3 months
4 to 6.2 mEq/L
3 months to 1 year
3.7 to 5.6 mEq/L
1 to 16 years
3.5 to 5 mEq/L
Protein, total
Premature neonate
4.3 to 7.6 g/dL
Newborn
4.6 to 7.4 g/dL
1 to 7 years
6.1 to 7.9 g/dL
8 to 12 years
6.4 to 8.1 g/dL
13 to 19 years
6.6 to 8.2 g/dL
Sodium
136 to 145 mEq/L
Triglycerides
See following tables for age- and gender-specific values
Urea nitrogen, blood
Cord blood
21 to 40 mg/dL
Premature (1 week)
3 to 25 mg/dL
Newborn
3 to 12 mg/dL
Infant to Child
5 to 18 mg/dL
Adolescent to Adult
7 to 18 mg/dL
Uric acid
1 to 3 years
1.8 to 5 mg/dL
4 to 6 years
2.2 to 4.7 mg/dL
7 to 9 years
2 to 5 mg/dL
10 to 11 years:
Male
2.3 to 5.4 mg/dL
Female
3 to 4.7 mg/dL
12 to 13 years: Male
2.7 to 6.7 mg/dL
14 to 15 years: Male
2.4 to 7.8 mg/dL
12 to 15 years: Female
3 to 5.8 mg/dL
16 to 19 years:
Male
4 to 8.6 mg/dL
Female
3 to 5.9 mg/dL

ENZYMES
Alanine aminotransferase (ALT) (SGPT)
≤7 days
6 to 40 units/L
8 to 30 days:
Male
10 to 40 units/L
Female
8 to 32 units/L
1 to 12 months
12 to 45 units/L
1 to 19 years
5 to 45 units/L
Alkaline phosphatase (ALKP)
1 to 9 years
145 to 420 units/L
10 to 11 years
140 to 560 units/L
12 to 13 years:
Male
200 to 495 units/L
Female
105 to 420 units/L
14 to 15 years:
Male
130 to 525 units/L
Female
70 to 230 units/L
16 to 19 years:
Male
65 to 260 units/L
Female
50 to 130 units/L
Aspartate aminotransferase (AST) (SGOT)
Newborn ≤7 days:
Male
30 to 100 units/L
Female
24 to 95 units/L
8 to 30 days
22 to 71 units/L
1 to 12 months
22 to 63 units/L
1 to 3 years
20 to 60 units/L
3 to 9 years
15 to 50 units/L
10 to 15 years
10 to 40 units/L
16 to 19 years:
Male
15 to 45 units/L
Female
5 to 30 units/L
Creatine kinase (CK)
Cord blood
70 to 380 units/L
Newborn 5 to 8 hours
214 to 1,175 units/L
Newborn 24 to 33 hours
130 to 1,200 units/L
Newborn 72 to 100 hours
87 to 725 units/L
Adult
5 to 130 units/L
Lactate dehydrogenase (LDH)
<1 year
170 to 580 units/L
1 to 9 years
150 to 500 units/L
10 to 19 years
120 to 330 units/L


Blood Gases
Arterial
Capillary
Venous
pH
7.35 to 7.45
7.35 to 7.45
7.32 to 7.42
pCO2 (mm Hg)
35 to 45
35 to 45
38 to 52
pO2 (mm Hg)
70 to 100
60 to 80
24 to 48
HCO3 (mEq/L)
19 to 25
19 to 25
19 to 25
TCO2 (mEq/L)
19 to 29
19 to 29
23 to 33
O2 saturation (%)
90 to 95
90 to 95
40 to 70
Base excess (mEq/L)
-5 to +5
-5 to +5
-5 to +5


Hyperbilirubinemia Assessment in the Newborn Infant
Nomogram for designation of risk in 2,840 well newborns at ≥36 weeks gestational age with birth weight of ≥2,000 g or ≥35 weeks gestational age and birth weight of ≥2,500 g based on the hour-specific serum bilirubin values. The serum bilirubin level was obtained before discharge and the zone in which the value fell predicted the likelihood of a subsequent bilirubin level exceeding the 95th percentile (high-risk zone).
Reproduced with permission from: American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant ≥35 weeks of gestation. Pediatrics. 2004;114(1):297-316. Available at http://pediatrics.aappublications.org/content/114/1/297.long


Classification of Serum Lipid Concentrationsa
Total Cholesterolb
(mg/dL)
LDL-Cb
(mg/dL)
HDL-Cb
(mg/dL)
Apolipoprotein A-1
Triglyceridesc
(mg/dL)
Apolipoprotein B
Children and Adolescents
Young Adults
Children and Adolescents
Young Adults
Children and Adolescents
Young Adults
Children and Adolescents
Children 0 to 9 years
Children ≥10 years and Adolescents <19 years
Young Adults
Children and Adolescents
Low
<40
<40
<115
Borderline low
40 to 44
Acceptable/optimal
<170
<190
<110
<120
>45
>45
>120
<75
<90
<115
<90
Borderline high
170 to 199
190 to 224
120 to 159
130 to 159
40 to 45
115 to 120
75 to 99
90 to 129
115 to 149
90 to 109
High
≥200
≥225
≥130
≥160
≥100
≥130
≥150
≥110
aAdapted from: Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128(Suppl 5):S213-S256.
bTo convert cholesterol results to SI units, divide value by 38.6.
cTo convert triglyceride results to SI units, divide value by 88.6.


Serum Lipid Concentrations by Age and Gender
Males
(mg/dL)
Females
(mg/dL)
5 to 9 years
10 to 14 years
15 to 19 years
5 to 9 years
10 to 14 years
15 to 19 years
Total Cholesterol
50th percentile
153
161
152
164
159
157
75th percentile
168
173
168
177
171
176
90th percentile
183
191
183
189
191
198
95th percentile
186
201
191
197
205
208
Triglycerides
50th percentile
48
58
68
57
68
64
75th percentile
58
74
88
74
85
85
90th percentile
70
94
125
103
104
112
95th percentile
85
111
143
120
120
126
LDL-C
50th percentile
90
94
93
98
94
93
75th percentile
103
109
109
115
110
110
90th percentile
117
123
123
125
126
129
95th percentile
129
133
130
140
136
137
HDL
5th percentile
38
37
30
36
37
35
10th percentile
43
40
34
38
40
38
25th percentile
49
46
39
48
45
43
50th percentile
55
55
46
52
52
51
Adapted from: American Academy of Pediatrics Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122:(1)198-208.


Thyroid Function Tests
Age
Normal Range
T4 (thyroxine) serum concentrations
1 to 7 days
10.1 to 20.9 mcg/dL
8 to 14 days
9.8 to 16.6 mcg/dL
1 month to 1 year
5.5 to 16 mcg/dL
>1 year
4 to 12 mcg/dL
Free Thyroxine Index (FTI)
1 to 3 days
9.3 to 26.6
1 to 4 weeks
7.6 to 20.8
1 to 4 months
7.4 to 17.9
4 to 12 months
5.1 to 14.5
1 to 6 years
5.7 to 13.3
>6 years
4.8 to 14
T3 serum concentration
Newborn
100 to 470 ng/dL
1 to 5 years
100 to 260 ng/dL
5 to 10 years
90 to 240 ng/dL
10 years to Adult
70 to 210 ng/dL
T3 uptake
35% to 45%
TSH serum concentration
Cord sample
3 to 22 micro international units/mL
1 to 3 days
<40 micro international units/mL
3 to 7 days
<25 micro international units/mL
>7 days
≤10 micro international units/mL


Hematology Values
Age
Hgb
(g/dL)
Hct
(%)
RBC
(mill/mm3)
RDW
MCV
(fL)
MCH
(pg/cell)
MCHC
(%)
PLTS
(x 103/mm3)
≤30 days
15 to 24
44 to 70
4 to 5.5
12% to 15%
99 to 115
33 to 39
32 to 36
84 to 478a
1 to 23 months
10.5 to 14
32 to 42
72 to 88
24 to 30
150 to 450
2 to 9 years
11.5 to 14.5
33 to 43
76 to 90
25 to 31
10 to 17 years (male)
12.5 to 16.1
36 to 47
78 to 95
26 to 32
10 to 17 years (female)
12 to 15
35 to 45
78 to 95
26 to 32
≥18 years (male)
13.5 to 18
42 to 52
78 to 100
27 to 31
≥18 years (female)
12.5 to 16
37 to 47
78 to 100
27 to 31
aValue for ages 0 to 7 days, for ages >7 days similar to range for all patient ages


WBC and Diff
Age
WBC
(x 103/mm3)
Segs
Bands
Lymphs
Monos
Eosinophils
Basophils
Myelocytes
≤30 days
9.1 to 34
54% to 62%
3% to 5%
25% to 33%
3% to 7%
1% to 3%
≤0.75%
0%
1 to 23 months
6 to 14
2 to 9 years
4 to 12
10 to 17 years
4 to 10.5
≥18 years
4 to 10.5
Segs = segmented neutrophils, bands = band neutrophils, lymphs = lymphocytes, monos = monocytes


Erythrocyte Sedimentation Rates and Reticulocyte Counts
Sedimentation rate, Westergren
Child
0 to 20 mm/hour
Adult male
0 to 15 mm/hour
Adult female
0 to 20 mm/hour
Sedimentation rate, Wintrobe
Child
0 to 13 mm/hour
Adult male
0 to 10 mm/hour
Adult female
0 to 15 mm/hour
Reticulocyte count: Neonatal and infant data based on capillary specimen
1 day
0.4% to 0.6%
7 days
<0.1% to 1.3%
1 to 4 weeks
<1% to 1.2%
5 to 6 weeks
<0.1% to 2.4%
7 to 8 weeks
0.1% to 2.9%
9 to 10 weeks
<0.1% to 2.6%
11 to 12 weeks
0.1% to 1.3%
Reticulocyte count: Whole blood specimen
Adult
0.5% to 1.5%


Cerebrospinal Fluid Values, Normal
Cell count:
% PMNs
Preterm mean
9 (0 to 25.4 WBC/mm3)
57%
Term mean
8.2 (0 to 22.4 WBC/mm3)
61%
>1 month
0.7
0
Glucose:
Preterm
24 to 63 mg/dL
mean 50 mg/dL
Term
34 to 119 mg/dL
mean 52 mg/dL
Child
40 to 80 mg/dL
CSF glucose/blood glucose:
Preterm
55% to 105%
Term
44% to 128%
Child
50%
Lactic acid dehydrogenase
5 to 30 units/mL
mean 20 units/mL
Myelin basic protein
<4 ng/mL
Pressure: Initial LP (mm H2O):
Newborn
80 to 110 (<110)
Infant/Child
<200 (lateral recumbent position)
Respiratory movements
5 to 10
Protein:
Preterm
65 to 150 mg/dL
mean 115 mg/dL
Term
20 to 170 mg/dL
mean 90 mg/dL
Child:
        Ventricular
5 to 15 mg/dL
Cisternal
5 to 25 mg/dL
Lumbar
5 to 40 mg/dL


REFERENCE
American Heart Association Emergency Cardiovascular Care Committee. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC). Circulation. 2005;112(24 Suppl):IV-167.

Lexi-Comp, Inc. (Pediatric & Neonatal Lexi-Drugs®). Lexi-Comp, Inc.; January 25, 2018.