Ten fingers. Ten toes. A pair of blue eyes, or maybe brown eyes. Babies, who are, after all, human, have a lot in common with adults. On the other hand, so much is different. Yet, it’s precisely these differences to prompt new parents to wonder if everything is normal. And one trait that frequently gets them to ask that question is the baby’s breathing.
Infant caregivers may undergo some distress when they hear noisy baby breathing. And what they see when they look at a sleeping baby can be as concerning as what they hear. Is the breathing too deep? Too shallow? Is the chest moving all right? And—right there, see it? She looked like she stopped breathing altogether!
Fortunately, as concerning as these events may be, they can be pretty normal in a majority of babies. Let’s look at why our youngest patients breathe the way they do before talking a little more about a couple of the behaviors noted above.
Breathing’s Different in Babies
How is baby breathing unique? Let me count the reasons:
- Infant nasal passages are smaller than those of oldsters. This can lead to some interesting breathing noises. Think of blowing into a bottle to make a noise as opposed to trying to do the same thing by blowing into a jar.
- The respiratory muscles of our youngest are less well developed.
- Immature brains are wired differently. Since breathing is controlled by the brain, it makes sense that babies’ respiratory patterns would be different.
Now, some breathing patterns you might see or hear in infants are not normal and can spell trouble. We’ll talk about some warning signs, and it also makes sense to call your baby’s provider anytime his breathing concerns you. But let’s talk a little more about some usually normal patterns you might see—or hear.
Those Breathing Noises!
Whether on a monitor or live and in person, babies can be noisy breathers. Most of it is due to that air movement through little nasal passages. Sometimes, gently clearing mucus out of the nose with a suction bulb—perhaps using a couple of saline nose drops, which are available over the counter—is helpful. But if she’s sleeping comfortably, you may not need to do that!
Another somewhat harsher sound you might hear is due to something called laryngomalacia. In this condition, parts of the larynx, or “voice box,” are soft. They can collapse when the baby breathes in, causing the noise. In most cases, this resolves on its own as the baby gets older. However, it’s worth having her provider take a look at the behavior. (Hint: this is a situation where providers love cellphones in the office! Infants rarely perform the concerning behavior in the office, so it’s definitely worth taking a video.) Severe cases of laryngomalacia may need treatment, and other things, like birth defects or gastroesophageal reflux disease, may need to be ruled out.
Periodic Breathing: Periodic Worry?
Parents might get concerned if they notice any of the following behaviors in their new arrival:
- Periods of fast, deep breathing.
- Periods of slow, shallow breathing.
- Periods of NO breathing (under 15 seconds).
You might see a pattern here. Actually, these three events, one after the other, constituted something that’s very common in young infants. It’s known as periodic breathing, and it’s totally normal.
OK, Then, When Should I Be Concerned?
Generally, if the baby looks and feeds well, he’s probably OK. But there are breathing behaviors that should prompt a call to your little one’s provider, or, in some cases, a trip to the local emergency room. Here are some reasons to be concerned:
- The baby is not feeding well.
- His respiratory rate—the number of times he breathes in and out per minute—is too high. Newborns shouldn’t have a respiratory rate above 60 when sleeping; older infant normally max out at about 45. (Check his clothing and bedding and the room’s temperature, because overheating is a cause of rapid breathing in infants.)
- He stops breathing for longer than 15 seconds. NOTE: never shake a baby to start her breathing again!
- He is not his usual color, particularly if he has a grayish or bluish appearance.
- He has other signs of illness, such as a fever or cough.
- His breathing movements look unusual, especially if they are different than they were before. Babies do use their stomach muscles to breathe, but the movements should be fairly small. And he shouldn’t have nasal flaring (nostrils going in and out) or pulling in of the spaces between the ribs.
- His neck isn’t moving well, or he can only breathe in certain positions.
Pediatricians have seen a lot of infant breathing patterns. When it’s your child, everything is happening for the first time. It’s never a bad idea to call for advice or a look (and remember that video!), and there are certainly situations where it may be helpful or even lifesaving. But knowing about what’s usually normal breathing in an infant just might have you, the parent, breathing a little easier!
