As you watch your little one snooze (or listen in closely on the baby monitor), it’s easy to worry about every whine, whistle or wheeze you hear, and wonder whether or not it’s normal newborn breathing. Chances are, it is. Newborn breathing sounds very different than it does in older children.
Remember, your little one’s tiny lungs and nose were just introduced to the concept of inhaling air mere weeks ago. Babies breathe through their noses more than their mouths, and their breathing passageways are very small.
As a result, you may hear a lot of noisy breathing or even pauses in breathing. Most of the time, it’s no cause for concern, although certain red flags warrant a call to the doctor. Here’s how to tell what’s up — and why you can probably breathe easy yourself.
What does normal breathing sound like in newborn babies?
A newborn takes about 40 to 60 breaths each minute while awake. A normal breathing rate during newborn sleep is anywhere from 30 to 60 breaths per minute. If a baby breathes faster, it may indicate he’s having some trouble breathing.
Newborn breathing patterns during sleep can also sound irregular, and that’s normal (even if it’s stress-inducing to you). It may stop for 5 to 10 seconds, then start again with a burst of rapid breathing at the rate of 50 to 60 breaths a minute for 10 to 15 seconds, followed by regular breathing before it repeats again.
Your newborn’s skin color should not change with these breathing pauses. It’s also not the same thing as apnea, a more serious condition where breathing stops for at least 20 seconds. You can expect your baby to outgrow this type of breathing, known as normal periodic breathing of infancy, by about 6 months of age.
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To find your newborn’s breathing rate, count the number of times his stomach moves up and down in 30 seconds. One rise and fall equals one breath. Double that number to get the breathing rate per minute.
What causes breathing problems in newborns?
What’s normal, and what’s a symptom of breathing problems in newborn babies? Here’s a guide to the most common breathing variations you’ll hear in newborns and what causes them.
Fast breathing
When a baby’s awake, he can take more than 60 breaths a minute — especially if he’s coming off a crying jag. That’s a lot faster than grown-ups — and it’s perfectly normal. But while an upset baby may be breathing fast, the rate should slow when he stops crying. Continuous rapid breathing indicates a problem.
Periodic breathing
Apnea is a pause in breathing that lasts at least 20 seconds. It may be caused by brain immaturity (seen in preemies), or in babies with heart disease, or neurological, genetic or GI issues. Sometimes, the cause is unclear.
A neonatologist or pulmonologist may recommend medications to stimulate breathing. Most newborns outgrow apnea on their own.
Wheezing
If your baby comes down with a respiratory virus, you may notice noisy or wheezing breathing. This is most likely due to an infection that has settled in your baby’s lungs, a condition known as bronchiolitis. It’s extremely common — about 100,000 babies under a year wind up at the pediatrician with this condition.
If your baby was born prematurely or has lung or heart disease, your pediatrician may recommend steroids or that he receive a monthly shot, called Synagis, during the winter to help prevent respiratory syncytial virus (RSV) infections.
Otherwise, give your little one lots of fluids, try nasal saline drops and use a bulb syringe to help relieve congestion.
Grunting
You may wonder why your newborn grunts, usually as he exhales. A lot of snorts and grunts happen because babies are nose-breathers. That’s a good thing since it makes it possible for them to breathe and nurse at the same time.
But persistent grunting actually can indicate something serious: It’s his body’s way to try to keep air in his lungs to build up the oxygen level. Contact your pediatrician right away.
Whistling
It’s normal for some newborns to sound wheezy. You may hear this when your baby inhales, exhales or both. When it happens, it’s called stridor, and is due to a narrowed airway.
It’s very common in newborns because their airways are so tiny even a small blockage can make it harder to breathe. The most common cause in newborns is laryngomalacia, a condition where throat tissues are so soft, they flop into the airway. It usually resolves by the time your child turns 2 years old.
Barking cough
This is often due to croup, an illness usually caused by a respiratory virus. Croup causes throat tissues to become swollen and makes it harder for air to get into the lungs. It typically gets worse at night.
You can help relieve this by bringing baby outside into the cold air, or inside to a humid area (think a hot steamy shower). In severe cases, your little one may need steroid treatment.
What to call a doctor for your newborn’s breathing
You may wonder when you should worry about your baby’s breathing. There are some signs that your newborn isn’t getting enough air. If you notice any of the below, call 911 or head to the emergency room.
- Fast breathing (more than 60 breaths per minute) that doesn’t slow down when he’s calm
- Persistent grunting when he exhales
- Flaring nostrils
- Bluish coloring around the lips, eyes, hands or feet (including the nail beds) that doesn’t go away.
- Pauses between breaths that last longer than about 10 seconds
- Your baby’s chest pulls in with each breath, especially around the collarbone and ribs
A shifting repertoire of baby sneezes, squeaks and snorts is par for the course when it comes to a newborn baby — and not an indication of anything to be concerned about. Chances are, your baby’s symphonic breathing is perfectly fine. Try taking a deep “om” inhalation yourself, and call your pediatrician with any concerns.
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