New parents often worry about their baby’s irregular breathing patterns and whether a newborn can intentionally hold their breath. Newborns cannot voluntarily hold their breath, a capability that requires neurological control they have not yet developed. A newborn’s breathing is governed by the primitive, involuntary functions of the central nervous system, meaning any pauses in respiration are reflexive, not deliberate. Understanding the difference between these normal, temporary respiratory pauses and more serious medical conditions helps ease parental anxiety.
The Truth About Newborn Respiration
The control center for breathing resides in the brainstem, part of the central nervous system (CNS), which is still developing in infants. Newborn respiration is an automatic process, driven by the body’s need to maintain oxygen and carbon dioxide levels, making conscious breath manipulation impossible. This immaturity means the infant’s breathing pattern is inherently irregular and highly reactive.
A common and normal phenomenon is “periodic breathing,” characterized by cycles of short pauses followed by rapid, shallow breaths. These pauses typically last five to ten seconds, and the subsequent rapid breathing (tachypnea) is the body’s way of catching up on oxygen intake. Periodic breathing is a normal variation of the developing respiratory control system, especially during sleep, and generally resolves by six months of age. The respiratory rate of a newborn is rapid, ranging from 30 to 60 breaths per minute.
Common Triggers for Involuntary Pauses
While newborns cannot deliberately stop breathing, intense stimuli can trigger a temporary, reflexive interruption in the respiratory cycle. These interruptions are not medical emergencies but involuntary responses to overwhelming sensory or emotional input. They are distinct from periodic breathing because they are linked to a specific, immediate trigger.
One example is the “breath-holding spell,” which most commonly begins between six and eighteen months but can occur earlier in response to a sudden shock or pain. During an intense crying fit, a baby may exhale forcefully and then reflexively fail to inhale for a few moments. This involuntary response is a result of the autonomic nervous system’s reaction to the stimulus. The pause is typically brief, and the baby will spontaneously resume breathing once the reflex resets.
Understanding Infantile Apnea
A pause in breathing exceeding the normal ten-second duration of periodic breathing is defined as apnea, a medical concern. Infantile apnea is officially defined as a cessation of breathing lasting 20 seconds or longer, or a shorter pause accompanied by specific physiological changes. These changes include a drop in heart rate (bradycardia) or a change in skin color, such as paleness or a bluish tint (cyanosis).
The two main categories of apnea are Apnea of Prematurity (AOP) and Apnea of Infancy (AOI). AOP is far more common, especially in babies born before 34 weeks of gestation. Apnea is classified into three types based on its cause: central, obstructive, and mixed. Central apnea occurs when the central nervous system fails to signal the respiratory muscles to initiate a breath. Obstructive apnea involves a physical blockage of the airway, while mixed apnea combines both central and obstructive causes.
Identifying Signs That Require Medical Attention
While short, normal pauses are harmless, parents must be aware of specific warning signs that signal a need for immediate medical intervention. Any pause lasting longer than 20 seconds is a clear indication that the infant requires immediate attention. A pause of this duration suggests the respiratory drive failed to restart, which can quickly lead to oxygen deprivation.
Other red flags include significant color changes, such as the baby’s lips, tongue, or skin turning dusky or blue, indicating a low oxygen level in the blood. If the infant becomes limp, unresponsive, or exhibits severe difficulty breathing—characterized by flaring nostrils or the chest sinking in with each breath—emergency services should be contacted immediately. These signs suggest a serious underlying respiratory or systemic issue.