Breathing through the nose is the natural and preferred method for infants, designed to filter, warm, and humidify the air before it reaches the lungs. Newborns are considered obligate nose breathers, meaning they breathe almost exclusively through their nose during the first few months of life. If a baby consistently breathes through their mouth instead of their nose, it often signals an underlying issue causing an obstruction in the nasal passages. Encouraging the return to a nasal breathing pattern helps ensure the proper intake of oxygen and supports healthy development.
Recognizing Infant Mouth Breathing and Its Effects
Identifying chronic mouth breathing involves simple observation, particularly when the baby is asleep or at rest. A persistent open-mouth posture, where the lips are parted without tension, is the most obvious sign that a baby is breathing orally. Other indicators include frequently chapped or dry lips and a dry mouth upon waking, which results from the constant passage of air.
Mouth breathing can also be associated with noisy breathing, such as snoring or snorting, which suggests resistance in the airway. Parents may notice frequent waking, restlessness, or a lack of deep, restorative sleep, as the baby struggles to maintain consistent airflow. This poor sleep quality can lead to irritability and fussiness during waking hours.
Bypassing the nose’s filtering mechanism means that unconditioned air, containing dust and irritants, enters the body directly. A dry mouth environment reduces the protective function of saliva, which can increase the risk of oral health issues like gingivitis and tooth decay as the child grows.
Common Underlying Causes of Nasal Blockage
The primary reason an infant resorts to mouth breathing is a physical inability to draw sufficient air through the nose, usually due to nasal blockage. The most frequent cause is temporary congestion caused by common viral infections, such as a cold or respiratory syncytial virus (RSV). These illnesses cause inflammation and swelling of the nasal tissues, leading to increased mucus production that obstructs the small nasal passages.
Allergies to environmental factors like pollen, dust mites, or pet dander can trigger persistent nasal congestion. Allergic rhinitis causes swelling of the turbinates, making it difficult for air to pass through. Exposure to environmental irritants, such as tobacco smoke or strong odors, may similarly irritate the nasal lining and contribute to chronic stuffiness.
For chronic, non-cold-related obstruction, a blockage in the upper airway is often the mechanism. Enlarged adenoids or tonsils are a common medical cause, as these tissues sit near the back of the nasal and throat passages and can swell, blocking the airway. Less common are structural issues present from birth, such as a deviated septum or choanal atresia, where the back of the nasal passage is blocked by bone or tissue.
Practical Home Strategies to Encourage Nasal Breathing
Home strategies focus on keeping the nasal passages clear and supporting the natural function of the nose. Using a cool-mist humidifier in the baby’s room can help by adding moisture to the air, which thins mucus and soothes irritated nasal lining. This is especially helpful in dry climates or during winter months when indoor heating can dry out the air.
Managing congestion involves using saline solutions and nasal aspiration devices. A few drops of saline spray or mist into each nostril helps to loosen and thin the mucus. After waiting a minute or two, a bulb syringe or similar nasal aspirator can be used to gently remove the loosened secretions, clearing the path for nasal airflow.
Positioning can also offer temporary relief, though safe sleep guidelines must always be followed strictly. While babies must always be placed on their back for sleep on a firm, flat surface, keeping the baby in an upright position after feedings can help reduce spit-up, which sometimes contributes to nasal congestion. If medically advised for congestion, the head of the crib mattress may be slightly elevated by placing an object under the mattress.
If mouth breathing is purely habitual and not due to physical obstruction, gentle reminders can encourage a closed-mouth resting posture. Parents can gently lift the baby’s chin to close their mouth when they notice it hanging open during rest or sleep, holding the lips closed for a moment to encourage a lip seal. Optimizing feeding, especially breastfeeding, encourages the engagement of oral and facial muscles, promoting nasal breathing and proper jaw development.
When to Consult a Pediatrician or Specialist
Parents should seek medical advice when home strategies fail to resolve mouth breathing or when other concerning symptoms are present. Persistent mouth breathing that continues despite efforts to clear congestion is a clear trigger for a consultation. It suggests that the underlying cause may be structural or chronic rather than temporary.
Immediate contact with a doctor is necessary if the baby shows signs of respiratory distress, such as rapid breathing, flaring nostrils, or pauses in breathing during sleep. Chronic congestion that is not associated with a cold, or noisy breathing like loud snoring, may indicate a more significant issue, such as sleep-disordered breathing.
Consultation is also warranted if mouth breathing is accompanied by difficulty feeding, poor latching, or poor weight gain, as the baby may struggle to breathe and feed simultaneously. The pediatrician may investigate causes like enlarged adenoids or tonsils, or refer the baby to a specialist, such as an Ear, Nose, and Throat (ENT) doctor. Further evaluation might include allergy testing or a sleep study to diagnose breathing disorders.