Babies sometimes appear to “forget to breathe” while feeding, which can be unsettling for new parents. This common phenomenon, characterized by momentary pauses, gasping, or sputtering during feeding, often triggers alarm. This article explains why this happens, the physiology involved, and offers guidance for parents.
Understanding Infant Feeding and Breathing Coordination
Infants coordinate sucking, swallowing, and breathing, a complex process still developing in newborns. This coordination is essential for safe feeding, ensuring milk enters the stomach, not the airway. Typically, a baby coordinates one suck, one swallow, and one breath, though this ratio can vary. The soft palate lifts during swallowing, closing the nasal passage to prevent liquid entry.
Temporary pauses or gasping are normal developmental occurrences. They can result from immature oral motor skills or a protective reflex where the infant momentarily stops breathing to prevent aspiration. Fast milk flow, from breast or bottle, can also overwhelm a baby’s coordination, causing coughing or sputtering. Babies may also experience periodic breathing: short pauses up to 10 seconds, followed by rapid breaths, typically during sleep, resolving by six months.
Recognizing Signs and Immediate Actions
Struggling with breathing during feeding may appear as gasping, sputtering, or coughing, sometimes with a wide-eyed look or momentary breathing cessation. Milk might also leak from the nose or mouth. While brief pauses are normal, parents should observe for signs of distress. Consistent struggle can indicate milk flow is too fast.
If a baby chokes or gags, respond calmly and immediately. Gently repositioning them to a more upright posture can help clear their airway. Pausing the feed and allowing burping can also provide relief and help regulate breathing. Observe the baby’s color; if lips or skin turn blue, it indicates a lack of oxygen and requires urgent action.
Strategies for Safer Feeding
Specific strategies can minimize feeding difficulties and promote smoother breathing. Proper feeding positions significantly impact a baby’s ability to coordinate sucking, swallowing, and breathing. Holding the baby semi-upright or upright, with head and shoulders elevated, helps prevent choking and allows gravity to assist milk flow. For breastfeeding parents, laid-back nursing positions, where the parent reclines and the baby lies tummy-to-tummy, can help control milk flow, especially with a strong let-down.
For bottle-fed infants, paced bottle feeding mimics breastfeeding’s natural rhythm, allowing the baby to control flow and take breaks. This method uses a slow-flow nipple, holding the bottle horizontally and tipping it only enough to fill the nipple halfway. Parents can pause by tilting the bottle downwards after a few continuous swallows, letting the baby signal readiness to resume. Ensuring a deep latch, whether at breast or bottle, is important for effective milk transfer and reduced air intake. Frequent burping during and after feeds releases swallowed air, preventing discomfort and breathing interference.
When to Seek Medical Attention
While many instances of a baby struggling to breathe during feeding are transient and related to developmental immaturity, certain signs warrant immediate medical evaluation. Contact a pediatrician if the baby frequently has prolonged breathing pauses, especially those lasting over 10 seconds. A baby consistently turning blue around the mouth or face, or experiencing a bluish tint to their skin, lips, or fingernails, indicates a serious lack of oxygen and requires urgent attention.
Other concerning symptoms include extreme lethargy or difficulty waking after feeding, poor weight gain despite adequate feeding, or repeated forceful vomiting. If a baby seems too breathless to feed, if their breathing rate is consistently fast (over 60 breaths per minute), or if they show signs of increased effort like flaring nostrils, grunting, or pulling in of the muscles between the ribs, medical consultation is advised. Trust parental instincts; if persistent concern about the baby’s feeding or breathing exists, seeking professional medical advice is always appropriate.