Observing a newborn’s breathing can be a source of worry for new parents. The subtle variations in a baby’s respiratory patterns, including movements like nostril flaring, often prompt concern and a search for clarity. Understanding these breathing nuances is important for distinguishing between normal infant behavior and potential signs of distress.
Normal Newborn Breathing Patterns
Newborns exhibit breathing patterns that differ significantly from older children and adults. A healthy newborn breathes between 40 to 60 times per minute while awake, slowing to 30 to 40 breaths per minute during sleep. Their breathing is often shallow and can appear irregular.
One common characteristic is periodic breathing, where a baby may breathe rapidly for a short period, then pause for 5 to 10 seconds before resuming. These pauses are usually followed by a few quick breaths. Such irregular patterns are considered normal, especially during deep sleep, and generally resolve as the baby matures, typically by six months of age. Slight, intermittent nostril flaring can sometimes be observed during active sleep or crying, as newborns are obligate nose breathers. This flaring, when not accompanied by other signs of struggle, is a normal variation.
When Nostril Flaring Signals Concern
Nostril flaring occurs when a baby’s nostrils widen with each inhaled breath. While a mild, occasional flare might be normal, persistent, pronounced, or continuous nostril flaring indicates a newborn is working harder to breathe.
Continuous or significant nostril flaring suggests the baby is not getting enough oxygen. This symptom should not be disregarded, as it can be a sign of respiratory distress. It suggests the body is attempting to reduce airway resistance to facilitate breathing.
Other Signs of Respiratory Distress
Beyond concerning nostril flaring, several other signs indicate a newborn is struggling to breathe. Retractions are when the skin pulls inward between the ribs (intercostal), below the rib cage (subcostal), or above the collarbones (supraclavicular) with each breath. These movements show the baby is using accessory muscles to force air into the lungs due to increased breathing effort.
Grunting is a short, low-pitched sound made during exhalation. This grunting attempts to keep air in the lungs, preventing them from collapsing fully. Rapid or labored breathing, consistently over 60 breaths per minute even when calm or sleeping, also signals distress.
Cyanosis, a bluish discoloration of the skin, lips, tongue, or nail beds, indicates insufficient oxygen in the blood. While peripheral cyanosis (bluish hands and feet) can sometimes be normal, central cyanosis (blue around the mouth, head, or torso) is always a medical concern. Changes in activity level, such as unusual lethargy, difficulty waking, or inconsolable irritability, can also be subtle signs of respiratory distress.
When to Seek Professional Help
Parents should seek immediate medical attention if they observe any persistent or worsening nostril flaring in their newborn. The presence of other signs of respiratory distress, such as retractions, grunting, or continuously rapid breathing, also warrants prompt evaluation. If a baby’s skin, lips, or tongue appear bluish, this requires emergency care.
Changes in a newborn’s alertness, feeding patterns, or overall behavior, particularly when combined with breathing concerns, indicate a need for medical consultation. Trusting parental instincts is important; if something feels wrong about a baby’s breathing, contact a healthcare provider without delay.