Pneumonia is an infection causing inflammation in the lungs, specifically affecting the small air sacs called alveoli. With pneumonia, these sacs become blocked with fluid or pus, severely limiting oxygen intake. This condition is serious for babies because their small airways are easily obstructed, and their developing immune systems struggle to fight the infection. Recognizing the subtle signs of respiratory distress in an infant is paramount for quick diagnosis and successful treatment.
Specific Audible Indicators of Distress
One noticeable sound of respiratory distress is grunting, a short, low sound made during exhalation. This occurs because the baby briefly closes the vocal cords, attempting to create positive pressure in the lungs. This effort helps keep the air sacs from collapsing and improves oxygen transfer.
A rapid or shallow breathing rate, termed tachypnea, is another sign. For infants under two months old, a rate over 60 breaths per minute is abnormal. For babies between two and eleven months, a rate exceeding 50 breaths per minute is generally considered abnormal. Parents can count the breaths in a full minute while the baby is calm to determine this rate.
A high-pitched whistling sound, or wheezing, may be heard as the baby breathes out, indicating a narrowing of the lower airways. Stridor is a high-pitched sound heard primarily when breathing in, suggesting an obstruction higher up in the throat or windpipe. A wet or productive cough, which sounds heavy and may bring up mucus, often accompanies pneumonia.
Visual and Behavioral Symptoms to Watch For
The increased effort required to breathe often manifests as visible signs of muscle strain. One sign is retractions, where the skin visibly sinks in between the ribs (intercostal), below the rib cage (subcostal), or above the collarbone (suprasternal) with each breath. These retractions demonstrate the infant is using accessory muscles to pull air into the lungs.
Nasal flaring is another visual indicator where the nostrils widen with every inhalation, reflecting the infant’s attempt to reduce airway resistance and maximize air intake. Behavioral changes are also telling. Lethargy and poor feeding are common symptoms because the baby expends significant energy on breathing.
While fever is a common sign of infection, infants, especially newborns, may present with a low body temperature, or hypothermia, which is also serious. A change in the baby’s skin color, such as paleness or a grayish tint, is a subtle sign of reduced oxygen.
When Immediate Medical Attention is Necessary
Certain signs indicate that the infant is in severe respiratory distress and requires immediate emergency intervention. Any appearance of cyanosis—a bluish tint around the lips, tongue, or nail beds—signals a dangerously low level of oxygen in the bloodstream. This is a life-threatening symptom that demands urgent medical care.
Difficulty waking the baby, extreme limpness, or a significant change in alertness should also be treated as an emergency. These changes in consciousness can signal that the brain is not receiving sufficient oxygen. Additionally, any pause in breathing (apnea) or sustained periods of very rapid, shallow breathing that interfere with feeding or crying are high-risk indicators.
If the infant is under three months old and has a fever over 100.4°F (38°C), or exhibits severe retractions, uncontrolled grunting, or wheezing, seek emergency medical attention without delay. Any concern about a baby’s breathing warrants a call to a healthcare provider.