Monitoring a newborn’s breathing pattern is fundamental to assessing their overall well-being. Unlike older children and adults, a newborn’s respiratory system is still developing, resulting in a breathing style that can seem fast and irregular. Understanding the expected parameters for a healthy infant’s breathing is necessary for recognizing when medical attention may be needed.
The Expected Normal Respiratory Rate
The expected range for a healthy, resting newborn’s respiratory rate is significantly higher than that of an older person, typically falling between 40 and 60 breaths per minute. This rate must be measured when the baby is calm, as crying or activity will cause a temporary increase in breathing speed. The faster rate is a physiological adaptation necessary due to the infant’s smaller lung capacity and high metabolic needs.
Newborns have a high rate of oxygen consumption relative to their body size because they are growing rapidly. Because their lungs are small and their chest wall is pliable, they take shallower breaths than adults. To compensate for the smaller volume of air, the infant must breathe more often to ensure adequate oxygen delivery and carbon dioxide removal.
The respiratory rate naturally slows down as the infant matures; a sleeping newborn may breathe closer to 30 breaths per minute. This rate is a baseline for a baby who is not distressed, crying, or experiencing a fever. A consistently high rate, especially above 60 breaths per minute when the baby is calm, signals that the baby is working harder than normal to breathe.
Practical Monitoring: Counting and Recognizing Normal Patterns
To accurately determine a newborn’s respiratory rate, count the breaths for a full 60 seconds. A single breath is counted as one cycle of the chest or abdomen rising and falling. Perform this check when the baby is asleep or quiet, as movement and crying will skew the true resting rate.
Because infants are considered “belly breathers,” observing the movement of the abdomen is the clearest way to count the breaths. Their primary breathing muscle, the diaphragm, is more active than the chest muscles. Using a hand placed gently on the baby’s stomach or watching the rise and fall of their clothing helps track the rhythm.
Newborns also exhibit “periodic breathing,” which is considered normal but can concern new parents. This pattern involves the baby taking several rapid, shallow breaths, followed by a short pause lasting up to 10 seconds, before returning to faster breathing. This reflects an immature respiratory control center in the brain.
A pause in breathing should not last longer than 10 seconds, even during periodic breathing. If the baby’s skin color remains normal and there are no other signs of distress during these short pauses, the pattern is not a cause for concern. Familiarizing oneself with a healthy, relaxed breathing pattern establishes a baseline for noticing potential changes.
Identifying Signs of Respiratory Distress
Recognizing signs that a newborn is struggling to breathe requires looking beyond the respiratory rate. The baby may be in respiratory distress if the rate is consistently very fast (more than 60 breaths per minute) or extremely slow (less than 30 breaths per minute) while at rest. These abnormal rates suggest the body is having difficulty maintaining adequate oxygen levels.
Several physical signs indicate the baby is using extra muscles to move air, which is a significant warning sign. Nasal flaring occurs when the nostrils widen with each inhalation to take in more air. Retractions appear as the skin pulling inward under the rib cage, between the ribs, or above the collarbone with each breath.
An audible grunting sound accompanying exhalation is an indicator of distress, as the baby tries to keep air in the lungs to improve oxygen exchange. A change in skin color, known as cyanosis, is a serious sign where a bluish or grayish tint appears around the lips, tongue, or nail beds, showing a lack of oxygen saturation.
If these signs (retractions, grunting, or color changes) are observed, immediate medical attention is warranted. Caregivers should contact a pediatrician or seek emergency care if the baby is displaying any combination of these symptoms. A baby who is limp, lethargic, or having trouble feeding may also be experiencing breathing difficulty.