Infant breathing patterns differ significantly from adults, often causing confusion for parents. Understanding these unique patterns and recognizing deviations is important. This article clarifies typical infant breathing and highlights specific signs indicating a baby may need medical attention.
Understanding Typical Infant Breathing
Infants exhibit breathing patterns distinct from older children and adults. A newborn typically breathes much faster, with a normal respiratory rate ranging from 30 to 60 breaths per minute while awake, slowing to 30 to 40 breaths per minute during sleep. This rapid breathing is normal as their respiratory systems are still developing.
Babies commonly display irregular breathing patterns, including occasional pauses known as periodic breathing. This involves periods of rapid breathing followed by pauses, typically lasting up to 10 seconds. These brief pauses are usually harmless and resolve as the infant matures.
Newborns often make various sounds while breathing, such as snorts, squeaks, gurgles, or sighs. These noises can stem from residual fluid in their nasal passages after birth or their still-developing airways. Infants are primarily “belly breathers,” meaning their abdomen will noticeably rise and fall with each breath, as their diaphragm is the main muscle they use for respiration.
Key Signs of Breathing Distress
An increased respiratory rate beyond typical rapid breathing, such as consistently more than 60 breaths per minute in infants under two months, indicates the baby is working harder to get enough air.
Nasal flaring, where nostrils widen with each breath, is a visual cue a baby is struggling to breathe.
Retractions appear as the pulling in of skin around the ribs, breastbone, or collarbone with each breath. These can be intercostal (between the ribs), subcostal (below the ribs), suprasternal (above the breastbone), or supraclavicular (above the collarbone), indicating the use of accessory muscles to draw air into the lungs. Their presence at rest signifies the baby is exerting considerable effort to breathe.
Grunting is a short, low-pitched sound made at the end of exhalation, as if the baby is trying to keep air in their lungs. While occasional grunts are normal, continuous grunting with every breath indicates respiratory distress. Wheezing, a high-pitched whistling sound typically heard during exhalation, suggests narrowed lower airways. Stridor, a harsh, high-pitched sound usually heard during inhalation, indicates an upper airway obstruction.
Bluish discoloration of the lips, tongue, or skin (cyanosis) is a serious emergency, indicating dangerously low oxygen levels. While peripheral blueness of hands and feet (acrocyanosis) can be normal in newborns, central cyanosis (around the mouth, head, torso) is never normal and requires immediate attention.
If a baby becomes unusually sleepy, limp, or difficult to rouse (lethargic or unresponsive), it is a serious concern. Prolonged pauses in breathing (apnea) lasting longer than 15-20 seconds are also concerning and differ from normal periodic breathing. These signs indicate the baby is working too hard to breathe and potentially not getting sufficient oxygen.
Knowing When to Get Medical Help
Certain signs warrant immediate emergency attention. If a baby’s lips, tongue, or skin appear bluish, or if there is severe pulling in of the chest (retractions), emergency care is necessary.
Other critical signs requiring an immediate call to emergency services or a visit to the emergency room include prolonged pauses in breathing (apnea) lasting longer than 15-20 seconds, or if the baby becomes unresponsive, extremely floppy, or difficult to awaken. Delaying medical attention can have serious consequences.
For less severe but still concerning symptoms, contacting a pediatrician for advice is appropriate. This includes persistent mild-to-moderate retractions, continuous grunting, or a consistent fast breathing rate without other severe distress signs. Any changes in feeding or activity associated with altered breathing patterns also warrant a call to the doctor. Parents should trust their instincts; if concerned about a baby’s breathing, seeking professional medical advice is the best course of action.