Newborn breathing patterns differ significantly from older children or adults, often causing anxiety about what is normal and when fast breathing signals a serious issue. This article clarifies these differences, helping parents understand typical newborn breathing and when it warrants closer attention.
Understanding Normal Newborn Breathing
Newborns breathe significantly faster than older individuals, typically taking between 40 to 60 breaths per minute while awake. This rate can slow down to about 30 to 40 breaths per minute during sleep. Their breathing patterns are frequently irregular, characterized by periods of faster breathing followed by slower rates, and even short pauses. These brief pauses, lasting around 5 to 10 seconds, are a normal phenomenon known as periodic breathing.
Newborns are obligate nose breathers, meaning they primarily breathe through their noses. Their smaller lungs and less developed respiratory muscles contribute to their naturally faster breathing. The respiratory system continues to mature after birth, with lungs not fully developing until around eight years of age, meaning their breathing can often appear quick or uneven.
Common Non-Concerning Reasons for Fast Breathing
Several benign and temporary situations can cause a newborn to breathe faster. When a baby cries, feeds, or becomes excited, their breathing rate naturally increases. Being too warm can also lead to faster breathing as the body attempts to regulate its temperature. These instances are typically short-lived, with breathing returning to its normal pattern once the activity or condition subsides.
During active sleep, also known as REM sleep, a newborn’s breathing can become irregular and rapid. This is part of their natural sleep cycle, where short pauses may be followed by bursts of faster breathing before settling back to a regular pace. This phenomenon, periodic breathing, is common and usually harmless, with most babies outgrowing it within their first few months.
When Fast Breathing Signals a Concern
While some fast breathing is normal, certain signs indicate it may be a symptom of an underlying medical problem. If a newborn breathes consistently faster than 60 breaths per minute, especially when calm or sleeping, it can be a cause for concern. Other indicators of respiratory distress include nasal flaring, where the nostrils widen with each breath, and retractions, visible pulling in of the skin between the ribs, below the breastbone, or above the collarbones. A grunting sound during exhalation can also signal breathing difficulty.
Bluish discoloration of the lips, tongue, or skin, known as cyanosis, indicates that the baby is not receiving enough oxygen. Several conditions can cause these concerning breathing patterns.
Conditions Causing Fast Breathing
Transient tachypnea of the newborn (TTN) occurs when excess fluid remains in the lungs after birth, leading to rapid, labored breathing that typically resolves within 24 to 48 hours. Respiratory infections such as Respiratory Syncytial Virus (RSV), bronchiolitis, and pneumonia can also cause fast breathing. These infections often present with cold-like symptoms that worsen, leading to increased breathing effort, wheezing, and sometimes poor feeding. Sepsis, a serious systemic infection, can manifest as fast breathing alongside symptoms like fever or low body temperature, lethargy, and poor feeding. In some cases, congenital heart defects may also contribute to rapid breathing due to inefficient oxygen circulation.
Knowing When to Seek Medical Help
Parents should seek immediate medical attention if their newborn exhibits bluish discoloration of the lips, tongue, or fingernails. Pauses in breathing lasting longer than 20 seconds also require urgent evaluation. Signs of significant respiratory distress, such as severe retractions, grunting, or persistent nasal flaring, are red flags.
If the baby is unusually lethargic, unresponsive, or difficult to wake, or if they are feeding poorly with reduced wet diapers, these symptoms warrant prompt medical consultation. A fever, especially a rectal temperature of 100.4°F (38°C) or higher in an infant under three months old, should also prompt a call to the pediatrician.