Dr. Tariq Jagnarine

Newborns often make unusual noises while breathing. Most of those noises are no cause for concern; however, being aware of a baby’s typical breathing pattern can help to identify any concerns early.
A newborn’s breathing looks and sounds different from those of adults because:
* They breathe more through their nostrils than their mouth.
* Their breathing pathways are much smaller and easier to obstruct.
* Their chest wall is more pliable than an adult’s because it’s made of mostly cartilage.
* Their respiration isn’t fully developed, since they still must learn to use their lungs and the associated breathing muscles.
* They may still have amniotic fluid and meconium in their airways right after birth.

Usually, there’s nothing to worry about, but parents and caregivers may worry anyway. They need to pay careful attention to a newborn’s typical breathing pattern; in this way, they can learn what’s usual for the newborn.

Typically, a newborn takes 30 to 60 breaths per minute. This can slow down to 30 to 40 breaths per minute while they sleep. At 6 months, babies breathe about 25 to 40 times per minute. An adult, meanwhile, takes about 12 to 20 breaths per minute.
Newborns can also take rapid breaths, then pause for up to 10 seconds at a time. All of this is very different from an adult’s breathing pattern, which is why new parents might be alarmed. Within a few months, most of the irregularities of newborn breathing resolve themselves.
Some newborn breathing concerns are more common in the first few days, such as transient tachypnea. But after 6 months, most breathing concerns are probably due to allergies or a short-term illness like the common cold.

Parents must become familiar with their baby’s typical breathing sounds and patterns in order to be able to discern if something sounds different. Respiratory distress is one of the most common causes of neonatal intensive care hospital admittance, according to 2020 research.
The following are common sounds you might hear, and their potential causes.

* Whistling noise
This might be a blockage in the nostrils, that will clear when it’s suctioned (removed). Ask a pediatrician how to gently and effectively suction mucus.

* Hoarse cry and barking cough
This noise may be from a windpipe blockage. It might be mucus or inflammation in the voice box, such as croup. It can be a sign of croup; in which case it may get worse at night.

* Deep cough
This is likely a blockage in the large bronchi. Large bronchi are tubes that carry air between the windpipe and the lungs. A doctor would need to listen with a stethoscope to confirm this diagnosis.

* Wheezing
Wheezing can be a sign of blockage or narrowing of the lower airways. The blockage might be caused by:
o Asthma
o Pneumonia
o Respiratory syncytial virus
o Fast breathing
This can mean there’s fluid in the airways from an infection such as pneumonia. Fast breathing can also be caused by fever or other infections, and should be evaluated right away.

* Snoring
This is usually due to mucus in the nostrils. In rare cases, snoring can be a sign of a chronic condition, such as sleep apnea or enlarged tonsils.

* Stridor
Stridor is a constant, high-pitched sound that indicates airway obstruction, according to 2021 research. It can sometimes be caused by laryngomalacia.

* Grunting
A sudden, low-pitched noise on an exhale usually signals an issue with one or both lungs. It can also be a sign of severe infection. You should visit a doctor immediately if your baby is ill and is grunting while breathing.

* Frequent sneezing
Sneezing is common in newborns, and is not usually cause for concern.
This is because newborns have smaller nasal passages than adults, and are still adjusting to breathing through their noses as they grow and develop.
If sneezing is accompanied by other symptoms, like coughing, difficulty breathing, or a fever, parents should talk with a doctor. It could be a sign of a respiratory infection. Frequent sneezing can also be a sign of an allergy to certain types of formula, as well as neonatal abstinence syndrome.

* Periodic breathing
Periodic breathing is common in newborns. It is characterised by pauses in breathing that last at least 3 seconds, followed by clusters of breaths, which are often fast and shallow. This is typical, and doesn’t usually require any treatment. However, if pauses in breathing last more than 20 seconds, it may indicate a problem, such as infant apnea.

* False “first cold”
Many newborns seem to experience symptoms of a false first cold very early, which occurs because their nasal passages are very small and can become easily clogged. Though this doesn’t usually require any treatment, parents may consider talking with a paediatrician about ways to help improve the newborn’s breathing if needed, such as using saline drops or a nasal aspirator.

* Hiccups
Hiccups are common, and can happen in babies, children and adults. Eating too quickly and swallowing air while feeding are two possible causes of hiccups in newborns. Hiccups may also be a symptom of gastroesophageal reflux, which occurs when the contents of the stomach flow into the esophagus, causing regurgitation.

Never hesitate to reach out to a doctor if concerned about a baby’s breathing. Irregular breathing can be very alarming, and may cause anxiety in parents or caregivers. But first, slow down and look at your baby to see whether they look like they’re in distress.

o Learn a child’s typical breathing patterns, so you’re better prepared to identify what’s not typical.

o Take a video of a baby’s breathing and show it to a doctor.

o Always have a baby sleep on their back. This decreases the baby’s risk of sudden infant death syndrome (SIDS).

o Saline drops, sold over the counter at drugstores, can help loosen thick mucus.

o Sometimes babies breathe fast when they’re overheated or upset. Clothe a baby in breathable fabrics.

o Sleep positioners and wedges are not recommended while feeding or sleeping.

Catching an issue early gives a baby the best chance for recovery in the short term, and decreases future concerns. A change in a newborn’s breathing pattern may indicate a serious breathing problem. If concerned, call your doctor right away. Doctors may use a chest X-ray to diagnose breathing concerns, and make a treatment plan.

o Blue colour appears in lips, tongue, fingernails and toenails.
o Doesn’t breathe for 20 seconds or more.
o Grunting or moaning at the end of each breath.
o Nostrils flaring, which means they’re working harder to get oxygen into their lungs.
o Muscles pulling in on the neck, around collarbones, or ribs.
o Difficulty feeding in addition to breathing issues.
o Lethargic in addition to breathing issues.
o Fever as well as breathing issues.