I will never forget the first time I heard the sound of my baby boy letting out his first cry. It was the sound of relief, of months of waiting, of hours of hard work. It was the precious sound of life. I remember that in that moment, I looked at my husband and said “OK! He’s breathing!” and everyone in the room laughed – partly because I had a big goofy grin on my face, but mostly because we were all sharing in that miraculous instance of my baby’s first breath.
When you spend months and months waiting to hear the sound that proves that your baby is healthy, it can be hard not to obsess over his breathing every night after that. As moms, we worry about every little thing and a baby’s breathing is a big deal (and the internet is not always our friend when seeking information)! So let’s take a look at what’s normal, and what’s not, so you can rest easy knowing that your baby’s weird little noises are just that – weird little noises.
Baby’s Breathing: What’s Normal?
It’s important to first understand that newborn babies don’t breathe like adults or even older infants. They breathe mostly through their noses and rely heavily on their abdominal muscles to take deep breaths (whereas adults rely on the chest muscles and diaphragm). This means that a baby’s stomach will move more than her chest when she takes breaths. Because infants breathe mostly through their noses, they can get pretty noisy when they’re stuffed up. Brand new babies may sneeze a lot and sound congested for the first few days after birth while they work to clear any leftover fluids from their nasal passages. So those adorable snorts and tiny snores are all normal sleeping newborn noises.
Another interesting fact about newborns is that they breathe much faster than adults – babies 0-3 months can have a normal respiration rate of about 30-60 breaths per minute (a healthy adult is only 12-20 breaths per minute). Not only is this a pretty fast rate, but it’s also a pretty big range. This means that it’s completely normal for a baby to breathe at 55 breaths per minute for a minute or two, and then slow down to 35 breaths per minute for a while, and then change again! Often this will happen in waves, and will include a pause for up to 10 seconds. Babies born prematurely will take these 10-second pauses more frequently than full-term infants, and that’s still considered normal and healthy.
Newborns will often make little grunting sounds, squeaks, tiny coos or cries and take sudden deep breaths – all of which are incredibly cute but surprisingly loud at times. These are all just part of your baby teaching himself to breathe, and to sleep! Since newborns spend a lot of time in light REM sleep, they tend to make a lot of little noises while they dream and process all the learning they did that day.
Okay, So What’s NOT Normal?
We know that newborns have irregular breathing patterns, and may make cute little grunting and snoring noises. There are, however, some breathing changes that may be cause for concern.
Breathing that is too fast or too slow. Often if a baby is breathing faster than 60 breaths per minute, it is because she is overheated. Remove some layers and monitor for a few minutes to make sure her breathing goes back to normal. Breathing that is too slow may just be a baby who is in a very deep sleep. If this happens often you should let your healthcare provider know. If your baby does not wake easily and is breathing less than 22 breaths per minute, you should seek medical help right away.
Grunting, wheezing or stridor. Babies can be very noisy breathers, but there are some noises that can indicate a problem. Grunting with every breath, persistent wheezing when breathing in or out, or a high-pitched sound when taking breaths (stridor) are all sounds that baby makes when he isn’t getting enough air, either via his airway or his lungs.
Increased work of breathing. Sometimes a babe can have a stuffy nose, and be a bit grunty or otherwise noisy, but if she’s feeding well, awake and alert and isn’t working to breathe, it’s usually just noise. If a baby is working hard to breathe, however, that’s when we want to get some extra help. Increased work of breathing is seen in several ways: flared nostrils, chest retractions (that’s when the chest sinks in just below the neckline or under the breast bone), head bobbing with each breath, accessory muscle use (when the neck muscles are being used to help with breathing), and sweating. A baby who is working hard to breathe will also likely have a hard time feeding and may be more tired than normal. A baby with these symptoms should be seen by a medical professional as soon as possible, especially if he is making any of the noises mentioned above or is difficult to wake up.
Pauses lasting more than 20 seconds. This is referred to as apnea and may be paired with cyanosis (blue colour around the face). This one is pretty scary, I’ll admit, but it’s also pretty rare. If you’re able to wake your babe within the 20 seconds, and he starts breathing properly, call your healthcare provider and let them know what happened. Otherwise, this is a medical emergency and you should get help ASAP.
Knowing the difference between what’s normal and what’s not will allow you to relax and rest easy when you put your baby to sleep. Following safe sleep practices (lying on her back to sleep, nothing but a thin blanket or sleep sack over snug pajamas) will also help you to know that your babe is sleeping safely and soundly. At any point, if you feel that your baby is working too hard to breathe, or is making noises that just don’t sound right, don’t hesitate to seek help by calling your medical provider or 911. No one will ever begrudge a mother who was worried about her child’s breathing. Remember, you know your baby best!
If you want some extra assurance, consider taking an Infant CPR Workshop offered by any of our Mama Coaches. It’s a great way to ensure you know when and how to react if your baby does need some extra help. You got this, Mama!