How high can the expected respiratory rate of a neonate for the first 3 minutes after the birth *?

Newborns often make unusual noises while breathing. Most of them are no cause for concern. But being aware of your baby’s typical breathing pattern can help you identify any concerns early.

Newborns often have irregular breathing patterns that concern new parents. They can breathe fast, take long pauses between breaths, and make unusual noises.

Newborns’ breathing looks and sounds different from 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 have to 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.

One thing you can do is to pay careful attention to your newborn’s typical breathing pattern. This way you can learn what’s usual for them — so you’ll be able to tell if something is different later.

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 adult breathing patterns, 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.

It’s important that you become familiar with your baby’s typical breathing sounds and patterns. If something sounds different, listen carefully so you can explain what’s different to your pediatrician.

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 your 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 large bronchi. Large bronchi are tubes that carry air between the windpipe and lungs. A doctor will 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:

• asthma
• pneumonia
• respiratory syncytial virus

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, you should talk with a doctor. It could be a sign of a respiratory infection, according to 2021 research.

Frequent sneezing can also be a sign of an allergy to certain types of formula as well as neonatal abstinence syndrome. Per 2020 research, neonatal abstinence syndrome occurs when babies are exposed to opioid drugs before birth.

Periodic breathing

Periodic breathing is common in newborns. It is characterized by pauses in breathing that lasts 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, you may consider talking with a pediatrician about ways to help improve their breathing if needed, such as using saline drops or a nasal aspirator.

If your baby is also experiencing other cold symptoms like irritability, decreased appetite, or difficulty sleeping, it’s best to talk with a doctor to address any concerns and determine whether they may have a cold or other infection.

Hiccups

Hiccups are common and can happen in babies, children, and adults.

Eating too quickly and swallowing air while feeding are two of the 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 your doctor if you’re concerned about your 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.

Here are some tips if you’re concerned about your baby’s breathing:

• Learn your child’s typical breathing patterns so you’re better prepared to identify what’s not typical.
• Take a video of your baby’s breathing and show it to a doctor. Many medical professionals now offer online appointments or communication by email, saving you a possibly unnecessary trip to the office.
• Always have your baby sleep on their back. This decreases your baby’s risk of sudden infant death syndrome (SIDS), per 2021 research. If your baby has a respiratory infection and isn’t sleeping well, ask your doctor for safe ways to help clear congestion. It’s not safe to prop them up or put their crib on an incline.
• Saline drops, sold over the counter at drugstores, can help loosen thick mucus.
• Sometimes, babies breathe fast when they’re overheated or upset. Clothe your baby in breathable fabrics. You should only add one extra layer more than what you yourself are wearing for the weather that day. So, if you’re wearing pants and a shirt, your baby might wear pants, a shirt, and a sweater.

Safety note

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

These padded risers are intended to keep your baby’s head and body in one position but are not recommended by the Food and Drug Administration due to the risk of SIDS.

Catching an issue early gives your 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 you’re ever concerned, call your doctor right away. Memorize the doctor’s after-hours phone numbers or have them available at all times. Most offices have a nurse on call that can answer and help direct you.

Doctors may use a chest X-ray to diagnose breathing concerns and make a treatment plan.

If your child experiences any of these symptoms, call 911 or your local emergency services:

• blue color in lips, tongue, fingernails, and toenails
• doesn’t breathe for 20 seconds or more

See your doctor immediately if your child:

• is grunting or moaning at the end of each breath
• has nostrils flaring, which means they’re working harder to get oxygen into their lungs
• has muscles pulling in on the neck, around collarbones, or ribs
• has difficulty feeding in addition to breathing issues
• is lethargic in addition to breathing issues
• has a fever as well as breathing issues

Babies tend to breathe faster than older kids and adults. Sometimes they make unusual noises. Rarely, infants may have trouble breathing because of a serious health concern.

It’s important that you can tell right away if your baby is having trouble breathing. Familiarize yourself with your baby’s usual breathing patterns and get help right away if something seems wrong.