Children's Health and Wellness

Breathing Problems

What might breathing problems indicate in a newborn?

Babies breathe much faster than older children and adults. A newborn's normal breathing rate is about 40 times each minute. This may slow to 20 to 40 times per minute when the baby is sleeping. The pattern of breathing in a baby may also be different. A baby may breathe fast several times, then have a brief rest for less than 10 seconds, then breathe again. This is often called periodic breathing and is a normal occurrence. Babies normally use their diaphragm (the large muscle below the lungs) for breathing.

Changes in a baby's breathing rate or pattern, using other muscles and parts of the chest to breathe, or changes in color may mean the baby is having respiratory distress and needs immediate medical attention.

Signs of respiratory problems may include, but are not limited to, the following:

  • Rapid or irregular breathing. Rapid breathing is more than 60 breaths each minute. A baby who is overheated or upset and crying may breathe rapidly, but the rate should slow when the baby is no longer too hot or crying. Continuously rapid breathing is a sign of a problem. Breathing that stops longer than 20 seconds, called apnea, can be a serious problem.

  • Flaring nostrils. A baby who is having trouble taking in enough air will have nostrils that widen with each inhaled breath.

  • Retracting. Another sign of difficulty taking in air is retracting, when the baby is pulling the chest in at the ribs, below the breastbone, or above the collarbones.

  • Grunting. This is a sound made by a baby who is having difficulty breathing. The baby grunts to try to keep air in the lungs to help build up the oxygen level. Another sound may be a moan or sigh when exhaling.

  • Blue color. Cyanosis, a generalized blue coloring, can be a sign the baby is not getting enough oxygen. This is often seen in babies with heart defects, as well as respiratory problems.

  • Coughing. Occasionally, coughing or choking may occur when a baby takes in milk too quickly with feedings. Persistent coughing or choking may indicate a breathing problem, or a problem with digestion that should be examined by your baby's doctor.

For any sign of respiratory problems, you should consult your baby's doctor immediately.

Print Source: Kliegman: Nelson Textbook of Pediatrics. Kliegman. 2011, ed. 19, ch. 95.
Print Source: Pathogenesis, Clinical Presentation, and Diagnosis of Apnea of Prematurity, from Up to Date
Print Source: Rakel: Textbook of Family Medicine. Rakel, Robert E. 2007, 7th edition, p. 543.
Online Source: American Academy of Pediatricshttp://www.healthychildren.org/English/ages-stages/baby/Pages/Common-Conditions-in-Newborns.aspx
Online Source: Emergent Evaluation of Acute Respiratory Compromise in Children, from Up to Datehttp://www.uptodate.com
Online Editor: Green, Chelsea
Online Medical Reviewer: Dozier, Tennille, RN, BSN, RDMS
Online Medical Reviewer: newMentor board-certified, academically affiliated clinician
Date Last Reviewed: 12/27/2013
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