What might breathing problems mean in a newborn?

Babies breathe much faster than older children and adults. A newborn's normal breathing rate is about 40 to 60 times per minute. This may slow to 30 to 40 times per minute when the baby is sleeping. A baby’s breathing pattern may also be different. A baby may have a short pause in breathing for 5 to 10 seconds, then rapidly breathe again for about 10 to 15 seconds. The brief pauses in breathing are not linked with a change in color or heart rate. This is called periodic breathing and is normal. It is more common in premature babies. 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 medical attention right away.

Signs of respiratory problems may include the following:

• Rapid or irregular breathing. Rapid breathing is more than 60 breaths per 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, is 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 trouble 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 trouble 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 is an overall blue coloring to the skin. This 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 healthcare provider.

For any sign of respiratory problems, call your baby's healthcare provider right away or seek emergency care right away.