Breathing Patterns In Newborns: Is Cluster Breathing Normal?

Newborns have developing lungs and weaker muscles, so their breathing patterns may appear fast and irregular. While newborn breathing may sound different, it's usually nothing to worry about. Newborns breathe through their noses more than their mouths, and their breathing passageways are very small. Their respiration isn't fully developed, and they are still learning to use their lungs and breathing muscles. This can result in unusual breathing patterns, such as cluster breathing, which is characterised by clusters of fast and shallow breaths.

Newborns' breathing patterns and why they differ from adults'

Newborns' Breathing Patterns and Why They Differ from Adults

Newborns have distinct breathing patterns that may seem unusual or alarming to new parents, but are usually perfectly normal. Newborns breathe a lot faster than older babies, kids, and adults, taking anywhere from 30 to 60 breaths per minute while awake, and 30 to 40 breaths per minute during sleep. In comparison, an adult's respiratory rate is typically between 12 to 20 breaths per minute.

Newborns' breathing patterns during sleep can also sound irregular, with pauses of up to 10 seconds between breaths, followed by rapid breathing of up to 60 breaths per minute for 10 to 15 seconds. This type of breathing is known as normal periodic breathing of infancy and is typically outgrown by 6 months of age.

There are several reasons why newborns' breathing patterns differ from those of adults:

• Nasal breathing: Newborns breathe more through their nostrils than their mouths. In the first few months of life, infants can only breathe through their noses, which can cause them to make various sounds such as snorts, grunts, and whistles as they inhale and exhale.
• Smaller breathing pathways: Newborns' breathing pathways are much smaller and easier to obstruct. Their nasal passages are very small and can become easily clogged with mucus, lint, fuzz, spit-up, or other substances.
• Chest wall composition: Newborns' chest walls are more pliable than adults' because they are made mostly of cartilage.
• Developing lungs and muscles: Newborns' respiration is not yet fully developed, and they are still learning to use their lungs and associated breathing muscles.
• Residual amniotic fluid and meconium: Newborns may still have amniotic fluid and meconium in their airways right after birth, which can affect their breathing.

While most breathing irregularities in newborns are normal, it is important for parents and caregivers to be aware of their newborn's typical breathing pattern so that they can identify any potential concerns. Warning signs that may indicate a serious breathing problem include:

• A breathing rate of more than 60 breaths per minute
• Persistent grunting while exhaling
• Bluish colouring around the lips, eyes, hands, or feet
• Pauses between breaths that last longer than 10 seconds
• The chest pulling in with each breath, especially around the collarbone and ribs
• Difficulty feeding
• Lethargy or excessive sleepiness

Signs of breathing problems in newborns

Newborns have developing lungs and weaker muscles, so their breathing patterns may appear irregular and fast. While this is usually normal, there are some signs that indicate a newborn is having breathing problems.

Signs of respiratory distress

• Rapid or irregular breathing: A newborn's normal breathing rate is around 40 times per minute, slowing to 20-40 times per minute during sleep. Rapid breathing is more than 60 breaths per minute. While a baby may breathe rapidly when upset or crying, the rate should slow once the baby calms down.
• Flaring nostrils: If a baby is struggling to breathe, their nostrils will widen with each inhaled breath as they try to take in more air.
• Retracting: The baby may pull their chest in at the ribs, below the breastbone, or above the collarbones as they struggle to breathe.
• Grunting: A baby who is having difficulty breathing may make grunting sounds as they try to keep air in their lungs and build up oxygen levels.
• Blue colouring: Cyanosis, a blue tinge to the skin, can indicate that a baby is not getting enough oxygen. This is often seen in babies with heart defects or respiratory problems.
• Coughing: Persistent coughing or choking may indicate a breathing problem or a problem with digestion.

Other signs of breathing problems

• Wheezing: This could be a sign of blockage or narrowing of the lower airways.
• Snoring: Snoring is usually due to mucus in the nostrils but can sometimes indicate a chronic condition such as sleep apnea.
• Barking and hoarse cry: This could be caused by a windpipe blockage, such as mucus or inflammation in the voice box, or croup.
• Fast, heavy breathing: This could be a sign of fluid in the airways, indicating an infection such as pneumonia.
• Persistent dry cough: This may be a sign of an allergy.
• Long pauses between breaths: If a newborn stops breathing for at least 20 seconds, it could be a sign of apnea.

If you are concerned about a newborn's breathing, seek immediate medical attention.

When to seek medical attention for a newborn's breathing

When to be concerned but not to panic:

• If your newborn is experiencing trouble sleeping or eating, call a doctor or go for a walk-in appointment.
• If your newborn has a fever above 100.4°F or 38°C, seek immediate care if your baby is under 3 months old.
• If your newborn is dehydrated from a lack of eating, seek immediate care.

When to seek immediate medical attention:

• If your newborn has trouble catching their breath.
• If your newborn is breathing faster than 60 breaths per minute.
• If your newborn is grunting at the end of each breath.
• If your newborn is experiencing breathing difficulties, such as the muscles pulling in under the ribs or around the neck.
• If your newborn's skin has a blue, grey, or purple tinge, especially around the mouth, head, and central body.

When to call emergency services:

• If your newborn is not breathing for long periods.
• If your newborn's lips, tongue, fingernails, or toenails turn blue.
• If your newborn is lethargic in addition to breathing issues.

Tips for parents and caregivers

It's understandable that the breathing patterns of newborns can be a cause for concern for parents and caregivers. Here are some tips to help you navigate this:

• Understand the typical breathing patterns of newborns: Newborns typically take 40 to 60 breaths per minute while awake, and this can slow down to 30 to 60 breaths per minute during sleep. Their breathing may also pause for up to 10 seconds at a time, which is usually not a cause for worry.
• Learn your newborn's individual breathing pattern: Every newborn is unique, so it's important to familiarize yourself with your baby's typical breathing pattern when they are healthy and relaxed. This will help you notice any changes or deviations from their normal breathing.
• Monitor your newborn's behavior: If you are concerned about your newborn's breathing, observe them over a few hours. This will help you determine if they are experiencing a mild issue or something more serious.
• Seek medical advice when needed: If you notice any signs of distress or irregular breathing that lasts longer than 10 seconds between breaths, don't hesitate to contact your healthcare provider. They can guide you on the next steps and recommend treatments such as saline drops or a nasal aspirator to improve your newborn's breathing.
• Use technology for peace of mind: If you're unsure, take a video of your baby's breathing and share it with your healthcare provider. Many professionals now offer online consultations, making it convenient to get expert advice without leaving your home.
• Ensure a safe sleeping position: Always place your baby on their back when sleeping. This reduces the risk of sudden infant death syndrome (SIDS). If your baby is struggling to sleep due to respiratory issues, consult your doctor for safe ways to clear congestion.
• Maintain a comfortable environment: Dress your baby in breathable fabrics, and avoid overdressing them. As a guide, they should only have one extra layer of clothing compared to what an adult would wear in the same conditions.

Remember, it's always better to be cautious and seek professional advice if you have any concerns about your newborn's breathing. Trust your instincts and don't hesitate to reach out for help.

How to check a newborn's breathing rate

Newborns have much faster breathing rates than older children and adults. They also have irregular breathing patterns, which can be alarming for new parents. However, it's important to familiarise yourself with your newborn's typical breathing pattern so that you can identify any potential issues. Here are some tips on how to check and what to look out for:

• Learn their typical breathing pattern: Newborns typically take 30 to 60 breaths per minute while awake. This can slow down to 30 to 40 breaths per minute during sleep. Knowing what's typical for your baby will help you identify any deviations.
• Count their breaths: To find your newborn's breathing rate, count the number of times their stomach moves up and down in 30 seconds. Double that number to get the breathing rate per minute.
• Be aware of pauses: Newborns can take rapid breaths and then pause for up to 10 seconds. This is normal and not a cause for concern. However, if pauses in breathing last for more than 20 seconds, it may indicate a problem such as infant apnea.
• Look for physical signs of distress: If your baby is having trouble breathing, you may notice physical signs such as a blue or grayish tinge to the skin, especially around the mouth, head, and central body. Other signs include the baby's chest pulling in with each breath, grunting at the end of each breath, and nostrils flaring as they work harder to get oxygen.
• Monitor for changes: If your newborn has a cold or other illness, monitor them over a few hours to determine if it's a mild illness or something more serious.
• Seek immediate medical care: If your newborn is having significant difficulty breathing, has a bluish tinge to the lips, tongue, fingernails, or toenails, or isn't breathing for several seconds, call 911 or your local emergency services immediately.
• Contact your doctor: If you're ever concerned about your newborn's breathing, don't hesitate to call your doctor. They can provide guidance and advice. Many doctors now offer online appointments or communication via email, which can be helpful in non-emergency situations.

Frequently asked questions