Newborns And Phlegm: What's Normal And What's Not?

Newborns tend to have irregular breathing patterns, alternating between fast and slow, with occasional pauses. They also tend to make strange noises when breathing, which can be caused by leftover fluid from the birth process, giving them a congested, cold-like sound. This is completely normal. However, if your newborn is making a whistling noise, it could be a sign of a small blockage in the nostrils, which can be cleared using a bulb syringe. If your newborn has a hoarse cry and a barking cough, this could be a sign of croup, an infection of the larynx, trachea and bronchial tubes. If your newborn is breathing with a high-pitched squeak, especially when agitated, feeding, crying or sleeping on their back, this could be a condition called laryngomalacia, which usually resolves on its own by the time the child turns two.

Whistling noise

It is normal for newborns to have irregular breathing patterns that alternate between fast and slow, with occasional pauses. Noisy breathing is very common in newborns and is usually caused by a blocked nose during a cold, or a more serious condition like pneumonia or asthma.

A whistling noise in a newborn's nose is often caused by a blocked nostril, which can be cleared by suctioning it out. Newborns breathe out of their noses, so even a small blockage can cause a whistling noise or difficulty breathing. This is usually nothing to worry about and is easily remedied.

However, if the whistling noise is accompanied by other symptoms, it could indicate a more serious problem. For example, a whistling noise when the baby breathes out could be a sign of bronchiolitis or asthma. A whistling noise accompanied by a cough could be a sign of croup, an infection of the larynx, trachea, and bronchial tubes. If you are concerned about your baby's breathing, it is important to seek advice from your doctor.

Hoarse cry and a barking cough

A hoarse cry and a "barking" cough in a newborn could be a sign of croup. Croup is a respiratory illness that causes a barking cough, hoarseness, and difficulty breathing. It is usually caused by a viral infection, such as a common cold, and affects the windpipe (trachea) and voice box (larynx). While croup is not a common infection in newborns, it can occur in children from 6 months to 10 years of age, with the highest risk being between 6 months and 3 years.

The symptoms of croup include a stuffy or runny nose, a low fever, and noisy or laboured breathing. The characteristic barking cough is caused by swelling and irritation around the voice box and windpipe, which narrows the upper airway and makes it harder to breathe. The condition is typically worse at night and when the child is upset or crying.

Most cases of croup are mild and can be treated at home. Keeping the child calm is important, as crying can worsen the symptoms. Offering fluids and breathing moist air, such as through a cool-mist humidifier or steam from a hot shower, can help ease symptoms. In some cases, medication such as ibuprofen or acetaminophen may be given to reduce fever or throat discomfort.

However, if your newborn exhibits any of the following symptoms, it is important to seek immediate medical attention:

• Fast or laboured breathing
• Difficulty breathing, speaking, or drinking
• Blue or gray tint around the nose, mouth, or fingernails
• Drooling or difficulty swallowing
• Extreme tiredness or difficulty waking
• Signs of dehydration, such as a dry mouth, few or no tears when crying, or sunken eyes

High-pitched, squeaky sound

A high-pitched, squeaky sound when a newborn is breathing in is called stridor or laryngomalacia. This is caused by excess tissue around the larynx and is usually harmless. It is more pronounced when a child is lying on their back, and symptoms usually start within a few weeks or months of birth. Laryngomalacia is the most common cause of noisy breathing in babies and toddlers, but it typically passes by the time a child reaches the age of 2.

Laryngomalacia is often referred to as a birth defect, but it can also be thought of as an immaturity of the voice box that most children grow out of. As children get bigger, their larynx gets stronger, and their breathing becomes less noisy. In rare cases, surgery may be required to remove excess tissue and release tight areas.

If you are concerned about your baby's breathing, it is important to contact your paediatrician or doctor.

Deep cough

It is normal for newborns to sound phlegmy, as mucus helps keep their nose, mouth, and throat moist and soft, and also protects them from germs. However, you will need to keep an eye on and remove excess mucus, as it can clog up their nose and throat, and sometimes indicate an illness or infection.

A deep cough in newborns could be a sign of a blockage in the large bronchi (divisions of the trachea, which lead into the lungs). This type of cough will bring up mucus or phlegm, which is a mixture of mucus, debris, and cells from the lungs.

If your baby has a deep cough, it is important to monitor their breathing and look out for the following signs of respiratory distress:

• A persistently increased rate of breathing (greater than 60 breaths per minute)
• Grunting at the end of respiration
• Flaring nostrils during breathing
• Retractions in the muscles in the baby's chest (under the ribs) and neck
• Cyanosis (blue-tinged skin, especially around the lips or nostrils)
• Difficulty feeding
• Poor feeding
• Lethargy
• Fever

If your baby is exhibiting any of these signs, contact your paediatrician immediately.

Whistling sound (wheezing)

A whistling sound, or wheezing, in newborns is usually caused by a blockage in the bronchioles (small airways that come from the bronchi). This blockage could be due to inflammation or a build-up of mucus, causing the infant to make a whistling sound when breathing out.

Wheezing in babies is often linked to respiratory infections such as bronchiolitis, pneumonia, or a common cold. In some cases, it may be an indicator of asthma or cystic fibrosis. Allergies can also cause wheezing, as they can lead to an increase in phlegm, which, if left uncleared, can result in a whistling noise when the baby breathes.

If your baby is wheezing, it is important to monitor their breathing and look out for other symptoms, such as a high temperature, cough, or lethargy. While occasional breathing problems are normal, persistent or severe wheezing may indicate a more serious issue and should be assessed by a doctor.

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