Noisy Breathing In Newborns: Is It Normal?

Noisy breathing is very common in newborns and is usually caused by a partial blockage or narrowing of the airways. Newborns tend to have irregular breathing patterns that alternate between fast and slow, with occasional pauses. Their breathing pathways are much smaller and easier to obstruct than those of adults, and their chest wall is more pliable because it is made mostly of cartilage. Noisy breathing can be caused by anything from a blocked nose during a cold to a more serious condition like pneumonia or asthma. While most cases of noisy breathing in newborns are benign, some require urgent medical attention.

Whistling noise

A whistling noise when your newborn is breathing is usually caused by a blocked nostril. Newborns breathe out of their noses, and their narrower airways can be blocked by even a small amount of mucus or dried milk. This blockage can cause a whistling noise or, occasionally, difficulty breathing.

If your newborn is making a whistling noise when breathing, you can try using a bulb syringe to carefully suction out their nose. If the whistling noise continues, or if it is accompanied by other symptoms, contact your paediatrician.

Other potential causes of a whistling noise include:

• Allergies: Allergies can cause your baby’s body to create extra phlegm, which can build up in their narrow nasal passages. Allergies are uncommon in babies younger than one year.
• Bronchiolitis: A lower respiratory infection that is especially common in infants during winter. It is typically caused by a virus and results in inflamed bronchioles and congestion.
• Asthma: Whistling or wheezing can be triggered by certain things, such as exercise or cold air.
• Cystic fibrosis: A chronic or congenital disease that can cause noisy breathing.

Hoarse cry and a barking cough

A hoarse cry and a barking cough in newborns could be indicative of croup. Croup is a respiratory illness that affects young children, causing a barking cough, hoarseness, and difficulty breathing. It is usually caused by a viral infection, often beginning as a common cold. The virus causes the windpipe (trachea) and voice box (larynx) to swell and narrow, making it harder for air to get into the lungs.

Croup is characterised by a hoarse cry and a distinctive barking cough, often compared to the sound of a seal's bark. It is typically accompanied by noisy or laboured breathing, and symptoms are often worse at night and when the child is upset or crying. Croup can occur at any time of year but is more common in the fall and winter. It usually affects children from 6 months to 10 years of age, but it can occur in younger infants.

If you suspect your newborn may have croup, it is important to monitor their symptoms and seek medical advice if necessary. Most cases of croup are mild and can be treated at home, but some severe cases may require hospitalisation. To help your child breathe easier, you can try having them breathe in cool night air or humidified air, such as by sitting with them in a steamy bathroom or using a humidifier. It is also important to keep your child calm, as crying can trigger coughing.

While croup is usually not serious, it is important to contact your child's healthcare provider if symptoms are severe, worsen, or last longer than 3 to 5 days. Seek immediate medical attention if your child is having trouble breathing, you notice blueness around their mouth and lips, or they are unresponsive.

High-pitched, squeaky sound

A high-pitched, squeaky sound, known as stridor or laryngomalacia, is a sound that very young babies make when breathing in. It is caused by excess tissue around the larynx and is typically harmless. The condition is usually worse when a child is lying on their back, and it is often accompanied by gastroesophageal reflux (GER). Laryngomalacia occurs when a baby's larynx (or voice box) is soft and floppy, and when the baby takes a breath, the part of the larynx above the vocal cords falls in and temporarily blocks the baby's airway.

Most babies with laryngomalacia do not have trouble breathing or feeding, even though their breathing is noisy. However, breathing usually becomes noisier when the baby is crying, feeding, sleeping, lying down, or has an upper respiratory infection. Symptoms of laryngomalacia usually worsen over several months before starting to improve after 3-6 months. By the time a baby turns one, the condition typically resolves on its own.

Babies with laryngomalacia often experience gastroesophageal reflux (GER), which is when food and acid go back up into the oesophagus. Formulas or medicines to help with reflux may help with breathing symptoms. Doctors usually prescribe anti-reflux medication since most babies with laryngomalacia also have GER.

If your baby is struggling to breathe, you should call the doctor right away. Signs of breathing difficulties include tugging at the neck or stomach, breathing pauses (apnea), and blue skin or lips (cyanosis).

Deep cough

A deep cough in newborns can be a symptom of a blockage in the large bronchi (divisions of the trachea, which lead into the lungs). This is one of the causes of noisy breathing in newborns, which is very common.

Newborns tend to have an irregular breathing pattern that alternates between fast and slow, with occasional pauses. Their airways are smaller and softer than adults, so even small amounts of blockage or narrowing of the airway may cause noisy breathing.

• Watch your baby's breathing when they are well, so you can get used to how it looks. Time how many breaths they take in a minute. Knowing what's normal for your baby's breathing will help you spot a potential problem more quickly.
• When in doubt, make a video of the breathing pattern that is worrying you to show to your baby's healthcare provider.
• Signs of potentially worrisome breathing problems include a persistently increased rate of breathing (greater than 60 breaths per minute or so), increased work to breathe (e.g., grunting, flaring nostrils, larger than normal movements of the chest), and difficulty feeding.
• If your baby is coughing, it's important to break down the details for a proper diagnosis and treatment. There are two types of coughs: a dry cough, which is unproductive and doesn't produce mucus, and a wet cough, which causes phlegm or mucus to form in the baby's airways.
• If your baby has a cough, try home remedies such as keeping them hydrated, using saline drops, sucking out mucus with a bulb syringe, using a humidifier, and patting their chest and back to help loosen mucus.
• If your baby is under 4 months old and has a cough, or if the cough is accompanied by other symptoms such as high fever, rapid breathing, or signs of breathing difficulty, call your doctor or seek emergency care.

Fast, laboured breathing

Newborns tend to have irregular breathing patterns that can be concerning for new parents. They can breathe fast, take long pauses between breaths, and make unusual noises. Their breathing pathways are much smaller and easier to obstruct. Their chest wall is also more pliable than an adult's because it's made mostly of cartilage. Their nostrils flare during breathing, showing increased effort to breathe.

Newborns typically take 30 to 60 breaths per minute, which can slow down to 30 to 40 breaths per minute during sleep. At 6 months, babies breathe about 25 to 40 times per minute. In comparison, an adult takes about 12 to 20 breaths per minute. Newborns can also take rapid breaths and then pause for up to 10 seconds at a time.

If you notice any of the following symptoms in your newborn, seek immediate medical attention:

• Grunting or moaning at the end of each breath
• Nostrils flaring as they work harder to get oxygen into their lungs
• Muscles pulling in on the neck, around collarbones, or ribs
• Difficulty feeding in addition to breathing issues
• Lethargy in addition to breathing issues
• Fever, especially if it's above 100.4°F or 38°C, along with breathing issues
• Bluish skin around the mouth, head, and central body

If you are concerned about your newborn's breathing, it is always best to consult with a doctor or pediatrician. They can help diagnose and address any underlying issues.

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