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Your Newborn Baby's Breathing Noises

If your baby makes noises when breathing, take note of what they sound like. This will help determine if there is a problem in the breathing passages and where:

Whistling noise: A small blockage in the nostrils tends to make a whistling noise that clears when you suction it out.
- Newborn babies breathe out of their noses, not their mouths. This is a good trick, as it allows them to breathe and eat at the same time. However, their little noses have small air passages, so a little bit of mucus or dried milk can make the breathing passage even smaller, causing a whistling noise or occasionally, difficulty moving the air in and out.
Hoarse cry and a "barking" cough: A blockage in the larynx (windpipe), often due to mucus, makes a hoarse cry and a "barking" cough. This is where croup hits.
Deep raspy sound: A blockage in the trachea (which is in the neck) makes a deep raspy sound during breathing. This sound is rarely due to a blockage since the trachea is pretty big. More often it is caused by a harmless condition called tracheomalacia, in which the tissues of the trachea are soft and flexible and make noise when the infant breathes in and out, but it doesn't really cause significant trouble with breathing.
Deep cough: A blockage in the large bronchi (divisions of the trachea, which lead into the lungs) makes a deep cough.
Whistling sound (wheezing): A blockage in the bronchioles (small airways that come from the bronchi) makes a whistling sound when the infant breathes in and out, (as in bronchiolitis or asthma later on).
Fast, labored breathing: Fluid in the smallest airways (the "alveoli") causes pneumonia, an infection due to a virus or bacteria. Pneumonia causes fast, labored breathing, occasionally cyanosis, a persistent cough, and crackly sounds ("rales") when listened to with a stethoscope.

Tips for Concerned Parents:

Watch your baby's breathing when she's well, so you can get used to how it looks. Time how many breaths she takes in a minute. It's probably faster than you imagined. Knowing what's normal for your baby's breathing will help you spot a potential problem more quickly.

When in doubt of what's going on, make a video of the breathing pattern that is worrying you to show to your baby's health care provider.

When to Worry About Baby's Breathing

Signs of potentially worrisome breathing problems in your baby include:

Persistently increased rate of breathing (greater than 70 breaths per minute or so)
Increased work to breathe. Signs of this include:
- Grunting. The baby makes a little grunting noise at the end of respiration. This serves to try to open up blocked airways.
- Flaring. The baby's nostrils flare during breathing, showing increased work effort.
- Retractions. The muscles in the baby's chest (under the ribs) and neck are visibly seen going in and out much more deeply than usual.
Cyanosis. This means the blood has remained blue and has not gotten sufficient oxygen from the lungs (such as with pneumonia). For true cyanosis, the blood all over the body should look blue. Check areas that get a lot of blood flow, such as the lips, the vagina of a female, and the tongue. Sometimes the hands and feet of newborns turn bluish, but the rest of the body is fine. This is not cyanosis, but a common response to changes in temperature.
Poor feeding. "Respiratory distress" is often accompanied by a noticeable decrease in feeding intake.
Lethargy. Your baby's energy level may be markedly decreased if she has a significant lung problem.
Fever. Most infections of the lung will cause a fever as well. Always check your baby's temperature when you are concerned.