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When should you worry about your baby's breathing?

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Signs of potentially worrisome breathing problems in your baby include a persistently increased rate of breathing (greater than 60 breaths per minute or so) and increased work to breathe. Signs of extra work include:

  • Grunting. The baby makes a little grunting noise at the end of respiration. This serves to try to open blocked airways.
  • Flaring. The baby's nostrils flare during breathing, showing increased 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 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 he or 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.

SOURCE:  "Diagnostic approach to respiratory disease." Haddad G. and Hauck F., Nelson Textbook of Pediatrics, 17th edition, Behrman R, Kliegman R and Jenson H (eds.), Saunders: 2004.

Reviewed by Renee A. Alli on June 25, 2019

SOURCE:  "Diagnostic approach to respiratory disease." Haddad G. and Hauck F., Nelson Textbook of Pediatrics, 17th edition, Behrman R, Kliegman R and Jenson H (eds.), Saunders: 2004.

Reviewed by Renee A. Alli on June 25, 2019

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