What to know about newborn respiratory rates

Children's Health

Newborn babies breathe faster than older children and adults. A newborn may breathe more slowly when they sleep, but their respiratory rate should always fall within a healthy range.

Very fast or slow breathing may signal an infection or another condition.

Labored breathing, or respiratory distress, is a serious issue that affects around 7% of newborns. Some signs of respiratory distress in babies include loud breathing, nostril flaring, sucking in of the chest, and changes in skin or nail color.

If a baby with labored breathing does not receive prompt treatment, there is a risk of serious complications.

Read on to learn about the healthy range of respiratory rates for newborns. Also, learn how to measure a newborn’s respiratory rate and what to do when the rate is faster or slower.

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A newborn may have an infection if they are breathing very quickly or slowly.

A newborn should take 40–60 breaths per minute. A single breath is one inhalation and one exhalation.

However, researchers behind a 2016 study of 953 healthy, full-term newborn babies found that their respiratory rates varied significantly.

The average respiratory rate was 46 breaths per minute 2 hours after birth. Still, around 5% of the babies took 65 breaths per minute or more. This suggests that a slightly faster breathing rate may be common and healthy, in some cases.

Respiration steadily slows as a baby gets older. The typical breathing rate for a toddler, aged between 1 and 3 years, is 24–40 breaths per minute.

Babies who are very upset may hyperventilate while crying. If their breathing returns to normal, they are usually fine.

A fast respiratory rate, or tachypnea, tends to be more common than a slow rate in newborns. Tachypnea usually means that the baby is not getting enough oxygen and compensating by breathing more frequently.

Many issues can lead to labored breathing in newborns. Some common risk factors for respiratory distress include:

  • premature birth
  • delivery via cesarean section
  • inhaling their own stool, called meconium, during delivery
  • a low level of amniotic fluid, which is a condition called oligohydramnios
  • an infection in the fetal membranes or amniotic fluid, which is called chorioamnionitis
  • gestational diabetes in the mother

Newborns have a higher risk of respiratory problems than older babies or children. Some causes and contributing factors include:

  • Transient tachypnea: This involves the newborn temporarily breathing more rapidly than usual. It typically does not signal a serious problem and tends to resolve within 72 hours, while the baby is still in the hospital. It is more common in those born via cesarean section.
  • Pneumonia: Infants have a high risk of pneumonia because their immune systems have yet to develop fully. Newborns may show no symptoms, but they may experience vomiting, a fever, hard, fast breathing, and a range of other issues.
  • Persistent pulmonary hypertension of the newborn (PPHN): This involves the baby’s circulatory system still functioning as it did in the womb and directing too much blood away from the lungs. PPHN can cause fast breathing, a fast heart rate, and a blue tinge to the skin.
  • Congenital abnormalities: These are differences in the anatomy that are present at birth. Some can cause a baby to consistently breathe faster than is healthy. These include abnormalities of the lungs, heart, nose, or respiratory passages.
  • Collapsed lung: When air collects between the lung and chest wall, this makes it difficult for the lung to inflate, impeding breathing. Collapsed lungs can occur in babies with lung abnormalities or those who have experienced a traumatic injury, such as a fall or car accident.

The most reliable way to measure newborn breathing is to count the number of breaths in 60 seconds. This is because some newborns breathe at irregular intervals. Those in respiratory distress are more likely to breathe in an unusual pattern.

The following methods can help with measuring a newborn’s breathing:

  • Gently place a hand on the baby’s stomach or chest. Each rise of the chest or stomach counts as a single breath.
  • Position a hand a few inches away from the baby’s nostrils. Every exhalation from the nose counts as a single breath.

Sleeping babies tend to breathe more slowly, at a rate closer to 30 breaths per minute. During sleep, a baby may also breathe at an irregular rate or stop breathing for a few seconds.

If the baby shows no other signs of respiratory distress, slightly slow or irregular breathing during sleep is usually no cause for concern.

Newborns with respiratory infections or heart or lung disorders have a higher risk of breathing problems at night. Anyone with concerns about nighttime breathing in babies should consult a pediatrician, who can provide guidance.

Respiratory distress is the medical term for labored breathing. Lasting respiratory distress can be a sign of hypoxia — a low level of oxygen in the blood. Oxygen deprivation can cause brain and organ injuries, and it can be fatal.

A baby who is breathing more or less than usual and shows signs of respiratory distress needs immediate medical attention.

Some signs of respiratory distress in newborns include:

  • Loud breathing: Babies struggling to breathe may grunt, wheeze, or squeak.
  • Nostril flaring: The baby may flare their nostrils to try to take in more air.
  • Retracting: This involves sucking in the chest, either between the ribs, below the breastbone, or above the collarbones. Retraction indicates that the baby is breathing harder to get more oxygen.
  • Color changes: Babies experiencing severe oxygen deprivation may change color. Their skin may be pale or white, and their lips, tongue, fingers, or nail beds may turn white or blue.

Closely monitor babies who breathe very quickly or slowly. If the issue persists, contact a doctor or midwife, or otherwise seek medical care.

If a baby shows any of the following signs, take them to a doctor:

  • any signs of respiratory distress
  • irregular breathing that lasts longer than a few minutes
  • unusual breathing accompanied by a fever — or any fever in a baby under 2 months
  • unusual breathing after a bath or being in water
  • unusual breathing after a choking or near-choking episode

Respiratory distress can come on suddenly in newborns and is more dangerous in babies than it is in older children. A person should seek medical attention without delay.

If a baby stops breathing or loses consciousness, contact emergency services immediately. In the United States, dial 911.

Breathing problems in newborns can be frightening for caregivers. However, the underlying causes are often treatable. Receiving prompt medical care lowers the risk of serious complications.

Contact a doctor if a baby:

  • has trouble breathing
  • breathes rapidly or very slowly
  • appears ill
  • shows signs of respiratory distress, such as loud breathing, nostril flaring, sucking in of the chest, and changes in skin or nail color

If the symptoms persist and the doctor is unavailable, take the baby to the emergency room.

Contact emergency services immediately if a baby stops breathing or loses consciousness.

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