Newborn babies are watched closely. We marvel when they grimace or yawn; we are amazed as they start to move their arms and legs; first smiles (even if elicited by gas) are a delight. As new parents watch their baby, they are bound to worry if anything seems a bit out of the ordinary.
Some parents worry when they see their infant breathing a little faster than they think she should or seeming to stop breathing for a few seconds. With the specter of SIDS in the back of every parent’s mind, breathing patterns that seem off cause alarm. Often parents will bring babies to the office to have me listen and make sure that their lungs are clear and heart sounds are normal, and the vast majority of the time I can reassure parents that what they are seeing is normal periodic breathing.
Infants, some up until nearly six months of age, breath in cycles. At the start of the cycle, babies are taking deeper, faster breaths that gradually get shallower and less frequent until there is a pause in breathing that can last a few seconds before the cycle starts again. The babies aren’t in distress and unless you are really looking closely you may not even notice this patterned breathing.
Sometimes, however, parents notice the pauses in breathing or the more rapid deep breaths and get concerned. This pattern is called periodic breathing and is entirely normal. Most babies will exhibit this pattern especially in the first month of life and gradually the pattern disappears. A typical periodic breathing cycle of rapid, deeper breaths leading to shallower, slower breaths followed by a pause in breathing happens in 15-25 second cycles, 2-3 times each minute.
Infants with true apnea will stop breathing for 10 seconds or more and may even turn bluish around their lips when it occurs. Although very uncommon in near term and full term infants, if you notice your baby’s color change significantly when the pause occurs, have your child seen.
Infants with true rapid breathing issues will have persistent rapid breathing of more than 50 breaths per minute and the pattern is one of consistency, without the pauses seen in periodic breathing. The rapid breathing is seen for minutes at a time without a pause, helping to differentiate it from periodic breathing.
Newborn babies are watched closely by loved ones, held and attended to and if you know what to look for when the breathing pattern seems unusual, you can save yourself a lot of grief!