Baby’s Respiratory System & Respiratory Distress

What you will find on this page.

  • Anatomy of the Lungs.
  • Breathing in Babies.
  • Activity – Blowing up Balloons.
  • Normal and Abnormal Breathing.
  • Newborns Breathing.
  • Normal Breathing Rates.
  • Abnormal Breathing Patterns.
  • Comparison Between Adult and Baby.
  • What breathing noises may mean.
  • Whistling Noise.
    Hoarse cry and barking cough.
  • Deep Cough.
  • Wheezing.
  • Fast Breathing.
  • Snoring.
  • Stridor.
  • Grunting.
  • Frequent Sneezing.
  • Periodic breathing.
  • False “first cold”.
  • Hiccups.
  • Ways to Support Respiratory.
  • When to Contact a Doctor.
  • Seek Immediate Medical Care.

Anatomy of the Respiratory System

The respiratory system is made up of the organs involved in the interchanges of gases:

  • Nose
  • Mouth
  • Throat (pharynx)
  • Voice Box (larynx)
  • Windpipe (trachea)
  • Airways (bronchi)
  • Lungs

The Upper Respiratory tract includes the:

  • Nose
  • Air-filled space above and behind the nose (nasal cavity)
  • Sinuses

The lower respiratory tract includes the:

  • Voice box
  • Windpipe
  • Lungs
  • Airways (bronchi and bronchioles)
  • Air sacs (alveoli)
 
Baby’s Respiratory System

The lungs take in oxygen. The body’s cells need oxygen to live and carry out their normal functions. They also get rid of carbon dioxide. This is a waste product of the cells.

The lungs are 2 cone-shaped organs. They are made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm). They are inside a membrane called the pleura.

The lungs are separated by an area (called the mediastinum) that has the following:

  • Heart and its large vesselsBaby’s Respiratory System 2
  • Windpipe
  • Food pipe (esophagus)
  • Thymus gland
  • Lymph nodes
 

The right lung has 3 lobes. The left lung has 2 lobes. When you breathe, the air:

  • Enters the body through the nose or mouth
  • Travels down the throat through the voice box and windpipe
  • Goes into the lungs through tubes (mainstem bronchi):
    • One of these tubes goes to the right lung and one goes to the left lung
    • In the lungs, these tubes divide into smaller bronchi
    • Then into even smaller tubes called bronchioles
    • Bronchioles end in tiny air sacs called alveoli
 

Alveoli Tiny air sacs at the end of the bronchioles (tiny branches of air tubes in the lungs). The alveoli are where the lungs and the blood exchange oxygen and carbon dioxide during the process of breathing in and breathing out. Babies are born with only 10% of their alveoli,  only by the age of 2 do they have them all.

Cilia are tiny hair-like structures on the surface of cells in many parts of the body, including the lungs. When they are functioning correctly, cilia beat together in a wave-like motion to move mucus, germs and other foreign particles up toward the mouth where they can be coughed or sneezed out. Babies Cilia is to immature to be affective till the age of one.

Breathing in Babies

An important part of a baby’s lung development is the production of surfactant. This is a substance made by the cells in the small airways. By about 35 weeks of pregnancy, most babies have developed enough surfactant. It is normally released into the lung tissues. There it helps to keep the air sacs (lung alveoli) open. Premature babies may not have enough surfactant in their lungs which can lead to difficulty with breathing.

 

 

Activity – Blowing up Balloons.

1. Take in the biggest breath and blow it into the balloon, lets see who has the biggest lungs.

Let all the air out of your balloon.

2. Now take a normal breath and blow it into the balloon with out emptying your lungs, just a normal breath out.

Now you can see your reserved lung space.

3. Blow your cheeks out and using the air from your checks only blow it into the balloon. That is approximately a newborn lung around 40ml per kg

Normal and Abnormal Breathing

Breathing is a critical sign of life, and understanding the difference between normal and abnormal breathing patterns is essential for identifying respiratory distress in children. Newborns often make unusual noises while breathing. Most of them are no cause for concern. But being aware of your baby’s typical breathing pattern can help you identify any concerns early. Newborns often have irregular breathing patterns that concern new parents. They can breathe fast, take long pauses between breaths, and make unusual noises.

Newborns Breathing

Newborns’ breathing looks and sounds different from adults because:

  • They breathe more through their nostrils than their mouth.
  • Their breathing pathways are much smaller and easier to obstruct.
  • Their chest wall is more pliable than an adult’s because it’s made of mostly cartilage.
  • Their respiration isn’t fully developed since they still have to learn to use their lungs and the associated breathing muscles.
  • They may still have amniotic fluid and meconium in their airways right after birth.

One thing you can do is to pay careful attention to your baby’s typical breathing pattern. This way you can learn what’s usual for them — so you’ll be able to tell if something is different.

Normal Breathing Rates

Normal breathing rates vary by age, with infants typically breathing faster than older children and adults. For example, infants (0-12 months) should have a breathing rate of 30-60 breaths per minute, This can slow down to 30 to 40 breaths per minute while they sleep. At 6 months, babies breathe about 25 to 40 times per minute. Whereas adolescents (13-18 years) should breathe at a rate of 12-20 breaths per minute. Normal breathing should be smooth and regular without any wheezing or grunting.

 

Abnormal Breathing Patterns

Abnormal breathing patterns, indicating respiratory distress, include rapid or laboured breathing, the use of accessory muscles (neck and chest retractions), nasal flaring, cyanosis (a bluish tint to the skin, lips, or nails), and grunting or wheezing sounds. Causes of respiratory distress can range from infections such as pneumonia and bronchiolitis to chronic conditions like asthma and congenital heart defects, as well as physical obstructions and trauma to the chest or airway.

Comparison Between Adult and Baby.

Babies have limited reserved lung space.

With the limited chest expansion, the child can only increase their lung volumes by increasing their respiration rate, this explains why small children have a higher respiratory rate compared to adults.

Infants are diaphragmatic breathers; therefore, they are positioned in a head up position to ease the work of breathing.

Babies only have 10% of their alveoli and will develop them during the first two years. Cilia are poorly developed at birth.

Infants up to 6 months are preferential nose breathers.

Heart and other organs are relatively large in relation to the infant’s size, leaving less space for chest expansion.

Respiratory muscles of infants tire more easily than that of an adult due to the smaller proportion of fatigue resistant type 1 muscle fibre (39%) in their diaphragms than in adults (55%). This proportion is brought in line with that of an adult by the age of 1 year old.

What breathing noises may mean.

Baby’s Respiratory System & Respiratory DistressIt’s important that you become familiar with your baby’s typical breathing sounds and patterns. If something sounds different, listen carefully so you can explain what’s different to your Doctor.

Respiratory distress is one of the most common causes of neonatal intensive care hospital admittance, and is the number one reason for hospitalisation for children under the age of 4 years old according to 2020 research.

The following are common sounds you might hear and their potential causes.

Whistling Noise.

This might be a blockage in the nostrils that will clear when it’s suctioned (removed). Placing the child’s bassinet or cot on an angle when sleeping will allow gravity to clear the mucus. If you place the crib at an incline, make sure it is only at 10 degrees so as the baby does not slide to the foot of the bassinet. Using a mucus/snot remove available from your local chemist.

 

Hoarse Cry & Barking Cough

This noise may be from a windpipe blockage. It might be mucus or inflammation in the voice box, such as croup. It can be a sign of croup, in which case it may get worse at night. You will need to see a GP.

Deep Cough.

This is likely a blockage in large bronchi. Large bronchi are tubes that carry air between the windpipe and lungs. A doctor will need to listen with a stethoscope to confirm this diagnosis.

Wheezing.

Wheezing can be a sign of blockage or narrowing of the lower airways. The blockage might be caused by:

Asthma cannot be diagnosed until the child is 2 years old, due to the lungs being under developed.

Fast Breathing.

This can mean there’s fluid in the airways from an infection, such as pneumonia. Fast breathing can also be caused by fever or other infections and should be evaluated by a GP right away.

Snoring.

This is usually due to mucus in the nostrils. In rare cases, snoring can be a sign of a chronic condition, such as sleep apnea or enlarged tonsils.

Stridor.

Stridor is a constant, high-pitched sound that indicates airway obstruction, according to 2021 research. It can sometimes be caused by laryngomalacia.

Grunting.

A sudden, low-pitched noise on an exhale usually signals an issue with one or both lungs. It can also be a sign of severe infection. You should visit a doctor immediately if your baby is ill and is grunting while breathing.

Frequent Sneezing.

Sneezing is common in newborns and is not usually cause for concern.

This is because newborns have smaller nasal passages than adults and are still adjusting to breathing through their noses as they grow and develop.

If sneezing is accompanied by other symptoms like coughing, difficulty breathing, or a fever, you should talk with your GP. It could be a sign of a respiratory infection, according to 2021 research.

Frequent sneezing can also be a sign of an allergy to certain types of formula as well as neonatal abstinence syndrome.

Periodic Breathing.

Periodic breathing is common in newborns. It is characterized by pauses in breathing that lasts at least 3 seconds, followed by clusters of breaths, which are often fast and shallow.

This is typical and doesn’t usually require any treatment. However, if pauses in breathing last more than 20 seconds, it may indicate a problem such as infant apnea. Periodic breathing often stops by the time the baby is 3 months of age.

False “First Cold”.

Many newborns seem to experience symptoms of a false first cold very early, which occurs because their nasal passages are very small and can become easily clogged.

Though this doesn’t usually require any treatment, you may consider talking with a GP about ways to help improve their breathing if needed, such as using saline drops or a nasal aspirator, having the baby’s bed on an slight angle of no more than 10 degrees.

If your baby is also experiencing other cold symptoms like irritability, decreased appetite, or difficulty sleeping, it’s best to talk with a GP to address any concerns and determine whether they may have a cold or other infection.

Hiccups.

Hiccups are common and can happen in babies, children, and adults.

Eating too quickly and swallowing air while feeding is two of the possible causes of hiccups in newborns. Hiccups are believed to help strengthen the diaphragm in babies.

Hiccups may also be a symptom of gastroesophageal reflux, which occurs when the contents of the stomach flow into the oesophagus, causing regurgitation.

Ways to Support Respiratory.

Never hesitate to reach out to your GP if you’re concerned about your baby’s breathing.

Irregular breathing can be very alarming and may cause anxiety in parents or caregivers. But first, slow down and look at your baby to see whether they look like they’re in distress.

Here are some tips if you’re concerned about your baby’s breathing:

  • Learn your child’s typical breathing patterns so you’re better prepared to identify what’s not typical.
  • Take a video of your baby’s breathing and show it to a GP. Many medical professionals now offer online appointments or communication by email, saving you a possibly unnecessary trip to the Medical Centre.
  • Always have your baby sleep on their back. This decreases your baby’s risk of sudden infant death syndrome (SIDS), per 2021 research. If your baby has a respiratory infection and isn’t sleeping well, ask your doctor for safe ways to help clear congestion.
  • Research is changing the way we do things all the time. Research has demonstrating that baby sleeping at a slight angle can assist baby’s breathing due to gravity assisting with mucus drainage. Research also states it is not recommended to place your child’s bed on an angle more than 10-degree.  A baby at a 30-degree angle may fall to sleep in a chin to chest position that can restrict their airways. due to the fact they might slide down to bottom of the bassinet or cot. To raise the cot or bassinet by 10 degrees place a small wooden block under the bed frame.
  • Saline drops or spray, sold over the counter at your local chemist, can help loosen and thin out the thick mucus.
  • If the baby is having issues with to much mucus you may need to invest in a Nasal Aspirator for babies to assist in suctioning it out.
  • Sometimes, babies breathe fast when they’re overheated or upset. Clothe your baby in breathable fabrics. You should only add one extra layer more than what you yourself are wearing for the weather that day. So, if you’re wearing pants and a shirt, your baby might wear pants, a shirt, and a sweater.
  • Research has demonstrated that babies who use a dummy to assist in sleeping, have a decreased chance of SIDS.
  • Babies who are regular massaged prior to bed have a decreased chance of SIDS.
  • Do not have loose items in a baby’s bed.

When to Contact a Doctor.

  • Catching an issue early gives your baby the best chance for recovery in the short term and decreases future concerns.
  • A change in a baby’s breathing pattern may indicate a serious breathing problem. If you’re ever concerned, see your GP right away.
  • Doctors will listen to the chest and airways to determine the possible causes; they may require a chest X-ray to assist in diagnosing breathing concerns and make a treatment plan

Seek Immediate Medical Care

If your child experiences any of these symptoms, call 000 or your local emergency services:

  • blue colour in lips, tongue, fingernails, and toenails
  • doesn’t breathe for 20 seconds or more.

See your GP immediately if your child:

  • is grunting or moaning at the end of each breath.
  • has nostrils flaring, which means they’re working harder to get oxygen into their lungs.
  • has muscles pulling in on the neck, around collarbones, or ribs.
  • has difficulty feeding in addition to breathing issues.
  • is lethargic in addition to breathing issues.
  • has a fever as well as breathing issues.

Quiz

  • Voice box
  • Windpipe
  • Lungs
  • Airways (bronchi and bronchioles)
  • Air sacs (alveoli)

Our lungs comprise of a large amount of reserve air.

Babies don’t have reserve air space and only need small amounts of air.

Baby 0 to 12 months.

Awake is 30 – 60 breaths per minute,

Asleep is 30 – 40 breaths per minute.

Adolescents that are 13 to 18 years old have a 12 – 20 breaths per minute

Abnormal breathing patterns, indicating respiratory distress, include rapid or laboured breathing, the use of accessory muscles (neck and chest retractions), nasal flaring, cyanosis (a bluish tint to the skin, lips, or nails), and grunting or wheezing sounds. Causes of respiratory distress can range from infections such as pneumonia and bronchiolitis to chronic conditions like asthma and congenital heart defects, as well as physical obstructions and trauma to the chest or airway.

Babies have limited reserved lung space.

With the limited chest expansion, the child can only increase their lung volumes by increasing their respiration rate, this explains why small children have a higher respiratory rate compared to adults.

Infants are diaphragmatic breathers; therefore, they are positioned in a head up position to ease the work of breathing.

Babies only have 10% of their alveoli and will develop them during the first two years. Cilia are poorly developed at birth.

Infants up to 6 months are preferential nose breathers.

Heart and other organs are relatively large in relation to the infant’s size, leaving less space for chest expansion.

Respiratory muscles of infants tire more easily than that of an adult due to the smaller proportion of fatigue resistant type 1 muscle fibre (39%) in their diaphragms than in adults (55%). This proportion is brought in line with that of an adult by the age of 1 year old.

Whistling Noise

Blockage in the nostrils

Hoarse cry & barking cough

 

Deep cough

 

Wheezing

 

Fast Breathing

 

Snoring

 

Stridor

 

Grunting

 

Frequent Sneezing

 

Periodic Breathing

 

False First Cold

 

Hiccups

 
  • Learn your child’s typical breathing patterns so you’re better prepared to identify what’s not typical.
  • Take a video of your baby’s breathing and show it to a GP. Many medical professionals now offer online appointments or communication by email, saving you a possibly unnecessary trip to the Medical Centre.
  • Always have your baby sleep on their back. This decreases your baby’s risk of sudden infant death syndrome (SIDS), per 2021 research. If your baby has a respiratory infection and isn’t sleeping well, ask your doctor for safe ways to help clear congestion.
  • Research is changing the way we do things all the time. Research has demonstrating that baby sleeping at a slight angle can assist baby’s breathing due to gravity assisting with mucus drainage. Research also states it is not recommended to place your child’s bed on an angle more than 10-degree.  A baby at a 30-degree angle may fall to sleep in a chin to chest position that can restrict their airways. due to the fact they might slide down to bottom of the bassinet or cot. To raise the cot or bassinet by 10 degrees place a small wooden block under the bed frame.
  • Saline drops or spray, sold over the counter at your local chemist, can help loosen and thin out the thick mucus.
  • If the baby is having issues with to much mucus you may need to invest in a Nasal Aspirator for babies to assist in suctioning it out.
  • Sometimes, babies breathe fast when they’re overheated or upset. Clothe your baby in breathable fabrics. You should only add one extra layer more than what you yourself are wearing for the weather that day. So, if you’re wearing pants and a shirt, your baby might wear pants, a shirt, and a sweater.
  • Research has demonstrated that babies who use a dummy to assist in sleeping, have a decreased chance of SIDS.
  • Babies who are regular massaged prior to bed have a decreased chance of SIDS.
  • Do not have loose items in a baby’s bed.