Breathing Patterns in Sleeping Babies

Bringing a baby home from the hospital is undoubtedly one of the most exciting yet daunting moments in any parent's life. Getting to know your child's behaviour while waking and sleeping will take a while, and you can expect to feel alarmed by something you later realise is normal on more than one occasion during the first few weeks. Here's our helpful guide to what's normal and what's not for a baby when it comes to breathing during their sleep.

What's Normal?

'Normal' covers a surprising amount of noises, sighs, coughs and even whistles. Babies' breathing changes throughout the night; sometimes fast and deep, sometimes shallow and slow, sometimes even seeming to stop for up to five seconds. Medical professionals call the unusual patterns of breathing seen in sleeping babies 'periodic breathing'. This is a common phenomenon and is borne out of a baby's respiratory system being still immature at the point of birth, and having to adjust to the dramatic change of environment from being effectively 'under water', to permanently in the air. You may choose to spend some time getting to know your baby's patterns so that you can feel assured that they are well, but try not to do this at the expense of your own precious opportunities to rest and sleep. Incidences of babies stopping breathing for short periods are extremely rare (about 500 cases a year in the UK), so while it is natural for a new parent to be concerned about every aspect of their child's health, in most cases noisy sleeping and irregular breathing patterns are entirely normal and to be expected.

There is a well-established three stage check that is recommended to parents who have any concerns about their baby's breathing during sleep:

1. Listen. Put your ear next to your baby's mouth and nose and listen for sounds of breath.
2. Look. Position your eyes to be level with your baby's chest, and watch for the rising and falling of the breathing movement.
3. Feel. Put your cheek next to your baby's mouth and nose and feel the movement of air against your skin.

When To Take Action

As you can see, the breathing of babies during their sleep can vary enormously through the night with no cause for alarm. If your baby suffers from acid reflux or has a cold that is affecting their nasal passages, raising the head-end of their cot so as to tilt the child a little during sleep will afford them some relief. However, if you believe your baby to be suffering from noticeably irregular breathing, or he is gagging, choking, coughing severely, grunting, or rasping at the end of every breath, then it is time to seek emergency medical help. If his nostrils flare as he breathes, or his chest expands and contracts in an unusually laboured way, his breathing is rapid, (more than 60 breaths per minute)or he turns blue, particularly around the mouth and nose, again, you should seek medical assistance very promptly. This is also the case if you feel his heartbeat has become irregular, or you observe puffy or swollen extremities, decreased urine output or sweating.

Sudden Infant Death Syndrome

Sudden Infant Death Syndrome is mentioned here as it is, in its simplest terms, an extreme form of the irregular or periodic breathing patterns we now know are commonplace amongst a proportion of young babies. A victim of SIDS will stop breathing (called apnoea), but then, unlike other children who suffer similar events, fail to resume breathing. The causes of SIDS are still not fully understood, though it does appear that babies who succumb to SIDS (and those who have frequent apnoea-type events) have fewer night-time waking episodes, or 'active-sleep' time. The incidence of SIDS has declined dramatically around the world during the last 20 years and, thankfully, now effects less than 1 in 1000 babies in most western nations. This reduction has occurred due to intensive research that has found correlations between that behaviour of parents in certain key areas and the likelihood of SIDS. In short, there are things that you can do to reduce the possibility of it happening to your child.

So, what measures can you take? Here's a list of ideas to get you started.

• Put your baby down to sleep on his back every single time. Never allow them to fall asleep facing downwards on your chest. Guidance about how to lie your child down has changed considerably during the last 50 years, so stick to this latest guidance no matter what you are told by older members of your family. This one piece of advice has probably had the greatest impact on the reduction of numbers of deaths from SIDS.
• Keep your baby in the same room as you until they are at least six months of age.
• Avoid co-sleeping. (This point is controversial but the evidence does support its inclusion.)
• Employ a movement monitor that registers non-movement of more than 20 seconds duration. Some argue that they cause more worry than they resolve; that's for you to decide.
• Use a new mattress for every child; aging mattresses release gasses that may play a part.
• Keep the crib clear of clutter.
• Choose a sleeping bag over the more traditional sheets and blankets. If you do use blankets ensure they a cellular, as this design allows the passage of air.
• Avoid cot bumpers, as they do not allow the passage of air around the sleeping baby.
• Keep the air in your baby's room as close to the ideal of between 16 and 20 degrees centigrade as you can; cooler is always better than warmer.
• Do not smoke during pregnancy or in your home once the baby arrives and avoid drinking while you are supervising your baby.
• Breastfeed your baby if you can, even for a short while.
• Use a dummy (pacifier or soother) but make sure it meets safety standards and cannot be sucked too far into the mouth.