Newborn Breathing Sounds, Sneezing and Stuffy Noses: What's Normal

Why newborns sound so noisy

• Babies breathe mainly through tiny noses, so a little milk, mucus or dry air makes a lot of noise.
• Normal breathing rate for a newborn is about 30-60 breaths a minute while calm, faster than an adult and faster again when crying or feeding.
• Many new parents lie awake listening. That is normal, and most sounds are harmless.

Sounds that are usually normal

• Sneezing, often many times in a row. It clears the nose and is rarely a cold.
• Snorting, snuffling and whistling through the nose, especially after feeds.
• Periodic breathing: a few quick breaths, then a pause of up to about 10 seconds, then normal breathing again. Most common in deep sleep and in premature babies. It fades over the first months.
• Grunting and straining while passing stool or gas, then settling.
• Hiccups (see the hiccups and spit-up guide).
• Rattly chest sounds that change when the baby coughs or swallows. Usually mucus or milk at the back of the throat, not in the lungs.

Floppy airway (laryngomalacia)

• A high, squeaky sound when breathing in, worse on the back, when feeding, crying or excited.
• It comes from soft tissue above the voice box and is the most common cause of noisy breathing in babies. It often gets louder for a few months, then fades, usually by 12-18 months.
• Most babies need nothing but checkups. Mention it so the pediatrician can watch growth and feeding.

Easing a stuffy nose

1. Put 1-2 drops of saline in each nostril.
2. Wait a few seconds, then suction gently with a bulb syringe or nasal aspirator.
3. Do it before feeds and sleep, not every hour; too much suction irritates the nose.
4. A cool-mist humidifier helps in dry rooms. Clean it daily.
5. Keep the baby away from smoke, vaping and strong scents.
6. More on illness itself is in the stuffy nose and colds guide.

Signs of working too hard to breathe

• Breathing faster than about 60 breaths a minute, steadily, while calm.
• Skin sucking in between or under the ribs, or above the collarbone, with each breath.
• Nostrils flaring, head bobbing, or a grunt at the end of every breath.
• Pauses longer than about 20 seconds, or a pause with color change.
• Too breathless to feed.

When to check in

• Bring up squeaky breathing, frequent rattling, or noisy breathing that bothers you at the next checkup. A short video of the sound helps a lot.
• Any of the working-hard signs above, or a fever of 100.4°F (38°C) or higher under 3 months, needs a call to the pediatrician right away.
• If your baby's lips or face turn blue or gray, or they stop breathing, call 911.