Baby Breathing Problems and Their Causes
Contents
- OVERVIEW
- CAUSES OF BABY BREATHING PROBLEMS
- BABY BREATHING PROBLEMS
- Birth Asphyxia
- Bronchiolitis
- Pneumonia
- Croup
- Pharyngitis
- Miscellaneous
- HOW TO DIAGNOSE BABY BREATHING PROBLEMS?
- Complete blood count
- Chest X-ray
- Blood culture
- Gram staining
- Pleural fluid examination
- Tuberculin skin test
- When tO Seek Medical Help?
- Sources
OVERVIEW
Breathing problems in babies happen when a baby can’t move enough air in and out of the lungs or can’t get enough oxygen into the blood. When oxygen levels drop, the baby’s organs can’t work normally.
Babies born early (premature) or with low birth weight are at higher risk, because their lungs may not be fully developed. Infections such as RSV, colds, and pneumonia are common causes of breathing trouble in older babies.
If your baby is struggling to breathe, has blue or gray lips or skin, or pauses in breathing, call 911 right away.
CAUSES OF BABY BREATHING PROBLEMS
Problems around birth can come from the mother, the placenta, or the baby. Risk factors include:
- Maternal
- Maternal high blood pressure
- Eclampsia
- Pre-eclampsia
- Diabetes mellitus
- Kidney disease (nephritis)
- Infections
- Low oxygen levels in the mother
- Pelvic abnormality
- Placental
- Placental abruption
- Placental insufficiency
- Fetal
- Prematurity
- Anemia
- Infections
- Umbilical cord prolapse
- Abnormal position of the baby in the womb
- Heart problems
- Lung problems
- Being born past the due date (post-term)
BABY BREATHING PROBLEMS
Birth Asphyxia
Birth asphyxia happens when a baby doesn’t get enough oxygen before, during, or right after birth. A baby with asphyxia may not breathe or cry normally at birth, may have a slow heart rate, poor muscle tone, pale or blue skin, and weak reflexes.
Lack of oxygen can damage the brain, heart, and other organs. It is a medical emergency that the delivery team treats right away, often by helping the baby breathe.
Warning signs during labor include an abnormal fetal heart rate on monitoring and thick meconium (the baby’s first stool) in the amniotic fluid.
Bronchiolitis
Bronchiolitis is an infection that inflames the small airways of the lungs (bronchioles). It is one of the most common causes of breathing problems in babies. It mainly affects children under 2, with a peak at 3 to 6 months of age.
It is usually caused by a virus, most often respiratory syncytial virus (RSV). It starts like a cold and can lead to cough, wheezing, fever, rapid breathing, nostril flaring, and retractions, where the skin between or below the ribs sinks in with each breath.
Treatment focuses on fluids, saline drops with suction, and rest. Antibiotics don’t help because it is caused by a virus. Some babies need hospital care with oxygen and IV fluids.
Careful handwashing helps prevent it. Ask your pediatrician about RSV prevention options for your baby.
Pneumonia
Pneumonia is an infection of the lung tissue. In children it can be caused by viruses or bacteria, such as Streptococcus pneumoniae (pneumococcus).
A child with pneumonia may have fever, cough, fast breathing, nostril flaring, and retractions, and may seem drowsy or restless. Some children also have vomiting, diarrhea, or belly pain. Staying up to date on vaccines, including pneumococcal and flu vaccines, helps prevent it.
Croup
Croup is swelling of the upper airway around the voice box (larynx) and windpipe (trachea). It causes a cough that sounds like a seal barking, a hoarse voice, and sometimes a harsh, high-pitched sound when breathing in, called stridor.
It is usually caused by viruses, most often parainfluenza. It mostly affects children between 3 months and 5 years of age and is more common in fall and winter.
Symptoms are often worse at night. Croup typically starts like a cold, and the barking cough develops over a day or so. It usually lasts 3 to 7 days.
Doctors may treat moderate or severe croup with a steroid medicine, usually given by mouth, and nebulized epinephrine in more severe cases.
Cool or moist air may help a child feel more comfortable, though studies haven’t shown it reduces symptoms. Call 911 for stridor at rest, struggling to breathe, drooling, or bluish lips.
Pharyngitis
Pharyngitis is inflammation of the throat. It causes redness, swelling, and sometimes sores. It is usually caused by viruses, but bacteria such as group A strep can also cause it. It rarely causes serious breathing problems.
A child with pharyngitis may have a sore throat, fever, trouble swallowing, and swollen glands in the neck. Strep throat is diagnosed with a throat swab (rapid strep test or throat culture).
Viral pharyngitis is treated with fluids, rest, and fever and pain relief your doctor recommends. Strep throat needs antibiotics. Get care right away if a child drools, can’t swallow, or has noisy or labored breathing.
Miscellaneous
Other conditions that can cause breathing problems in babies include:
- Sinusitis
- tonsillitis
- acute epiglottitis
- otitis media
- Laryngomalacia
- pleural effusion
- bronchiectasis
- pulmonary abscess
- Pneumothorax
- Asthma
- cystic fibrosis
- acute respiratory infections
- Choanal atresia
- Pulmonary tuberculosis
HOW TO DIAGNOSE BABY BREATHING PROBLEMS?
Your doctor will start by examining your baby and checking breathing rate and oxygen level. Depending on the cause they suspect, they may order tests such as:
Complete blood count
A complete blood count measures white blood cells, which are often raised in bacterial infections.
Chest X-ray
A chest X-ray can show pneumonia and other lung problems. It can also show a pleural effusion, which is fluid in the space around the lungs.
Blood culture
A blood culture checks for bacteria in the blood.
Gram staining
If an older child is coughing up mucus (sputum), a Gram stain of the sample can help identify bacteria.
Pleural fluid examination
If the chest X-ray shows fluid around the lungs, a sample may be drawn out and tested.
Tuberculin skin test
A Tuberculin skin test may be done if tuberculosis is a possibility.
Viral tests on a nasal swab can identify viruses such as RSV, flu, or COVID-19.
When tO Seek Medical Help?
Get emergency help right away if your baby has bluish lips, face, or nails, pauses in breathing, grunting, retractions, nostril flaring, very fast breathing, or seems very sleepy or hard to wake.
Call your baby’s doctor promptly for fever in a baby under 3 months, a cough with fever, a cold that suddenly gets worse, or poor feeding.
Your doctor will examine your baby and may order tests to find the cause. Follow the treatment plan your doctor gives you.
Sources
- Bronchiolitis, MedlinePlus
- Croup, MedlinePlus
