Noisy Breathing in Babies: When to Worry & What’s Normal

The sound of a newborn’s breathing is often a beautiful, rhythmic comfort. However, sometimes these sounds can become a source of anxiety for new parents, especially when they are loud, rattling, or wheezy. Every new parent has spent at least one night hovering over their baby’s cot, listening to the strange array of snorts, whistles, and grunts their baby makes. While newborns are notoriously “noisy breathers,” it can be difficult to tell the difference between a harmless squeak and a sign of respiratory distress.

Noisy Breathing in Babies: What It Is and Why?

Noisy breathing in babies is a common occurrence and, in most cases, considered normal and harmless because newborns, until birth, do not have to breathe in the traditional sense, so having to do so all of a sudden means different babies deal with breathing for the first time and after that in different ways. In the womb, babies receive oxygen from their mother’s blood through the placenta and umbilical cord, while their lungs are filled with amniotic fluid, which moves in and out of their lungs during breathing practice to strengthen the lung muscles and prepare for their first breath after birth. This process is referred to as fetal breathing movements. We understand your family’s health is your priority. This guide breaks down the science of infant respiration, identifies common causes of noisy breathing in babies, and highlights the specific red flags that require immediate medical attention, to give you an idea of when it’s time to consult your doctor.

The Anatomy of a Baby’s Breathing

Before reaching for the phone, it is helpful to understand why babies make so much noise. Babies are “obligate nasal breathers,” meaning they primarily breathe through their noses for the first few months. Their airways are also incredibly narrow, and their cartilage is soft.

Because their nasal passages are so small, even a tiny amount of mucus or a stray piece of lint can create a whistling or rattling sound. Common sounds that are usually not a cause for concern include:

• Rhythmic Grunting: Often related to digestion or “breaking in” the respiratory system.

• Occasional Snorting: Usually just clearing the nasal passage.

• Periodic Breathing: Where a baby breathes fast, then slow, then pauses for a few seconds. This is common in newborns as their nervous system matures.

The most common types of sounds you might hear are the stridors and the stertor.

Stridor (Happens during Inhale/ Breathing in)

A high-pitched, at times musical sound, usually heard when a child breathes in. It often indicates or is caused by a partial blockage of the larynx (voice box) or trachea (windpipe) at the level of the voice box or just below it. Commonly known as Laryngomalacia, meaning “Soft Larynx”, which is a condition in which floppy tissue or soft cartilage of an infant’s voice box (larynx) collapses when they inhale and partially blocks the airway, causing “inspiratory stridor“, a noisy, high-pitched breathing sound.

Stertor (Happens during Exhale/ Breathing out)

A low-pitched, rumbling or noisy sound in the upper airway, similar to a loud snore, usually when an infant exhales/ breathes out. This is usually caused by vibrations or a partial obstruction in the soft tissues in the “nasopharynx” or “oropharynx”, which is the back of the mouth, nose or throat or a narrower than usual lower or upper airway. Stertor is sometimes considered a serious airway obstruction or a sign of congestion, like a common cold, or swelling of the lymph tissue behind the nose,  and requires medical evaluation, especially in infants, as it can lead to mouth breathing, snoring, and disturbed sleep.

Causes of Stridor

Laryngomalacia

Laryngomalacia is a very common cause of noisy breathing in infants, but rarely occurs in older children and sometimes adults with other medical conditions. When the laryngeal tissues above the vocal cords become floppy or softer than normal, breathing in causes the tissues above the vocal cords to partially collapse inwards over the airway.

This is when “Stridor” is created. If the noise is persistent or occurs with every breath, it may be categorised as stridor (a high-pitched sound during inhalation) or wheezing (a whistling sound during exhalation). This usually starts within the first week after a baby is born, but can also develop after 2-4 weeks in newborns.

Laryngomalacia is the leading cause of noisy breathing in infants. Commonly referred to as a floppy larynx, it is mostly described as an “immaturity of the voice box” rather than a condition. It occurs when floppy tissue above the vocal cords partially blocks the airway when a child breathes in.

Viral Infections and Bronchiolitis

Common respiratory viruses, such as RSV (Respiratory Syncytial Virus), can cause inflammation in the small airways. This often leads to wheezing and increased mucus. If your baby has a fever or a persistent cough alongside noisy breathing, it is worth consulting your GP.

While it sounds alarming, 90% of children outgrow this condition by age two as their larynx gets stronger.

Symptoms of Stridor

Symptoms of a “Soft Larynx”, if not severe, can mostly be considered normal until they start to negatively affect the infant. What to look out for is:

• Noisy breathing (stridor)
• Baby is not sleeping restfully
• When an infant has difficulty feeding
• Frequent spitting up, vomiting or choking episodes during feeding
• Weight gain issues, eg, when an infant is consistently below expected weight or does not gain weight.
• When an infant spends a lot of energy breathing
• Frequent stops during breathing or stops breathing during sleep
• A clear indentation on the chest or neck of infants when breathing

When to Seek Medical Advice for Infant Respiratory Issues

Parents always know best, so we’ll say “Trust your instincts”. While the sounds are often not harmful, the following signs warrant a call to your GP or paediatrician. We recommend looking for these specific “Red Flags.”

Physical Signs of Respiratory Distress

Beyond the sound, you must look at the baby’s body. If the baby is using too much energy just to breathe, they may exhibit:

1. Nasal Flaring: The nostrils widen significantly with every breath.

2. Chest Retractions: An indentation in the neck or chest (where the skin “sucks in” around the ribs) with each breath.

3. Cyanosis: A blue or greyish tint around the lips, tongue, or fingernails. This indicates a lack of oxygen.

4. Poor Weight Gain: If a baby is struggling to breathe, they may become too exhausted to feed properly, leading to “failure to thrive.”

5. Apnea: Any pause in breathing that lasts more than 20 seconds.

Immediate Emergency Triggers

If your baby has a sudden onset of noisy breathing or if they have potentially inhaled a small object, seek emergency care immediately.

Management and Treatment Options

Severity can vary. For mild cases of noisy breathing caused by laryngomalacia or reflux, doctors often recommend “putting gravity on your side.” This includes keeping the baby upright during feeding and ensuring plenty of supervised “tummy time” while awake. Laryngomalacia is usually nothing that requires treatment

In more severe cases, where the baby has difficulty eating or gaining weight, a specialist (otolaryngologist) may perform a minimally invasive surgery called a supraglottoplasty. This procedure removes excess tissue to clear the airway, and most babies recover quickly, often feeding the same day.

Conclusion

Balancing Vigilance with Peace of Mind. Noisy breathing in babies is frequently a byproduct of their developing bodies. In the majority of cases, those whistles and grunts are simply the sound of a small airway navigating a big world. However, by staying informed about symptoms like stridor and monitoring for physical signs of struggle, you can ensure your child gets the care they need.

Trust your parental intuition. If your gut tells you something is wrong, or if you see any of the red flags mentioned above, contact a healthcare professional.

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