I sit writing this blog having been awake half the night with my 6 month old, who currently has his 5th cold. He is the youngest of 4 so there’s no prizes for guessing where all these viruses have come from! He has a hacking cough, which makes him sound like a lifelong smoker and a wheeze that you can hear from the next room! As a Mum, I was worried about him – babies frequently sound wheezy with colds as their airways are so small, any mucous blocking them causes the air to whistle past – it’s horrible to see your own baby struggling. I have to put my objective doctor hat on to decide whether to be really worried or not. The following is a guide to knowing when your baby’s breathing is really a cause for concern…
1. How fast is your baby breathing? Babies already breathe much faster than adults – usually around 40-60 breaths per minute when they are very young, so their breathing already looks fast. I am not suggesting you try and count the rate but if you know what your baby’s breathing normally looks like and they now seem to be breathing more rapidly, they should be checked out.
2. How is your baby feeding? Babies under 6 months of age have to breathe through their nose. Understandably, if this is blocked or they are struggling to breathe for any other reason, feeding is extremely difficult. As a rough rule of thumb, if your baby is feeding less than half of their normal feeds, they need to be seen by a doctor. This is super tricky if you are breastfeeding so watch their nappies – if they are producing much less urine than normal, please take them to be seen.
3. How laboured is your baby’s breathing? Babies who are working hard to breathe often suck their chests in with each breath. Have a look at your baby’s chest when he or she is undressed. Babies who are working hard will often have a dip between each rib and under the ribs with each breath. Very young babies may also flare their nostrils or bob their heads with each breath if they are in distress. If you see any of these things, it is best to get a doctor to see them.
4. How is your baby in general? Babies who have been working hard to breathe use up more energy. This may mean that they are more sleepy or lethargic, and less interested in playing. Unwell babies may also look paler than usual – only you know how your baby looks normally so trust your instincts and get them seen if you are worried. It goes without saying, that no baby should look blue – this is a very worrying sign and a good reason to call an ambulance.
We, as doctors, are always happy to see babies with concerns about their breathing – we would much rather see and reassure than miss a poorly child, or leave a parent worrying alone.
As for my little man… he had no worrying signs and he always eats like a trooper, so he is now sleeping peacefully in his pram while I type this… fingers crossed that tonight is better!