The breathing of a newborn during sleep is something that parents should closely monitor. By frequency and other indicators, it is possible to recognize a dangerous disease in time or even prevent its occurrence and development. Consider how the respiratory system of children up to a year is arranged, what is its normal frequency and how to notice possible deviations in time.
Respiratory system of infants
The respiratory system of a child who has just been born is different from that of an adult. The baby has not yet developed the nasal passage, narrow bronchi, glottis and lumen of the trachea, underdeveloped pharynx. While the organs continue to form, new parents should carefully monitor the baby.
When the baby is still in the womb, his lungs are in a dormant state. After birth, the baby inhales and exhales, then screams. The walls of the alveoli of the lungs are covered with surfactant , which is responsible for the absorption of oxygen and is produced even in the prenatal period. With a shortage of surfactant , the development of respiratory distress syndrome in newborns is possible.
Features of the upper respiratory tract of the baby:
- extended and short nose;
- underdeveloped lower nasal passage;
- thin mucous;
- underdeveloped sinuses.
If inflammation occurs in the body, breathing becomes difficult because the nasal passages are clogged. But children in the first year of life cannot have angina due to other features – small tonsils, poorly developed lymph glands and a narrow throat.
The larynx of an infant is funnel-shaped, the mucous membrane is thin, it contains lymphoid tissue. Because of this structure, children are prone to various diseases, including laryngeal stenosis (narrowing of the larynx that prevents air from entering the respiratory tract).
Newborns have a clear voice. This is due to shortened vocal cords, a narrow glottis. The trachea in the period up to a year is funnel-shaped, it has a narrow passage. Differs in the pliability of cartilage, which can be displaced without effort. There are few mucous glands, which also causes the development of inflammation, dangerous processes, including stenosis.
In the first 12 months of life, the infant has narrowed bronchi with unstable elastic cartilage. The right bronchus is in a vertical position and continues the trachea, while the left bronchus departs from it at an angle. The mucous membrane is not rich in glands, but it is well supplied with blood.
In children under one year old, tissue in the lungs is poorly developed, which is elastic. The lungs themselves have many blood vessels. After the birth of a child, the alveoli in the lungs become larger, and they continue to appear until he is eight years old.
Not all parents know how to distinguish respiratory deviations from the norm. The first thing to start with is to determine the frequency. This is not a difficult procedure, but it requires its own conventions. The child must be healthy and relaxed, otherwise breathing may change due to illness or overexcitation.
The easiest way to calculate how many breaths per minute a child takes in a dream is using a stopwatch.
Norm for different ages:
Parents may notice that a newborn’s breathing alternates between regular breathing and irregular breathing. Otherwise, it is called periodic or Cheyne-Stokes breathing. It looks like this: shallow and rare breaths / exhalations gradually deepen and become more frequent. Upon reaching the maximum (on the fifth – seventh breath), they weaken again and become rare, after which there is a pause. Further, the entire breathing cycle is repeated in the same sequence. This phenomenon is considered normal for infancy. As they grow older, these failures usually disappear.
Sometimes the baby takes a deep breath, then his breath seems to stop. This is influenced by the special features of his respiratory tract (narrow passages in the nose, underdeveloped cavities, missing nasal passage with intense blood circulation). In a dream, the baby may snore, but you should not worry.
the individual details and reasons for the change in the frequency of children’s breathing during sleep within the normal range by examining the child.
What is apnea and why is it dangerous
Apnea is the stoppage of breathing during sleep. This syndrome, which occurs in infants, is quite rare and dangerous. More often it occurs in premature babies who were born prematurely. In such children, the centers for regulating breathing, which are located in the brain, are not fully formed.
In addition, sleep apnea can occur due to hereditary diseases, sore throat, hematomas in the brain or severe injuries during childbirth, hemorrhages in the central nervous system, congenital hernia of the diaphragm, esophagotracheal fistula, rhinitis.
Babies with excess weight, irregular jaw structure, chronic tonsillitis, disorders in the gastrointestinal tract, lack of important substances in the body, Down syndrome, and paralysis are prone to apnea.
The disease manifests itself mainly at night. Her signs:
- the child breathes slowly;
- the face turns blue, especially noticeable on the skin on the lips;
- weak, barely perceptible pulse;
- cessation of breathing, lack of respiratory movements.
Not all sleep apnea is dangerous. They are short-lived and disappear with age. Delays of 10-15 seconds or longer are considered heavy.
The syndrome has two types:
The reason for the first is problems with the nervous system. This type is called apnea of central origin. With it, the baby’s breathing is interrupted.
The second type – obstructive sleep apnea is caused by malfunctions in the respiratory system. A child suffering from this syndrome simply cannot inhale because his airways are clogged. Both types of the disease are dangerous, so you should consult a doctor as soon as possible after detecting the first signs.
What is tachypnea
In addition to respiratory arrest, newborns may experience an increase in its frequency. For this there is a term tachypnea, in another way – polypnea . The first signs are rapid breathing, rapid inhalations and exhalations.
To identify tachypnea, you need to pay attention to the pulse rate, comparing it with the number of breaths and exhalations per minute.
Breathing movements may become more frequent if the temperature of the air or the body of the baby rises. It can also be affected by excitement, crying, physical activity.
With tachypnea, sometimes auxiliary muscles are involved in the process of breathing. There is a possibility of pathologies – for example, malfunctions of the respiratory system or the cardiovascular system. Violations are pulmonary or cardiac dyspnea, which indicates heart failure. An accurate diagnosis can only be made by a doctor.
Other types of shortness of breath are provoked by diseases such as idiopathic cardiac hypertrophy, fibroelastosis (usually congenital), Fallot ‘s disease, and others.
Shortness of breath happens:
- inspiratory – the child has heavy breaths due to problems with the upper respiratory tract. The cause may be rhinitis, laryngitis, stridor .
- expiratory (mixed) – it is usually invisible in the first 12 months of life. Causes – pneumonia, various types of hernias, including diaphragmatic, flatulence, pleurisy, pneumothorax.
Allocate mild and severe shortness of breath. The first manifests itself when the baby is anxious or crying, there are no signs of it at rest. Severe is characterized by manifestations in the normal state of the child, it increases with any physical activity.
Shortness of breath can develop into suffocation. Its causes are diseases such as pneumothorax, complicated pulmonary edema, or severe laryngitis. With severe shortness of breath, the baby develops respiratory failure, which requires urgent treatment.
Types of respiratory failure
With such a pathology, there is no normal support for the gas composition of the blood, or failures occur in the external respiratory organs. This leads to the fact that the body wears out faster and is not able to function fully.
There are four degrees of respiratory failure in a newborn:
- At the first manifestation, they are not immediately obvious, they can become noticeable when the child is anxious, screaming. Symptoms include mild shortness of breath, initial tachycardia.
- The second degree – more severe shortness of breath, the number of breaths – exhalations increases markedly. The baby’s skin may turn pale.
- In the third degree, breathing is not only rapid, but also more superficial. The skin color changes, becomes unhealthy, the baby’s body can be covered with sticky sweat.
- The fourth degree can lead to loss of consciousness and coma. The cervical veins swell, inhalations and exhalations are irregular, impetuous.
What is bradypnea
Bradypnea is a term for a condition when a child makes less than thirty breaths per minute. In the normal state during sleep, the frequency decreases, the breathing itself becomes deeper. But there is a subspecies of pathology, and bradypnea can be a signal of a malfunction of the body.
A change in respiratory rate is often combined with autonomic disorders and problems with the central nervous system, other disorders in which shortness of breath is observed.
Failures of the respiratory rhythm become apparent in diseases of the central nervous system, which include meningitis, dropsy of the brain, encephalitis, convulsions, hemorrhages.
Another similar pathology is the deepening of respiratory movements, short pauses between them.
How to monitor the breathing of a newborn
To independently monitor the frequency of respiration, parents are encouraged to use electronic devices. The choice usually falls on baby monitors . With the help of these devices, which operate mainly on radio waves, the mother and father will hear the child even from another room.
Devices using a different technology – DECT – have a greater range (up to 300 meters).
Another thing suitable for tracking respiration is a breath monitor. The device controls the frequency of inhalations and exhalations. If the pause between them is 20 seconds or more, the respiration monitor gives a signal. Thanks to such devices, you can save your baby from serious seizures and sudden infant death syndrome.
Some monitors are produced as a separate device, while others are combined with electronic nannies. It is convenient to hang them over the child’s bed, put them on the shelves in the nursery, and even hang them on a diaper. Some of the devices are connected to a motion sensor, thanks to which parents will be able to monitor the movements of the baby.
To buy a monitor or baby monitor , you should study the range, talk with other parents who use similar devices, consult a doctor.
When to See a Doctor
If the baby has serious respiratory disorders, then doctors usually detect their signs even in the maternity hospital. But, when the baby has already been taken home, his parents should carefully monitor their breathing. For some disorders, do not delay going to the pediatrician.
When exactly to seek medical help:
- If the child wheezes when breathing. Whistling sounds and groans most often signal a narrowing of the airways, which makes it difficult for air to pass through. These sounds can also indicate inflammatory or infectious processes.
- The reason to immediately call an ambulance is cyanosis in the mouth area, severe drowsiness, respiratory arrest from 20 seconds.
- Baby snore. This is a common occurrence, an indicator of which is frequent breaths through the mouth. Perhaps the newborn has enlarged adenoids, which is also a serious reason to call a doctor.
- Wheezing with cough and coryza. Often accompanied by rapid heavy breathing, lack of appetite and increased moodiness. These are all symptoms of a cold. It may be mild, but there is a possibility that the baby has problems with the bronchi.
- Fever, constant weakness, poor appetite. All these symptoms can indicate various problems in the body, so you should not postpone a visit to the doctor.
There are also conditions in which there is nothing bad for the child, but they should be notified to the doctor:
- Gurgling in throat during sleep. Its cause is the accumulated saliva, which the child does not have time to swallow. When he breathes, air passes through saliva, and a gurgle is formed that can frighten parents.
- Other strange sounds during sleep are light wheezing, whistling. They usually indicate the structure of the nasopharynx, different from the adult. Such sounds are not a reason to panic, but there is no need to hide their existence from the doctor.
Extraneous sounds when breathing. If the child’s condition is normal, he eats well, recovers according to age, this is not dangerous. Such sounds should disappear on their own by the time the baby is one and a half years old.
It is better to “play it safe” and once again turn to a specialist than turn a blind eye to existing problems. Even insignificant deviations sometimes indicate diseases. The sooner the diagnosis is made, the higher the chance of a complete cure for the baby.
How to provide first aid for sleep apnea
People who already have children or who are trying to have them should be able to provide first aid in case of emergency. Below is a detailed instruction on how to save a child when breathing stops.
- Don’t panic. It is quite difficult to follow such advice, but with strong excitement, it will not be possible to help the baby. Shaking hands and confused thoughts will only get in the way.
- Take the baby in your arms, shake it up a little. The main thing is to do it gently, but tangibly.
- Start lightly massaging the ears and limbs, then move on to the chest.
- Sprinkle your baby’s face with cold water.
The previous points usually help if the situation is not critical and short-term respiratory arrest is not life-threatening. If the baby is still not breathing, it is worth moving on to artificial respiration and chest compressions. Exhalations during artificial respiration should be controlled without making them abrupt, so as not to damage the airways. It is better to take heart massage courses in advance with specialists who will tell you about all the subtleties.
Call an ambulance after the procedures have been completed. It is desirable that one of the parents provides emergency assistance, and the second at this time contacted the doctors.
Remember – do not self-medicate. And also give the child suitable, in your opinion, drugs or come up with sets of exercises. Improper treatment will not only not help, but also hurt. In no case should you follow the recommendations of friends or relatives who do not have a medical education and practice.