Key takeaways: Hiccups, sneezing, congested-sounding breathing, and grunting during sleep are usually normal. Newborns breathe through their noses and have small airways. Grunting with every breath, fast or labored breathing, or blue color are warning signs.
New parents often lie awake listening to every squeak and snort coming from the bassinet. Newborns are surprisingly loud sleepers. Most of those noises are normal, but a few breathing signs need attention right away. Here’s how to tell the difference.
Hiccups
Newborns hiccup often, sometimes several times a day, and even had hiccups in the womb. Hiccups are caused by sudden contractions of the diaphragm. They may happen after feeding, when your baby swallows air, or for no clear reason.
What helps: hiccups usually stop on their own within 5 to 10 minutes and rarely bother babies. Burping during feeds, feeding before your baby is frantic, and keeping your baby upright after feeds may reduce them. Don’t try adult remedies like startling your baby, pulling the tongue, or giving water.
When to call: if hiccups happen with frequent spit-up, back arching, crying during feeds, or poor weight gain, mention it to your doctor.
Sneezing
Newborns sneeze a lot. It’s how they clear their small nasal passages of mucus, amniotic fluid, milk, dust, and lint. Frequent sneezing on its own isn’t a sign of a cold or allergies.
Congested Breathing and Snorting
Newborns breathe mainly through their noses, and their nasal passages are tiny. A small amount of mucus or milk can make breathing sound snorty, whistly, or congested, especially during feeds and sleep.
What helps: if congestion seems to bother your baby or interfere with feeding, put a drop or two of saline in each nostril and gently use a bulb syringe or nasal aspirator. Don’t overdo suction, which can irritate the nose. A cool-mist humidifier can help in dry rooms.
Grunting During Sleep
Many newborns grunt, groan, whimper, and squeak while sleeping. They spend more time in active (REM) sleep than adults, and they move and make noise during it. They also grunt when passing gas or stool, since they’re still learning to coordinate relaxing the pelvic floor while pushing with the belly muscles (sometimes called infant dyschezia). This normal straining improves over the first months.
Irregular Breathing
Newborns often breathe in an irregular pattern called periodic breathing: a series of fast breaths followed by a pause of up to 10 seconds, then regular breathing again. It’s normal, especially in sleep, and is more common in premature babies. Normal newborn breathing rates are about 30 to 60 breaths per minute.
When Breathing Noises Are a Concern
Call 911 or go to the emergency room if your baby has:
- Blue or gray color around the lips, tongue, or face.
- A pause in breathing of 20 seconds or longer.
- Severe trouble breathing, or your baby seems to be struggling or tiring out.
- Limpness or can’t be woken.
Call your baby’s doctor promptly if your baby has:
- Grunting with every breath while awake, especially with fast breathing. This can be a sign of respiratory distress.
- Fast breathing: more than 60 breaths a minute when calm.
- Retractions: the skin pulls in between the ribs, below the ribcage, or above the collarbone with each breath.
- Nasal flaring: nostrils widen with each breath.
- Head bobbing with breathing.
- Wheezing or a high-pitched noise when breathing in (stridor).
- Breathing trouble that makes it hard to feed.
- Fever of 100.4°F or higher.
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Noisy Breathing That Lasts: Laryngomalacia
Some babies make a high-pitched, squeaky noise when breathing in that’s worse when they’re on their backs, feeding, or crying. The most common cause is laryngomalacia, a floppiness of the tissue above the vocal cords. It usually starts in the first weeks, peaks around 4 to 8 months, and goes away by 12 to 24 months. Most cases are mild, but your doctor should evaluate it, especially if your baby has feeding problems, poor weight gain, or breathing pauses.
How to Count Breaths
Watch your baby’s chest or belly rise and fall for a full 60 seconds while they’re calm or asleep. Count each rise as one breath. If you’re unsure or the number seems high, call your doctor and describe what you see. A short video can help.
The Bottom Line
Hiccups, sneezes, snorts, and sleep grunts are part of normal newborn life. Fast or labored breathing, grunting with every breath, pulling in at the ribs, and blue color are not. Trust your instincts and call if something seems off.
For a complete guide to newborn health and warning signs, see From First Breath to First Birthday.
Sources
- Altmann TR, Hill DL, eds. Caring for Your Baby and Young Child: Birth to Age 5. 7th ed. American Academy of Pediatrics; 2019.
- Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014;134(5):e1474-e1502.
- Patrinos ME, Martin RJ. Apnea in the term infant. Semin Fetal Neonatal Med. 2017;22(4):240-244.
- Benninga MA, Nurko S, Faure C, Hyman PE, St James Roberts I, Schechter NL. Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 2016;150(6):1443-1455.
- Thompson DM. Laryngomalacia: factors that influence disease severity and outcomes of management. Curr Opin Otolaryngol Head Neck Surg. 2010;18(6):564-570.
- World Health Organization. Integrated Management of Childhood Illness: Chart Booklet. Geneva: WHO; 2014.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
