Why do toddlers wake up at night?

Toddlers wake for reasons such as short sleep cycles, separation anxiety, or nightmares — not hunger. Understanding this helps parents respond calmly and guide their child toward independent sleep.

How long does toddler sleep training take?

Most toddlers adjust to sleep coaching within 1–3 weeks, though some take longer. Consistency is key and setbacks are normal during illness or routine changes.

What is the Slingshot Method?

The Slingshot Method is a gentle sleep coaching approach where parents gradually move farther from their toddler’s bed over several nights — from sitting beside them to eventually outside the room — to teach self-soothing without tears.

Can I sleep train my toddler while co-sleeping?

Yes. Some toddlers find comfort co-sleeping during transitions. You can maintain gentle boundaries and still encourage independent sleep through communication and gradual change.

What if my toddler gets out of bed repeatedly?

Calmly return your child to bed without extended conversation or play. Expect repetition at first, but consistency helps them learn that staying in bed is the new normal.

How fast should a newborn breathe?

A healthy, full-term newborn breathes about 40–60 times per minute. The rate may slow during sleep and increase when crying or feeding.

What is apnea in newborns?

Apnea is a pause in breathing lasting more than 20 seconds. Short pauses of 5–10 seconds are normal, but longer episodes require stimulation or medical evaluation.

Is it normal for my baby’s hands or feet to look blue?

Yes. Blue hands, feet, or a bluish area around the mouth—called acrocyanosis—are common in the first days of life. Blue inside the mouth or tongue, however, is not normal and needs emergency care.

When should I call the pediatrician about my baby’s breathing?

Call the pediatrician or 911 if your newborn has pauses in breathing longer than 20 seconds, blue lips or tongue, flaring nostrils, retractions, grunting with each breath, or appears weak and unresponsive.

How can I help my baby breathe comfortably?

Lay your baby on their back for every sleep on a firm, flat surface, keep nasal passages clear with saline or a bulb syringe, and avoid smoke or strong scents near the baby.

Air Quality Info for Families

June 8, 2023

Experiencing poor air quality due to wildfires and polluntants is becoming more common. Newborns and their parents in all parts of the US may be affected. This blog, Air Quality Info for Families aims to ease parents’ minds by providing information on how to keep babies, children and themselves safe.

Air Quality Info for Families showing colored graph — Air Quality Info for Families

Newborns, Infants and Older Children

There are specific health risks for newborns and infants. Children up to age 18 are also more at risk for issues related to poor air quality. Here’s why:

Developing respiratory systems: Because babies’ lungs and respiratory systems are not mature, they are particularly sensitive to air pollutants. Poor air quality can worsen respiratory conditions and even hinder lung development.
Higher breathing rates: Babies have higher breathing rates compared to adults, which means they inhale a larger volume of air relative to their body weight. They have an increased intake of polluted air when air quality is poor.
Weaker immune systems: Newborns and infants have immature immune systems, making them more susceptible to the harmful effects of air pollution. Exposure to pollutants can increase the risk of respiratory infections, allergies, and other health problems.
Long-term health effects: Early exposure to high levels of air pollution can have long-lasting effects on a child’s health. Studies have shown that children exposed to air pollution during infancy and early childhood are at a higher risk of developing respiratory disorders, allergies, asthma, and other chronic health conditions later in life.

Sensitive Groups: Who Are They?

Sensitive groups in the Air Quality Index (AQI) are those who are more vulnerable to the adverse effects of air pollution. The specific sensitive groups recognized by the U.S. Environmental Protection Agency (EPA) include:

Children under Age 18: Newborns, Infants, children and adolescents are considered sensitive, as their respiratory systems are still developing. Babies in particular also have higher breathing rates.
The Elderly: Age-related changes in the body’s respiratory and immune systems can increase older adults’ vulnerability. Natural age related health issues such as weakened immune system also add to this vulnerability.
Respiratory conditions: Individuals with asthma, chronic obstructive pulmonary disease (COPD), bronchitis, or other respiratory conditions are more sensitive to air pollution. Therefore, pollutants can exacerbate their symptoms.
Cardiovascular conditions: Those with heart disease, congestive heart failure, coronary artery disease, or other cardiovascular conditions may experience worsened symptoms. They are also at increased risk of cardiovascular events due to poor air quality.
Pregnancy: Pregnant individuals may be more sensitive to air pollution because it can affect both maternal health and fetal development. Exposure to pollutants during pregnancy has been associated with adverse outcomes. Preterm birth, low birth weight, and developmental issues are examples.
Outdoor workers: People who work outdoors are exposed to higher levels of air pollution for longer durations. They may experience increased risks to their respiratory and cardiovascular health.

Air Quality Index by the Numbers

On your weather app, you’ll see air quality index noted by numbers. Here is how they break down.

green: good; 0-50

yellow: moderate: 51-100

orange: unhealthy for sensitive groups: 101-150

red: unhealthy; 151-200

purple: very unhealthy; 201-300

maroon: hazardous; 301 and higher

3 year old girl looking at the sky while wearing sunglasses — air quality info for newborns and kids

Air Quality Info for Families: How to Protect Babies and Families

Stay Inside: try to remain in a well-ventilated, clean environment, avoiding outdoor activities that could expose them to polluted air.

Limit Physical Exertion: breathing heavy causes us to intake more air; try to limit this.

Get a Good Mask: As airnow.gov notes: N95 respirator masks can provide protection from wildfire smoke. Cloth masks will not work.

Take Indoor Breaks: If you must be outside, frequent breaks indoors in places where the air is clean can help.

Air Purifiers: Purchase an air purifier for your home for extra protection. Consumer Reports has a comprehensive list of indoor air purifiers.

For more information on the AQI and how it affects our health, visit airnow.gov.

Sleep Coach Your Toddler: A Parents Guide

May 26, 2023

updated, May 26, 2023 – Do you wonder why your toddler wakes up through the night? When will your child get on a routine or nap better? Parents of toddlers often have the same questions we hear about newborns. At Let Mommy Sleep our team of night nurses, nannies and postpartum doulas reassure parents: even if they haven’t been sleeping through the night, it’s not too late to sleep coach your toddler.

Getting Ready to Sleep Coach Your Toddler

A question we’re often asked at LMS is if we’ll soothe toddlers back to sleep if they wake through the night. Even though the night nannies are there to provide newborn care, the answer is yes we will try to care for toddler siblings. But here’s what we’ve learned: toddlers are usually not waking due to hunger or a wet diaper, they want MOMMY or DADDY. Understanding this distinction is crucial for successful sleep training.

Most toddlers adjust to sleep coaching within 1–3 weeks, though some take longer so remember to keep this expectation in mind. Consistency is key, and small setbacks are normal especially with illness, travel or changes in routine.

Two year old boy outdoors in striped short and jean shorts

Why Toddlers Wake at Night

Toddlers’ sleep cycles are shorter than adults’, and they’re sometimes experiencing separation anxiety, nightmares or transitions between light and deep sleep. Knowing this helps parents respond calmly rather than react in frustration. And if a toddler has never slept through the night without a parent’s help, it makes sense that they will continue to expect parent visits in the middle of the night -they don’t know any other way.

Pave the Way with Communication

Once you decide that it is appropriate for your toddler to learn to sleep through the night on their own, explain the change in an age-appropriate way:

Include your toddler in planning: Have a short family meeting to explain expectations, like staying in bed until the wake-up clock goes off. Review the plan nightly before bedtime.
Use positive reinforcement during the day. For example: “Wow, you’re growing up, and this new sleep routine is for big kids!”
Discuss nighttime expectations: “Remember, if you wake tonight, I’ll come in and lay you back down, but I won’t lie in bed with you.”
Reward charts can work too. For example, after three nights staying in bed, your child could choose a small toy.

Some parents consider sleep training when moving toddlers from the crib to the big kid bed. To learn more about that, read How to Ease Toddlers Into Big-Kid Beds.

It’s a Learned Skill

Your toddler must learn the skill of putting himself to sleep without help. But you can teach the skill without making him cry-it-out by communicating and then gradually intervening less and less through the night. Here’s how:

Slingshot Method: A Gentle Approach

When sleep training toddlers, you can do the regular wind down routine and then leave the room, checking in on your child as needed, or you can try this method:

Start awake but calm: Place your toddler in bed while drowsy but awake. Follow your usual wind-down routine (bath, books, rocking).
Gradual withdrawal:
- On Nights 1–2: Sit beside the bed, reassure with voice or touch, gently place them back if standing.
- Nights 3–4: Move chair farther from bed, reassure as needed.
- Nights 5–6+: Sit near the doorway, then eventually outside the room.

Key point: The goal is, “I’m here to help you calm down, but it is your job to fall asleep.”

Does this mean you must stop co-sleeping with your toddler? Nope. It’s completely normal for little ones to go through stages of wanting to sleep in the big bed. Like grown-ups, they may feel anxious or nervous about things. They may lack the words to verbalize their worries but they do know that being in the cozy bed with parents is comforting.

tweet about how to sleep coach your toddler — I mean…

Sleep Coach your Toddler: Handling Nighttime Out-of-Bed Behavior

If your toddler repeatedly gets out of bed and comes to your room, and you want them to sleep in their bed:

Calmly return them to bed.
Avoid lengthy interaction or play.
Expect to repeat this 10–15 times; consistency is crucial.

Tip: Use a wake-up clock that turns a different color when it’s morning time, or nightlight to reinforce the idea that it’s still bedtime.

Don’t Begin on Empty

Make sure on the day that you begin sleep coaching that your child has a full “sleep tank”; they’ve had a good nap during the day- if that means that you need to take her for a walk in the stroller, or for a car ride, then do it. Do whatever you need to do to get sleep. The naps should end 4-5 hours before bedtime. Remember, daytime sleep = nighttime sleep!

I have a plan, now what?

Soothing Bedtime Routine:

Toddlers, like babies, need a wind-down routine to transition from their energetic daytime selves to being receptive to sleep. This routine can include:

Bath or quiet play
Reading or singing
Lights dimmed

This transition signals the brain it’s time to sleep.

Bedtime cues include: Eye rubbing, yawning or fussiness indicate readiness. Missing these cues can lead to overtiredness and cortisol release, making it harder for them to settle.

Toddlers + Newborns: Maximizing Sleep for Both

In a perfect world, toddlers would be sleeping through the night before the new baby arrives. But we all know that the perfect world gets turned upside down pretty often in early parenting! Here are some strategies to help maximize sleep for your baby, your toddler and hopefully you:

Divide and Conquer – One parent gets the toddler to sleep and the other handles the infant. Getting both children to bed at the same time can help both children wind down properly, giving the toddler a better chance at uninterrupted sleep.
Gradual adjustments– If your toddler is used to having a parent present to get to sleep and you need to lessen the time spent doing this, gradually transition them to new habits. For example, you can slowly reduce the amount of time you spend rocking by moving to sitting beside their bed.
Hire help – Consider a mother’s helper or babysitter who can look after your newborn while you concentrate on your toddler’s bedtime routine for a few hours each night. You can read the Ultimate Guide to Baby Sleep Training if you’re interested in infant sleep coaching.

Once you begin, try your best stick to sleep training. Don’t go back to old habits like lying down beside your child until they are asleep, as this sends a mixed message. And that’s not fair to your toddler! It’s hard when you’re in the thick of sleep deprivation, but try to remember that your child is seeking reassurance when they wake up in the night.

We’re always happy to talk through toddler sleep on Reddit, join us anytime.

Quick Reference: Sleep Coach your Toddler at a Glance

Step	Focus	Key Actions
1	Communicate	Talk about the plan, use rewards
2	Routine	Bath, books, lights down
3	Gentle withdrawal	Slingshot Method
4	Boundaries	Return to bed calmly, consistently
5	Support	Prioritize naps and nutrition
6	Adjust	Respond to regressions with patience
7	Sustain	Rest and self-care for parents

Essential First Aid Skills for New Parents

May 18, 2023

There are so many unknowns to parents of newborns and infants! Being prepared in case of an accident or other emergency will not only help your baby, but also help you. Having the skills to help your newborn, twins or any infant in distress will not only give them the best chance of healing, but allow you to stay calm. Essential First Aid Skills for New Parents are detailed below.

Essential First Aid Skills for New Parents

Know How to Treat a Burn:

Burns are unfortunately a common childhood injury. Depending on the severity of the burn, they are categorized as first, second, or third-degree burns.

First Degree Burns: use cool water (not ice) to treat first degree burns and apply aloe cream to the area. Do not apply any other ointments or home remedies. The Mayo Clinic suggests, keeping the area clean with a sterile gauze pad for 24 hours. Take care not to use adhesive bandages on young children since they can be choking hazards.

Second and Third Degree Burns (more severe): Seek medical assistance immediately and try to elevate the burned area. While waiting for help, remove baby’s clothes, apply cool water for five minutes and then cover the area with a clean dry cloth. If the burn is chemical in nature, rinse the burn persistently before taking off his/her clothes. Then remove clothing from the burned area and continue flushing the burn.

Be able to stop excessive bleeding:

In many cases, the best way to stop bleeding is to use clean gauze and apply firm pressure. If a cut won’t stop bleeding after 5-10 minutes of applied pressure, or the cut is very wide or deep, it’s time to seek professional help by visiting an ER. Continue to apply pressure to the area while in transit to the ER.

It is okay to give your older baby an age-appropriate dose of acetaminophen (Tylenol) for the pain, but never give ibuprofen (Motrin,) which can sometimes increase bleeding. For very severe bleeding cases where blood is spurting out (arterial bleeding,) call 911 right away. While waiting for help, continue to apply pressure and elevate baby’s legs to increase the flow of blood to the heart and brain.

Essential First Aid Skills for New Parents – Save a Choking Baby:

If an object gets lodged in baby’s airway, all parents should know what to do. Please note, if baby has a strong cry or is coughing hard, do not perform this procedure. Strong cries and coughs can often push the object out without any additional intervention. But, if your baby is not coughing or crying, follow these steps, as outlined by the American Heart Association:

Place baby face down on your forearm, using your thigh or lap for support. Hold the infant’s chest in your hand and jaw with your fingers. Point baby’s head downward so it is lower than the body.
With the palm of your free hand, give up to 5 quick slaps between the infant’s shoulder blades.
Turn the baby on his/her back and use two fingers to give up to 5 chest thrusts if the object does not come out.
Continue the cycle of back blows and chests thrusts until the object becomes dislodges.
If the infant loses alertness, give CPR, shout for help and call 911.
Remove the object from baby’s mouth if at any point the object becomes dislodged and can be seen.

Choking First Aid for Infants — Choking First Aide for Infants

Essential First Aid Skills for New Parents – Poisoning

Part of babyproofing your home and the homes of others looking after baby means keeping harmful substances out of reach. If baby ingests something poisonous, or even if you just suspect they may have been exposed, call Poison Control or 911 immediately.

Put Poison Control in your phone contacts 1-800-222-1222. Contacting Poison Control is free and confidential.

It may be tempting to induce vomiting if your baby has ingested something harmful. But inducing vomiting in a baby should never be done without the explicit guidance of a healthcare professional.

In the past, parents were counseled to induce vomiting in a child that ingested something harmful using Ipecac syrup. This is no longer recommended. We learned that Ipecac syrup caused side effects such as prolonged vomiting, diarrhea, dehydration, and damage to the gastrointestinal tract.

Identify & Treat a Fever:

If your newborn or infant has a fever, it’s important to monitor their temperature. For babies making eye contact and responding to you, drinking fluids and/or playing, there’s probably no cause for alarm. However there are times when it’s vital to call the doctor.

Call your child’s primary care physician if:

Your newborn up to 3 months old has a rectal temperature of 100.4°F (38°C) or higher.
Your infant age 3 – 6 months old, has a temperature of 102°F (39°C) or higher
Infant age 3-6 months has a lower temperature but is acting unusually irritable, sluggish or uncomfortable
Baby age 7- 24 months has a 102°F temperature for longer than 24 hours or has additional symptoms such as cough, or diarrhea

In addition to fevers, Registered Nurse and Newborn Care Provider Liz reminds us: “Newborns temperatures will more commonly drop when septic or fighting serious illness, temps below 97.0 should be taken just as seriously as a high fever.” A doctor or 911 should be called.

List of infant temperature to know if too high or low — Infant Fevers: When to Call the Doctor

As always, if you feel something just isn’t right with your baby, call the pediatrician or even visit the ER.

In an emergency, if your baby is unresponsive and not breathing normally, call 911 and begin CPR. Below are general CPR instructions but these do not take the place of learning proper CPR. Parents and caregivers should take a class and get certified.

Place baby on a firm, flat surface
give 30 chest compressions using two fingers in the center of the chest.
Follow it with two rescue breaths, covering the baby’s mouth and nose with your mouth while maintaining a tight seal.

The above is not a substitute for actual CPR training. Attending a class is the only way to understand proper technique and practice skills.

What Should I ask a Night Nurse?

May 4, 2023

Newborns and their parents have different needs than families with older kids. Postpartum care, breast and bottle feeding and infant sleep safety are just a few of the areas that make overnight newborn care different. If you’re wondering, What Should I ask a Night Nurse? to find a great postpartum care, this blog is for you!

Question 1: Are you a Nurse?

The terms Night Nurse and Baby Nurse have been used for many years, but they are not always technically correct! Nurse is a legally protected term in most of the US and may only be used by Registered Nurses (RN) and Licensed Practical Nurses (LPN) or Licensed Vocational Nurses (LVN). Just like every tissue is not a “Kleenex” not every baby nurse is an RN or LPN! If you’re interviewing someone using this title, it’s a good idea to clarify their actual credentials.

Postpartum caregivers may use different titles such a postpartum doula, night nanny or newborn care provider. These terms are not protected and anyone can use them. While the spirit of care is the same, the level of education and focus can vary widely. However, all of these are non-medical caregivers. For example, a trained postpartum doula may be expected to prepare meals and provide care to older children, while a newborn caregiver may focus just on the baby. It’s good to clarify expectations before care begins.

Question 2: What’s Your Experience?

What Should I ask a Night Nurse?

Experience can look different in newborn baby care and it’s important to know that there’s no required state registry or requirements for newborn caregivers. We’ve compiled a list of basics that professional postpartum or newborn care providers should have:

First Aid and CPR Certification – this should also be a given for anyone in home health or child care. These expire after 2 years; an unexpired cert shows a commitment to understanding and practicing safety protocols.
Continuing Education Courses – Recommendations for baby care change over time, so continuing education is vital. Reputable agencies such as a daycare centers or online sources offer updated information in feeding, soothing and safety.
References – This is perhaps the most important question of all! Can you speak with multiple parents who can provide honest feedback? Are the references recent? And are the references excellent…or just okay?

What Should I ask a Night Nurse? Two Newborn caregivers smiling. — What Should I ask a Night Nurse?

Question 3: Do You Have a Background Check?

There is no single national database that contains all criminal records in the United States. Criminal records are maintained at the local, state, and federal levels by law enforcement agencies and each agency is responsible for maintaining and providing access to its own records, subject to applicable laws and regulations. (Source: FBI website) In other words, records from one state might not be shared with another.

While no background check is perfect, using a highly-rated background checking service along with references can give you a good picture of a caregiver’s character. If the night nanny has a clinical license, you can also investigate their history on the Board of Nursing.

Question 4: What are your care and feeding philosophies?

Hiring a night nurse or newborn caregiver whose values and philosophy match yours can make service a true partnership. Here are some things to think about:

Are you a parent that wants to get baby on a schedule right away, or do you favor a more baby-led approach?

Do you have specific opinions about infant sleep training? How about attachment parenting? Is it important that your caregiver have these same beliefs?

How about breastfeeding vs. bottle feeding? Are you a “fed is best” parent or do you prefer to have a lactation counselor who will on coach you through potential nursing challenges?

Having a postpartum caregiver who understands and supports your philosophy as a parent allows for consistency of care and ultimately the most comfortable relationship for your family. As a follow up, you may wish to ask your night nurse or doula to share soothing techniques for baby. Someone who can explain many safe ways to comfort single babies, preemies and twins is not only demonstrating experience, but also shows that they are attentive and alert to babies’ needs.

certified newborn care provider holding baby next to smiling mom. — Night Nannies and Nurses in action!

Night Nurse Jenny looking into camera smiling. — Night Nannies and Nurses in action!

5. Question 5: Are you vaccinated?

We know some folks have big feelings about vaccines. It’s important to note though that babies 6 months and under are a vulnerable population due to their developing immune systems and inability to receive vaccinations. Because of this, caregivers should take basic precautions to protect vulnerable newborns and infants. (NIH, 2019 and AAP 2021).

In addition to the flu vaccine, it’s recommended that all postpartum doulas and newborn care providers have proof of Hepatitis B, MMR (Measles, Mumps and Rubella) and TDaP (Tetanus, Diphtheria and Pertussis, also known as Whooping Cough). These are the childhood vaccines we all receive.

There are so many wonderful newborn care providers out there and while references and background checks are the most important part of the interview, the peace of mind of safety, good health and demeanor can be what defines a great partnership for your family. As we always say, someone may be an expert in babies, but you are the expert on your baby!

Sign up to receive our free newborn and postpartum support guide to see the advice from Let Mommy Sleep Night Nurses & Nannies

Newborn Breathing Patterns: What’s Normal?

April 30, 2023

Updated October 18, 2025 – Understanding your newborn’s breathing patterns can feel a little. The pauses, the quick breaths, the tiny sighs; it all looks so different from adult breathing. This guide, Newborn Breathing Patterns: What’s Normal? written with input from Let Mommy Sleep’s registered nurses and newborn care experts, explains what’s normal, when to call the pediatrician and how to help your baby breathe comfortably.

Reviewed by: Kathleen Hager, RN, BSN, Perinatal Nurse and Newborn Care Specialist
Edited by: Let Mommy Sleep Clinical Team

Newborn Breathing Patterns: What’s Normal? *image credit: RTD Photography*

Your newborn breaths differently than you! This is because up until birth,baby’s lungs were filled with amniotic fluid. They didn’t need to breathe on their own because oxygen was received from the placenta! Adapting to breathing breathing air instead of fluid happens right away of course but the lungs and airway passages are underdeveloped compared to an adults.

Normal breathing patterns for newborns can vary depending on their age, activity level, and sleep state but there are general guidelines to keep in mind.

Here’s a breakdown of normal newborn breathing patterns:

40-60 breaths per minute

You can assess your newborn’s breathing by looking at their abdomen. Your infant’s abdomen rises and falls with each breath. The normal rate is 40-60 breaths per minute in the healthy, full-term infant (counted for a full minute), and will vary depending on whether she or he is sleeping, awake, active, or crying. (More info in this study on UptoDate)

Apnea

A baby born preterm, or before 37 weeks gestation, is at risk for apnea. Apnea is a pause in breathing for more than 20 seconds. For any parent, this is a very long time! The good news is that pauses that are 5-10 seconds long are completely normal. These short pauses also called periodic breathing is commonly seen in preterm infants. After 15 seconds, the baby needs stimulation to resume breathing such as rubbing his or her back, arms, or legs, suggested in this article on KidsHealth.org. If your baby is prone to Apnea, the hospital will monitor this closely and may prescribe an apnea monitor upon leaving the hospital so you will know if baby ever needs stimulation.

Skin Color and Newborn Breathing

Another good indication that your baby is breathing well is his or her skin color.

Pink skin = good perfusion of tissues = good breathing.
Blue hands, feet, and around the mouth are actually normal in newborn babies too. This is called acrocyanosis and is often seen the first few days of life while newborns transition to life outside the womb.
Blue INSIDE the mouth is not normal and suggests that baby is not breathing well. 911 should be called immediately if this occurs at home. More on this below.

Luckily, breathing issues will resolve on their own as your baby’s brain and spinal cord mature and muscle tone strengthens. You can help your baby breathe best by laying baby on his or her back on a firm, flat crib or bassinet to ensure baby’s airway is open.

Obligate Nose Breathing

Babies are obligate nose breathers which just means they breath through their nose primarily. This is because they ae born with relatively small nasal passages and underdeveloped lungs compared to adults. It’s important to keep the space around their faces clear and have a bulb syringe on hand to clear any congestion.

Most babies start to develop the ability to breathe through their mouth around 3-4 months of age, as their airways and lungs continue to mature. Like adults, they will still prefer to breathe through the nose.

Grunting and Noisy Breathing

Parents might surprised by how LOUD their babies can be! Newborns often make noises while breathing, including during sleep. Grunting, snorting, or whistling are perfectly normal. These noises are usually harmless and may be due to their small nasal passages. Grunting in particular may also be due to normal digestion. Remember that the hard work of eating, digesting and ultimately passing breastmilk or formula is new to your baby’s system.

Sometimes grunting can be a sign of gastroesophageal reflux (GER), a common condition where stomach acid flows back up into the esophagus and makes baby uncomfortable. If grunting is accompanied by spitting up, irritability, and poor weight gain and you’re concerned, contact your pediatrician.

Newborn Breathing Patterns: What’s Normal? – Respiratory Distress

Below are signs of respiratory distress that while rare, require immediate medical attention:

Rapid breathing – breathing faster than usual, taking more than 60 breaths per minute.
Flaring nostrils – Flared nostrils during breathing show that baby is working harder than normal to breathe.
Retractions – The skin between the ribs or under the ribcage may be sucked in with each breath.
Grunting – Sounds of grunting with each breath, instead if just once in a while.
Wheezing – Baby may consistently make a high-pitched whistling sound when they breathe.
Cyanosis – The baby’s skin, lips, or nails may turn blue or grayish in color. This is different than acrocyanosis which is temporary and normal as newborns circulatory systems adjust to life outside the womb.
- A new presentation of cyanosis is a sign of low levels of oxygen in the blood. New cyanosis is serious.
- Persistent cyanosis is a sign of an underlying medical problem.
Lethargy: Weak or unresponsive, with little energy to cry or move.

When to Call the Doctor or 911

Sign	What It May Mean	What to Do
Breathing pauses >20 sec	Possible apnea	Call pediatrician or 911
Blue lips/tongue	Low oxygen	Emergency – call 911
Flaring nostrils/retractions	Working hard to breathe	Contact pediatrician
Lethargy or poor feeding	Possible infection or distress	Call pediatrician ASAP

When to Call the Doctor about Baby’s Breathing

How to administer Choking First Aid to infants in an emergency.

Babies are born with relatively small nasal passages and underdeveloped lungs compared to adults. Overwhlemingly this is not cause for concern but parents and infant caregivers should always contact the child’s pediatrician if they’re concerned about baby’s health.

What Can Parents Do

To help your baby breathe comfortably:

Keep baby on their back for every sleep.
Use a firm, flat surface without loose bedding.
Keep nasal passages clear with saline drops or a bulb syringe when needed.
Avoid smoking or strong fragrances near baby.
Stay calm; while most newborn breathing quirks are completely normal it’s never wrong to contact our pediatrician for reassurance and guidance.

Read Your First Week Home with Baby: Ultimate Q&A for more information like this.

LMS night nurse Kathleen Hager, RN, BSN who specializes in perinatal care of preemies, twins & triplets contributed to this article.

Blog

Air Quality Info for Families

Newborns, Infants and Older Children

Sensitive Groups: Who Are They?

Air Quality Index by the Numbers

Air Quality Info for Families: How to Protect Babies and Families

Sleep Coach Your Toddler: A Parents Guide

Getting Ready to Sleep Coach Your Toddler

Why Toddlers Wake at Night

It’s a Learned Skill

Slingshot Method: A Gentle Approach

Sleep Coach your Toddler: Handling Nighttime Out-of-Bed Behavior

I have a plan, now what?

Toddlers + Newborns: Maximizing Sleep for Both

Essential First Aid Skills for New Parents

Essential First Aid Skills for New Parents

Know How to Treat a Burn:

Be able to stop excessive bleeding:

Essential First Aid Skills for New Parents – Save a Choking Baby:

Essential First Aid Skills for New Parents – Poisoning

Identify & Treat a Fever:

What Should I ask a Night Nurse?

Question 1: Are you a Nurse?

Question 2: What’s Your Experience?

What Should I ask a Night Nurse?

Question 3: Do You Have a Background Check?

Question 4: What are your care and feeding philosophies?

5. Question 5: Are you vaccinated?

Newborn Breathing Patterns: What’s Normal?

Here’s a breakdown of normal newborn breathing patterns:

40-60 breaths per minute

Apnea

Skin Color and Newborn Breathing

Obligate Nose Breathing

Grunting and Noisy Breathing

Newborn Breathing Patterns: What’s Normal? – Respiratory Distress

What Can Parents Do

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