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Newborn and Infant Care

Newborn dry throat

07/30/2007

Question:

Hi, My newborn baby (3 weeks old) has started to clear his throat and make grunting noises when he is asleep or settling to sleep as though his throat is really dry. He doesn`t relaly let it upset him. He does this really often at the moment and has only just started a few days ago - I am breastfeeding and it doesn`t really seem to clear after a feed... Is this serious and what can I do to help?

Answer:

Newborns make a wide variety of normal sounds. So the issue is whether or not this is a normal sound or a sign of a breathing problem.

A good place to start in deciding if the baby is ill begins with counting the number of times your baby breathes for a full 60 seconds. If it is 60 breaths per minute or more when the baby is at rest or sleeping, you should have the baby seen by his doctor as soon as possible. Also, lift up his shirt and observe his chest. Other signs of respiratory illness include seeing the skin between his ribs over his collar bones pull inward when he breaths, the making of a soft "uh" sound every time he breathes out, difficulty feeding such that he only has the energy to to suck for a short time before he needs to rest, tiredness or sleeping a lot more than previously, a temperature of 100.4 degrees Fahrenheit, and losing weight. Blueness of the inside of the mouth and tongue or central trunk of the baby also indicates a serious problem breathing. Any of these symptoms alone or in combination can mean the baby has a respiratory illness that needs prompt care.

Several types of sounds are normal. They include those as a result of small amounts of mucus in the nose that makes a high-pitched, whistling sound as the baby breathes. If the mucus is removed with saline drops and a bulb syringe, the noise goes away. Babies have such small airways that even a small bit of mucus makes a lot of noise. This is very common.

Another common sound is deep and raspy, usually when the baby inhales. This is due to a weakened area in the breathing passageway or trachea called tracheomalacia (tray-key-o-ma-lasia) It is usually present from birth and is harmless. As the airway enlarges and becomes less flexible, the noisy breathing goes away.

If, on the other hand, your baby feeds vigorously, is an active baby who is playful and responsive to you, sleeping well, and not irritable, it is unlikely that there is anything wrong with your baby. As always, the only way to know for sure if all is well is to see the baby's doctor and discuss your concerns. If the sound comes and goes, make an audio or audio-video recording of the sound that concerns you to share with the doctor.

I hope that all is well with your son!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University