advice - Dr. Allen Cherer | Neonatal Care & Pediatrics

New parents may be alarmed when their newborn has trouble breathing. Babies often breathe irregularly in the hours following their birth and in the first few days of life. Here is a brief overview of irregular breathing in newborns — and what warrants a visit to the pediatrician.

Normal Breathing in Newborns

Newborns typically breathe through their nose rather than their mouth and have smaller breathing pathways. These smaller pathways mean babies can’t take in as much as oxygen and breathe more rapidly. Babies usually take between 30 and 60 breaths per minute while they are awake and 20 breaths per minute during sleep. In comparison, an adult breathes between 12 and 20 times per minute.

It is normal for a baby to take several rapid breaths and then pause for several seconds. This is especially true in the newborn days when the respiration system is still developing. Most breathing irregularities typically resolve within the first few months of life.

Breathing Problems in Babies

Becoming familiar with a baby’s normal breathing pattern can make it easier for parents to distinguish any problems that occur. Some of these problems may include:

Barking cough and/or hoarse cries

Croup often hits in the middle of the night and terrifies parents. It is marked by a barking, seal-like cough, hoarse cries, breathing difficulties and/or a fever.

Whistling noises

Whistling sounds are often due to blockages in the nostrils. Babies breathe through their nostrils rather than their mouths. Any blockage in the nostrils due to allergies or a cold can make breathing difficult.

Wheezing

Wheezing can be a sign of a more serious condition in babies. When the airways become constricted due to asthma, pneumonia or respiratory syncytial virus (RSV), the baby isn’t able to draw enough oxygen during each breath.

Fast-paced Breathing

Fast-paced breathing is often accompanied by an elevated heart rate. Fluid in the airway from pneumonia or another infection could be the cause.

When to See a Doctor

Breathing problems are common during cold and flu season. An estimated 15 to 29 percent of all hospital admissions in babies are due to breathing problems. If parents notice any changes in their child’s breathing, they should notify a doctor immediately. Call 911 or go to the nearest emergency room if:

the baby stops breathing for more than 20 seconds
a blue color is noticed in the lips, toenails or fingernails
the muscles in the neck pull in during breathing

Taking care of a child when their breathing is irregular can be very stressful. Learning to watch for the signs and knowing when to alert the child’s pediatrician can help keep newborns safe and healthy as they grow.

Neonatal professionals are skilled and trained to properly care for newborn infants, specifically within their first twenty-eight days of life. Neonatal nurses specialize in caring for healthy newborns, while neonatal nurse practitioners specialize in caring for infants that may need special care and attention. These infants may include those in the Neonatal Intensive Care Unit (NICU), emergency rooms, delivery rooms or specialty clinics. During the first twenty-eight days of life, infants are at high risk of infections and possibly developing abnormalities. It is the extensive training and education that neonatal professionals are required to have that prepares them for this line of work.

One of the first steps in becoming a neonatal professional is to earn a high school diploma or GED, this is a key requirement to begin a registered nursing program. A registered nursing program will set the foundation of a career as a neonatal professional. Nursing students may obtain an associate degree or a bachelor’s degree in nursing, this could take 2-4 years. Typically, the curriculum for these degrees focuses on anatomy and physiology, lifespan development, microbiology, community health nursing, and principles of ethics among other studies.

After the successful completion of a registered nursing program, registered nurses (RNs) need to pursue a suitable master’s program. This can be a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) program. Generally, an MSN program may require the completion of approximately 550 clinical hours and a DNP program may require the completion of 1,000 clinical hours. MSN programs are usually completed in two years, while DNP programs can take between 3-4 years for completion. During this time nurses experience working in neonatal settings with infants and their families.

With years of studying, training, experience and successfully completing an accredited master’s program, it is important to obtain proper licensing and certification. There are multiple ways to obtain national certification and state licensing. The American Nursing Credentialing Council offers a pediatric nursing certification, while most neonatal credentials are administered by the National Certification Corporation (NCC). Proper certification and licensing for practicing may vary from state to state. These certification requirements typically include a three-year revision. Maintaining certification also includes a “continuing competency specialty assessment”, which will determine the number of continuing education hours needed. Becoming a neonatal professional is a process and can take years of hard work and dedication but is also very rewarding.

Dr. Allen Cherer is a neonatal care expert with over 30 years of medical accomplishments to his name.

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Irregular Breathing in Newborns: What You Should Know

Becoming a Neonatal Professional: The Basics