Is your baby gasping for air?
There are several reasons why a baby gasps when laid down. Let’s take a look at some possible reasons and how to handle the situation.
A lot of parents have also shared their particular situations with babies that gasp for air in the comments section.
My baby has episodes of gasping for air when laid down. We have tried to find the reasons for this as it has happened a few times and we cannot find the reason this happens.
On rare occasions, when she is laid down for a diaper change, she will gasp as though she can’t breathe well. When picked up she recovers, an episode lasting around 20 seconds.
She had the first episode at 10 pm when she was about three months old and we took her to the emergency room. They tested her oxygen level and said it was near perfect. The second time it happened was at 6 pm at about 5 and a half months old, but she was only making the noise and was able to breathe through the whole episode.
And this last time, she had an episode at 10 pm that lasted over a minute and had more trouble breathing, turned red in the face, and was in pain.
We are worried and can’t find a doctor who will provide much help, especially since she seems fine after they occur, and the doctors can only go by our description. My baby is 6 and a half month old and otherwise very healthy and active.
Does anyone recognize this and know what it is if a baby is gasping for air? Or what to do about it?
Baby Gasping for Air When Laid Down: Possible Reasons and Remedies
Seeing your baby gasping for air is quite worrying just like you describe. And how frustrating to not be able to find out what is wrong. Don’t give up!
There can be several reasons why this happens, ranging from mild acid reflux to infections, and anatomical conditions blocking the airways.
Let’s take a look at several possible causes of shortness of breath in babies:
1. Baby Gasping for Air – Acid Reflux
Gastroesophageal Acid Reflux (GERD) is a common condition in children. This is common in babies under 2 years of age. This is caused by the underdeveloped lower esophageal sphincter (LES), which functions as a barrier between the esophagus and the airway. And because babies under 2 years old have underdeveloped LES, the sphincter does not fully close or relaxes too often, hence there is a backflow of acid esophageal contents into the airway.
Signs and symptoms include throwing up or spitting up after feeding, gagging during feeding, coughing, arching of the body during feeding, and sometimes, having trouble breathing. Other symptoms include frequent hiccups or belching, stomach pain, and loss of appetite.
GERD usually resolves around 12 months of age.
What can you do at home if you suspect your baby has GERD?
- Hold your babies upright for 30 minutes or more right after feeding.
- If bottle-fed, make sure the nipple part is filled with milk, to prevent your baby from swallowing too much air.
- Burp your babies after feeding.
- Refrain from giving too much citrus or acidic foods.
RED FLAGS: If your baby is not gaining weight and develops a fever, loss of appetite, vomits blood, develops a cough, wheezing, or difficulty of breathing, call your doctor immediately. These are signs of infection (i.e., pneumonia, esophagitis, esophageal ulcers). Frequent occurrence of reflux can cause aspiration pneumonia, esophageal ulcers, and infection of the esophagus.
This is a rare condition wherein the trachea becomes weak. The trachea is the main airway passage in our throats that is connected to the lungs. In this condition, the tracheal walls are weak and may collapse causing difficulty of breathing, occurring during feeding, coughing, or crying. This commonly occurs in the distal third of the trachea (near the esophagus).
This condition can be congenital or acquired. There are anatomical abnormalities in the trachea when a baby is born or there is a chronic trauma to the trachea causing the walls to weaken.
Signs and symptoms include the difficulty of breathing, noisy breathing most especially when asleep, but may disappear as the patient changes position, fits of cough, feeling of being choked, wheezing, and recurrent lung infections. Diagnosis can be made via bronchoscopy.
You should call your doctor if you suspect this is present in your babies.
Learn more about tracheomalacia in this video:
Laryngomalacia is a common congenital disorder in infants. This is caused by the weakness of the tissues in the larynx or more commonly known as the voice box, located above the vocal cords. In contrast to tracheomalacia, this is less serious and is located in the upper respiratory tract.
This condition is the most common cause of noisy breathing (stridor) in infants. However, infants with this condition thrive and can still eat and grow adequately. This condition commonly resolves on its own at around 18 months to 20 months of age.
The signs and symptoms for laryngomalacia include difficulty feeding, poor weight gain, choking or gagging while feeding, apnea (breathing stops for a period), vomiting (due to GERD), aspiration, and cyanosis (turning blue due to lack of oxygen). These symptoms usually occur or peak at 4 to 8 months of age, but resolve before the age of 18 to 20 months.
Diagnosis is made via nasopharyngolaryngoscopy, a process wherein a scope is inserted into the nose going into the pharynx then the larynx.
Treatment for this condition includes anti-GERD medications.
RED FLAGS: Call your doctor immediately or bring your baby to the emergency room when he experiences apnea, difficulty of breathing, cyanosis, and failure to gain weight. These symptoms may warrant surgical intervention.
This video is a very good explanation of laryngomalacia:
Bronchomalacia is a congenital weakening of the tissues below the trachea. The cartilage of the bronchi collapses during expiration. This leads to recurrent lung infections (pneumonia and bronchitis), chronic cough, respiratory distress, apnea and/or difficulty in breathing, and inability to expectorate.
Diagnosis is made via examination of the bronchi in the operating room. A flexible telescope is inserted into the bronchi.
Some cases of bronchomalacia resolve on their own, however, other symptoms persist for severe cases.
5. Respiratory Distress Syndrome
Respiratory distress syndrome is common among premature babies. This is caused by a lack of surfactant (foamy substance) in the lungs. Babies born prematurely have immature lungs, with little surfactant. This surfactant keeps the alveoli or tiny air sacs in the lungs from collapsing, allowing oxygen to enter into the lungs, and allowing the lungs to fully expand when babies breathe. Other names of this disorder include Hyaline Membrane Disease, Neonatal Respiratory Distress Syndrome, Infant Respiratory Distress Syndrome, Surfactant Deficiency.
Signs and symptoms include difficulty of breathing or fast breathing, cyanosis (bluish discoloration of the mouth and limbs), nasal flaring, and chest retractions (use of accessory muscles when breathing producing deep retractions in between the ribs and below the rib cage).
Diagnosis includes history and physical examination, as well as a chest x-ray.
Before giving birth, mothers are given a steroid injection for the development of the lungs of the baby. Postnatally, these babies are placed in incubators with a facemask and oxygen on. Babies are also given doses of surfactant.
Almost all babies recover from this condition.
6. Meconium aspiration syndrome
This condition commonly occurs in babies who are delivered past their due dates. Meconium is the early stool that is passed by the babies. When the baby poops while still in the womb, the meconium, mixed with amniotic fluid, is being aspirated by the baby.
This is a leading cause of death and severe illness in newborns. Hence mothers need to follow up on their scheduled dates of delivery when there is an absence of labor.
Upon delivery, the amniotic fluid is dark-colored due to the mixture of meconium and amniotic fluid. The newborn is limp, cyanotic, and with difficulty of breathing or not breathing at all. Suctioning of the newborn’s buccal and nasal cavities is done immediately after delivery. A chest X-ray is taken and shows patchy infiltrates in the lungs.
Treatment includes the administration of antibiotics. Close monitoring of the lung capacity and progress via chest x-ray is included in the treatment.
7. Respiratory Infections
Respiratory infections in children are common. Signs and symptoms include fever, cough, occasionally colds. For severe disease, there is difficulty of breathing, cyanosis observed on the lips, fingers, or toes, loss of appetite, altered mental state (drowsy to lethargic), signs of dehydration (poor skin turgor, sunken eyeballs, and fontanels), alar flaring, chest retractions, and sometimes, seizures.
The following diseases can cause these signs and symptoms:
- Pneumonia -upon physical examination, there are crackles heard in the lungs upon auscultation
- Effusion or empyema -reduced movement on the affected lung side
- Bronchiolitis – common in less than a year old
- Pulmonary Tuberculosis – an infectious disease most common in 3rd world countries. Exposure to a TB patient warrants further investigation when symptoms are manifested (chest x-ray, positive Mantoux test). The cough is chronic, occurring for more than 2 weeks, with loss of weight (significant stunting and wasting).
- Pertussis – this can be prevented with DPT (diphtheria, pertussis vaccine which is routinely given to babies during the first 6 months in 3 divided doses). There is a paroxysmal cough or whooping cough, accompanied by cyanosis or vomiting.
- Croup – this is characterized by a barking cough. There is an inflammation of the larynx, trachea, and bronchi. Inspiratory stridor (noisy breathing upon inhalation) is characteristic of this condition.
I am uncertain whether a respiratory infection is a relevant possible cause of your baby’s gasping, since it has been going on for so long. On the other hand, if there have been extended periods without her gasping for air, then this could be relevant.
Red flags for severe disease (described above) should prompt an immediate trip to the emergency room.
8. Asthma and Allergies
Asthma is a common chronic lung disease in children. This is characterized by inflammation of the airways and hyperproduction of secretions, as manifested by expiratory wheezing, cough occurring mostly at night, and shortness of breath or difficulty of breathing. They are usually responsive to bronchodilators. Episodes of asthma usually occur after exposure to triggers or allergens. Triggers include smoke (most significantly cigarette smoke, strong odor or scent, pollen, dust, among others.
Diagnosis is based on medical history, if a lung capacity test is not possible. Treatment includes long and short-acting bronchodilators, the use of antihistamines, steroids, and avoidance of triggers and allergens.
9. Sleep apnea
Obstructive sleep apnea causes breathing to stop for a period during sleep. This is common in children aged 3 to 6 years old. Usually, children outgrow this condition.
In this condition, the muscles in the upper airway tend to relax, partially or completely blocking the airway while a child sleeps. The most common cause of blockage is enlarged or inflamed tonsils, as a consequence of infection or overgrowth. However, other factors like obesity or being overweight, a tumor or abnormal growth in the airway passage, and certain congenital anomalies (i.e., Down Syndrome, Pierre-Robin Syndrome) can also cause sleep apnea.
Signs and symptoms include snoring, pause in breathing while asleep, mouth breathing, restlessness during sleep, sleepiness during daytime (caused by interrupted sleep the previous night), sleepwalking, night terrors, bedwetting, among others.
Diagnosis is done through a sleep study. Brain activity, heart activity, and airflow into the lungs are monitored during the sleep study.
Treatment of sleep apnea is targeted at addressing the cause of the blockage. Surgical interventions for enlarged tonsils and weight loss for obesity are among the treatment options.
10. Congenital Heart Defects (CHDs)
There are two types of congenital heart defects: cyanotic and acyanotic CHDs. The severity of the symptoms, prognosis, and treatment depends on the defect and location of the defect. Common signs and symptoms include:
- The irregular rhythm of the heart
- Fast heart rate
- Clubbing of the fingers (cyanotic type)
- Swelling of the extremities
- Failure to thrive and gain weight
- Interrupted feeding (cyanotic type of CHD)
The most common defects are the following:
- Septal defect – there is a hole in the septum that separates the chambers of the heart
- Coarctation of the aorta – there is a narrowing of the aorta
- Pulmonary valve stenosis – narrowing of the pulmonary valve
- Transposition of the great vessels – there is swapping in the position of the pulmonary aortic valves and the arteries
Diagnosis is made through a thorough medical history, chest x-rays, and ECG. Other modalities can be utilized, too. Some CHDs resolve on their own by the age of 2 years old. Septal defects usually close by that age. Surgical intervention is elective and is required for more severe cases and persistent defects.
11. Something stuck in the airways
Foreign body obstruction of the airway should be immediately addressed and brought to the emergency room. Cyanosis, difficulty of breathing, loss of consciousness are some of the symptoms when something is blocking the airway. There is sudden respiratory distress and stridor.
12. Pain – not related to breathing and/or reflux
Reviewing all the comments to this article (thanks a lot, all contributing parents!), it does seem fairly common that babies gasp due to pain from e.g. diaper rashes. This does sound logical, just considering how humans do react to pain.
In these cases, there certainly should be no indications of breathing difficulties (check the video below!) or illness.
Also, of course, treating the diaper rash should make the gasping disappear.
There could, of course, be other reasons for pain and thereby gasping. Acid reflux can also cause pain for a baby when laid down.
What to do when a baby is gasping for air?
So, the next question is of course what to do when a baby is gasping for air. Well, one thing is, of course, to try to find the root cause and treat it, just like you do.
To help the diagnosis, take notes of when this happens. Look out for patterns. Filming your child during these episodes can help you find this.
Gasping for air can also be an emergency, since the gasping may indicate breathing difficulties.
Here are some signs that you need to call an ambulance or take your baby to the emergency room immediately:
- Is gasping for breath for more than a very brief period
- Can’t cry or make noise because of breathing trouble
- Has blue lips
- Is breathing very fast
- Looks very sick
The video below is of great help in recognizing respiratory distress in babies.
I hope this helps.
Make sure you discuss these conditions with your baby’s doctor, to rule them out or diagnose them and get appropriate help!
Read Next about Babies Gasping For Air
- Acid Reflux in Babies and Toddlers: Symptoms, Causes, Treatments
- Chronic Cough in Baby; Important Reasons, Symptoms, Remedies
- 8 Week Baby With Reflux And How To Handle It
- Baby Rolling Eyes And Gasping For Air
- Laryngomalacia – StatPearls – NCBI Bookshelf
- Tracheomalacia and bronchomalacia in children: incidence and patient characteristics
- Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children
- Respiratory Distress Syndrome | NHLBI, NIH
- Meconium Aspiration Syndrome: An Insight
- Cough or difficulty in breathing – Pocket Book of Hospital Care for Children
- Asthma in Children
- Obstructive Sleep Apnea in Children
- Congenital heart disease
Find comments below, and please add your own experiences with babies gasping for air. The discussion is quite helpful!