Newborn Sleep: Holding Breath And What It Means

do newborns hold their breath when sleeping

It is normal for newborns to have brief pauses in breathing during sleep, but longer pauses could be a sign of infant apnea or pediatric sleep apnea. Breath-holding in babies is usually triggered by a sudden shock, pain, or strong emotions like fear, sadness, or anger. If you notice your baby holding their breath, it is important to stay calm and remember that this should pass in about a minute. If symptoms last longer, it is important to call emergency services.

Characteristics Values
Breath-holding in newborns It is usually triggered by a sudden shock, pain, or strong emotions like fear, upset, or anger.
How long does it last? A baby may hold their breath for up to 1 minute, often until they faint.
What to do Lay your child on their side to help blood flow to the brain and ensure they can't hit themselves. Make sure they get sufficient rest after.
When to seek medical help If there is no notable breathing or heart rate, or if symptoms last longer than 1 minute, start CPR and call emergency services.
Safe sleeping positions Always place your baby on their back to sleep on a firm, flat mattress with no loose bedding or toys that could block their airway.
Sleep apnea Full-term infants may experience apnea, a pause in breathing that lasts 20 seconds or longer. It can be caused by brain immaturity, neurological issues, heart disease, or gastrointestinal issues.

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Breath-holding in newborns: causes and risks

Breath-holding in newborns is characterised by a pause in breathing that can last up to a minute or until the baby faints. Although these episodes can be frightening for parents, they are usually harmless and the baby will breathe again once they faint. The episodes are too short to cause permanent harm to the child, and most infants outgrow them by the time they are one year old. However, it is important to keep your baby's airway clear during sleep to prevent breath-holding episodes and reduce the risk of sudden infant death syndrome (SIDS).

Causes

Breath-holding in newborns can be caused by various factors, including brain immaturity, neurological issues, heart disease, and gastrointestinal issues. It is also associated with the autonomic nervous system, which regulates involuntary functions such as heartbeat, blood pressure, and body temperature. If this system does not function properly, it may lead to episodes of breath-holding. Additionally, breath-holding can be triggered by sudden shock, pain, or strong emotions like fear, anger, or sadness.

Risks

The main risk associated with breath-holding in newborns is the potential for the baby to faint or experience seizures. In some cases, breath-holding may be a symptom of an underlying condition, such as unusual heart rhythms or epilepsy. If your baby is holding their breath, it is important to remain calm and lay your child on their side to help blood flow to the brain. If the episode lasts longer than a minute or if your child has difficulty recovering, seek medical help immediately.

Prevention

To prevent breath-holding episodes and ensure your baby's safety during sleep, it is crucial to maintain an open and clear airway. Always place your baby on their back to sleep on a firm, flat mattress, and remove all unnecessary items from their cot, including toys, pillows, and loose bedding. Keeping the cot clear lowers the risk of your baby's face being covered and ensures adequate airflow. Additionally, avoid using sleep positioners or anything that restricts your baby's ability to roll freely.

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How to keep a newborn's airway open while sleeping

A newborn's airway is very delicate and it is possible for it to become blocked, narrowed, or folded, making it difficult for them to breathe. Here are some ways to keep a newborn's airway open while sleeping:

Sleeping Position

Always place your baby on their back to sleep. Sleeping on their tummy can block or narrow their airway by putting pressure on their chest. Sleeping on the back, in a firm, flat sleep space, helps to keep a baby's airway clear and open.

Sleep Surface

Use a firm, flat mattress for your baby to sleep on. Soft, cushioned, or padded surfaces can restrict airflow and make it difficult for the baby to breathe. Remove all unnecessary items and loose bedding from the baby's cot, including toys, pillows, and cot bumpers. The safest cot is a clear cot, as it lowers the risk of the baby's face being covered by things that could block their airways.

Avoid Certain Products

Avoid using sleep positioners, duvets, cot bumpers, and thick, heavy, or weighted bedding. These items could cover the baby's mouth and nose, blocking their airway. Also, avoid letting your baby sleep in a baby bouncer, rocker, or reclining chair, as these are not designed for sleeping and can restrict the baby's airway.

Keep Face Clear

Keep the baby's face clear of any items such as bedding and toys. Young babies often breathe through their noses, so it is important to keep their whole face clear.

Safe Sleep Environment

Create a smoke-free environment for your baby to sleep in. Exposure to second-hand or third-hand smoke irritates babies' lungs and makes it harder for them to breathe.

Supervise During Feeding

If you are breastfeeding, check your baby's nose is clear of your breast. If you are bottle-feeding, be careful not to prop the bottle up, as this can cause choking.

By following these guidelines, you can help keep your newborn's airway open and clear while they sleep, ensuring they breathe easily and safely.

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Safe sleeping positions for newborns

Newborns do not hold their breath while sleeping. However, their breathing can be interrupted if their airway is blocked. Here are some safe sleeping positions for newborns to ensure clear airways and a reduced risk of sudden infant death syndrome (SIDS):

Place Baby on Their Back

The safest sleeping position for a baby is on their back, known as the supine position. Research has shown that placing a baby in this position for every sleep, day or night, lowers the risk of SIDS. Sleeping on the front or side can increase the risk of SIDS as the baby's airway can become narrowed or blocked.

Use a Firm, Flat Mattress

Always place your baby on a firm, flat, and smooth mattress. A soft, cushioned, or padded surface can restrict airflow and make it difficult for the baby to breathe. Ensure the mattress fits snugly within the crib or bassinet frame to prevent gaps that the baby could get trapped in.

Keep the Crib Clear

Remove all unnecessary items and loose bedding from the crib or bassinet. This includes toys, pillows, cot bumpers, and heavy or thick bedding. Keeping the crib clear lowers the risk of suffocation and ensures the baby's face remains uncovered, allowing for easy breathing.

Room Sharing

For the first six months, it is recommended that the baby sleeps in the same room as the caregiver. Room-sharing, where the baby sleeps in a separate bassinet or crib, can decrease the risk of SIDS by providing easy monitoring and quick response to any breathing difficulties.

Mattress and Crib Safety

Check the spacing of the crib slats to ensure they are no more than 2 3/8 inches apart. Use a new crib that meets current safety standards, avoiding old cribs with drop sides.

Alternate Head Direction

To prevent a flat spot on the back of the baby's head, alternate the direction they lie in the crib. This ensures the baby doesn't always sleep on the same side of their head.

Supervised Tummy Time

While awake, give your baby time to play and spend time on their tummy. This helps with their development and allows them to strengthen their neck and shoulder muscles. Always supervise tummy time and stop if the baby falls asleep.

Remember, these guidelines are general recommendations for safe sleeping positions. Always consult your healthcare provider for specific advice and guidance regarding your newborn's sleep position and safety.

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What to do if your newborn holds their breath

While it is natural to feel scared or anxious when your newborn holds their breath, it is important to remember that these episodes are usually harmless and brief. Here are some things you can do if you find yourself in this situation:

Stay Calm and Reassure Your Child: Try to remain calm and remember that the episode will likely pass in less than a minute. Reassure your child that everything is okay and that they are safe. It is important to know that your child is not holding their breath on purpose and cannot control what happens during a breath-holding episode.

Lay Your Child on Their Side: Place your child on their side to help maintain blood flow to the brain and ensure they don't hit themselves on anything. Make sure their nose and mouth are clear, and there are no objects or toys blocking their airway.

Keep the Environment Safe: Remove your child from any potentially dangerous surroundings. Keep them away from anything hard, sharp, or hazardous. Ensure they are in a safe and comfortable position, preferably on a firm, flat surface, such as a cot or Moses basket.

Monitor Your Child's Recovery: After the episode, make sure your child gets sufficient rest. Observe their behaviour and recovery. If the episodes become more frequent, longer, or more severe, or if your child experiences stiffness, shaking, or prolonged recovery, consult a doctor.

Seek Medical Attention: If this is your child's first breath-holding spell, it is important to get them checked out by a doctor. The doctor will assess your child and may perform further tests to rule out any underlying conditions. They may also check your child's blood iron levels, as iron-deficiency anaemia has been linked to breath-holding spells.

Remember, while breath-holding spells can be frightening to witness, they are typically not harmful, and most children outgrow them by the age of 4 or 5. However, it is always best to consult a healthcare professional if you have any concerns about your child's health or well-being.

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Newborn breath-holding: potential health issues

Breath-holding in newborns and infants is a common occurrence and is usually not something to worry about. However, there are some potential health issues associated with newborn breath-holding that parents and caregivers should be aware of.

Apnea

Apnea, or infant sleep apnea, is a condition where a baby experiences pauses in breathing during sleep that last 20 seconds or longer. This can be caused by a variety of factors, including brain immaturity, neurological issues, heart disease, gastrointestinal issues, or acid reflux, among others. Apnea is more common in premature babies, as their central nervous system is not yet fully developed enough to properly regulate breathing. Most infants outgrow apnea by the time they are one year old, and it is rarely associated with long-term complications. However, it can be a concern for parents and require medical attention in some cases.

Periodic breathing

Periodic breathing is an irregular breathing pattern that is common in newborns and babies younger than six months. It typically starts with rapid breaths, followed by slower breaths, and then a pause in breathing for five to ten seconds. This pattern then resumes with rapid breaths. Periodic breathing is considered normal and typically resolves by the time a baby is six months old.

Blocked airway

A blocked airway is a serious concern for newborns and infants, as their airways are delicate and can easily become blocked, narrowed, or folded, making it difficult for them to breathe. This can be caused by loose bedding, soft-sided pods and pillows, sleeping on their tummy, or sleeping in a sitting position or sling. It is important to keep the baby's cot clear of unnecessary items and to always place them on their back to sleep on a firm, flat mattress to reduce the risk of a blocked airway.

Breath-holding spells

Breath-holding spells are usually triggered by a sudden shock, pain, or strong emotions like fear, upset, or anger. During a breath-holding spell, a child's breathing pattern changes, and they may experience blue breath-holding spells, where their skin turns pale or blue. While breath-holding spells can be concerning, they are typically not harmful and do not require medical intervention.

It is important for parents and caregivers to be aware of potential health issues associated with newborn breath-holding and to take steps to ensure their baby's airway remains open and clear during sleep. Knowing how to perform infant CPR is also crucial in case of emergencies.

Frequently asked questions

It is normal for infants to have short pauses in breathing, but if you notice your newborn holding their breath, it is best to get them checked out by a doctor.

Newborns can hold their breath for up to a minute, and they will breathe again once they faint.

Your newborn may open their mouth but no sound will come out. They may become very pale and faint, and their arms and legs may become rigid.

If your newborn holds their breath, stay calm and lay them on their side to help blood flow to the brain. Make sure they can't hurt themselves by hitting anything. Call emergency services if there is no notable breathing or heart rate, or if symptoms last longer than a minute.

To prevent your newborn from holding their breath, make sure their airway is clear and open so they can breathe easily while sleeping. Remove unnecessary items and loose bedding from their cot, and always place your baby on their back to sleep on a firm, flat mattress.

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