Periodic Breathing in Newborns (Irregular Breathing Pattern)
The short answer
Periodic breathing in newborns is a normal pattern where breathing alternates between rapid breaths and brief pauses of up to 10 seconds. This is caused by the immaturity of the breathing control center in the brain and is very common in the first few months of life. It is different from apnea, where breathing stops for 20 seconds or more.
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By Age
What to expect by age
Periodic breathing is very common in newborns, especially during sleep. You may notice your baby breathing quickly for a few seconds, then pausing for 5-10 seconds, and then resuming normal breathing. This cycle can repeat multiple times. It is caused by the immature brainstem respiratory center that is still learning to regulate breathing. Periodic breathing is normal as long as pauses last less than 20 seconds, your baby does not turn blue or pale, and there is no change in muscle tone. This pattern is more common in premature babies but also occurs in full-term newborns.
Periodic breathing continues to be common during this period and gradually decreases as the respiratory control center matures. You may notice it less frequently as weeks pass. Continue to observe your baby's breathing, keeping in mind the distinction between normal periodic breathing (pauses under 10-15 seconds) and concerning apnea (pauses over 20 seconds with color change).
Periodic breathing becomes much less common by 3-6 months as the brainstem matures. Most babies have more regular breathing patterns by this age. If periodic breathing persists or new breathing irregularities develop, discuss with your pediatrician.
Periodic breathing should be rare or absent by this age. Any significant breathing pauses, irregular breathing, or episodes of color change at this age should be promptly evaluated by your doctor.
What Should You Do?
When to take action
- Brief breathing pauses (up to 10 seconds) during sleep followed by normal breathing
- Alternating fast and slow breathing patterns during sleep
- Baby maintains normal skin color during breathing pauses
- Baby resumes breathing on their own without any intervention
- Breathing pauses seem to be lasting longer than 10-15 seconds
- You notice periodic breathing occurring more frequently or during wakefulness
- You are anxious about your baby's breathing pattern and want reassurance
- Breathing pauses lasting 20 seconds or more (apnea), or any pause accompanied by blue or pale skin color, limpness, or change in muscle tone
- Baby requires stimulation to resume breathing or does not restart breathing on their own after a pause
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
Normal Baby Breathing Patterns
Newborns and young babies have breathing patterns that can seem alarming to parents but are perfectly normal. Periodic breathing -- rapid breaths followed by brief pauses of up to 10 seconds -- is common, especially during sleep. Normal newborn breathing rates range from 30-60 breaths per minute and are naturally irregular. Babies are obligate nose breathers and may sound congested without being sick. True warning signs include persistent fast breathing, pauses longer than 20 seconds, chest retractions, grunting, or color changes.
My Baby Stops Breathing Briefly (Apnea)
Brief pauses in breathing lasting under 10 seconds are very common in newborns and are called periodic breathing. This is a normal pattern where the baby breathes rapidly, then pauses briefly, then resumes. However, true apnea (pauses lasting 20 seconds or longer, or shorter pauses accompanied by color changes or heart rate drops) is a medical concern that should be evaluated promptly.
Normal Noisy Breathing in Newborns
Newborns are notoriously noisy breathers. Squeaking, whistling, snorting, rattling, and gurgling sounds are very common and usually normal because babies have small, flexible airways and narrow nasal passages. As long as your baby is breathing comfortably, feeding well, and has normal skin color, noisy breathing is rarely a cause for concern.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.