Pectus Deformity (Chest Wall Shape) in Babies
The short answer
Pectus deformities are variations in the shape of the chest wall. Pectus excavatum (sunken or "funnel" chest) is a depression in the breastbone, while pectus carinatum ("pigeon" chest) is a protrusion. Both are relatively common, affecting about 1 in 300-400 children. In babies, a visible or prominent xiphoid process (the small cartilage at the bottom of the breastbone) is very common and is not a pectus deformity. Most mild pectus findings in infancy are monitored without treatment.
By Age
What to expect by age
Many parents notice that their baby's breastbone looks prominent or that there is a small bump or dip at the bottom of the sternum. In most cases, this is the xiphoid process, a normal piece of cartilage that is simply more visible in thin babies. True pectus excavatum (a noticeable funnel-shaped dip in the center of the chest) can be present from birth and is usually mild. Your pediatrician will monitor it at well-child visits.
As your baby grows, a mild pectus excavatum may become more or less noticeable. In most cases, it does not affect breathing, heart function, or development. Pectus carinatum (chest protrusion) is rarely noticed in infancy and more commonly becomes apparent during the growth spurt of adolescence. If you notice your baby's chest seems to pull inward significantly when breathing, mention this to your pediatrician.
Mild pectus excavatum in toddlers is common and typically does not require treatment. The chest wall is still very flexible and may change shape as your child grows. If the dip appears to be getting deeper or your child seems to tire easily during physical activity, further evaluation may be recommended. Treatment (bracing or surgery) is rarely considered before school age and is usually reserved for moderate to severe cases.
What Should You Do?
When to take action
- A small bump at the bottom of the sternum (xiphoid process) that is more visible when your baby leans forward
- A mild, shallow dip in the center of the chest that does not affect breathing
- Visible ribs in a thin baby, which is normal and not a chest wall deformity
- The chest shape looking slightly asymmetric, which is common and usually harmless
- You notice a noticeable depression or protrusion in your baby's chest that seems more than mild
- The chest wall seems to change shape when your child breathes or exerts effort
- You want reassurance about your baby's chest shape at a well-child visit
- A family member has pectus excavatum or carinatum
- You notice significant chest retractions (the skin pulling in between or below the ribs) with every breath, which could indicate breathing difficulty
- Your baby is breathing rapidly, grunting, or appears to be working hard to breathe
- Your child tires very easily during physical activity and has a noticeable chest deformity
- A sudden change in chest shape appears after an injury
Sources
Related Resources
Related Physical Concerns
My Baby Is Breathing Fast
Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.
My Baby's Spine Looks Curved
A gentle C-shaped curve when your baby is held in a seated position is completely normal, because babies' spinal muscles are still developing. True spinal abnormalities in infants are rare. However, a visible curve when your baby is lying flat, a bony bump along the spine, or a curve that seems rigid should be evaluated by your pediatrician.
My Baby's Belly Button Bulges When Crying
This is almost always an umbilical hernia, which is very common (occurring in about 1 in 5 babies) and usually harmless. It happens when a small opening in the abdominal muscles near the belly button doesn't close completely after birth. The bulge you see is intestine pushing through when baby cries, strains, or coughs. Most umbilical hernias close on their own by age 2-5 without any treatment.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
Baby or Toddler Body Odor - When Is It Normal?
Babies and toddlers can develop body odor from several benign causes: sour milk caught in skin folds, sweating, diaper area odor, strong-smelling foods in the diet, and certain medications or vitamins. True body odor (like adult BO from apocrine glands) should not occur before puberty. If your baby or young toddler has a persistent unusual body odor that is not explained by skin folds, diaper, or diet, it could indicate a metabolic condition, infection, or foreign body (especially in the nose or vaginal area). Unusual persistent odor warrants a doctor visit.
Baby Born with Teeth - Natal Teeth
Natal teeth (teeth present at birth) occur in about 1 in 2,000-3,000 births. In most cases, these are actual primary (baby) teeth that erupted early, not extra teeth. Most natal teeth are the lower front incisors. While natal teeth can sometimes cause breastfeeding difficulties or have a risk of becoming loose and being a choking hazard, many can be left in place and monitored. The decision to keep or remove a natal tooth depends on how firmly it is attached and whether it is causing problems.