What's That Noise? Is My Baby Going To Stop Breathing?

Being a new mom is hard.  Most moms will tell you that the first months of baby's new life were a blur of fatigue and misery.  You are tired from child birth and then from waking up every three hours to feed baby.  You are depressed from what pregnancy has done to your body, and new baby does not give back much love.  All baby seems to do is cry, eat, sleep, and make dirty diapers.  And then, if this is your first baby, babies do odd things that scare you.  They get rashes on their faces, they hiccup, and your instinct is to think "What's wrong?  Is this the beginning of a horrible illness?" We see a lot of new born babies in the Emergency Department for a lot of new mom worries.  The vast majority of these things are normal and safe.  Most moms call or see their doctors to get reassurance, or read a book on raising babies.  Some moms don't think to call their doctor though, or don't have a doctor yet after they leave the hospital.  Then when the sun goes down, the baby does something that really scares them, and they come in. Parental worries about newborns come in two groups- breathing and feeding.  The breathing worry is basically: Is my baby going to stop breathing?  Moms lay awake at night and hear their babies make a snoring-like sound.  Babies do this because they have to breathe through their nose, and any dried up mucus up there makes for noisy breathing.  But moms worry- is that going to block baby's airway?  Worse for mom is when babies have a runny nose and gag and choke on mucus.  Then they are really afraid!  Finally, many babies have irregular breathing, what we call "periodic breathing."  They will sometimes pause for a few seconds between breaths.  Though all of these things are normal and safe, moms worry that this is the beginning of crib death, or SIDS (Sudden Infant Death Syndrome).  The other big category of mom worries is spitting up and pooping.  When babies spit up, moms are concerned that baby will choke to death on the vomit.  This is a particular worry these days when we tell moms to lay babies down on their backs.  Moms also worry that babies who spit all the time won't gain weight, and will waste away.  Finally, some newborns will go three or four days without pooping, and moms worry that that is bad.  Again, all these things are normal.  Babies spit up, but are designed to cough and gag and swallow, and thus clear their airway when they are on their backs.  Newborns may spit up a lot, but they hold down enough calories to grow and thrive.  And babies can normally go three or four days without pooping, and this is normal as long as when they do poop, it comes out soft.  Babies don't explode or get blocked by skipping days pooping.  The only things that really worry us about newborns is fever, and sleeping in bed with mom.  In this blog I talk a lot about not worrying about fevers in children.  The only exception to this is fevers in newborns.  Any temperature above 100.4 in a newborn needs to be checked out by a doctor right away.  Sometimes this could mean a more serious infection.  Even more worrisome is moms who worry about their babies so much that they bring baby into their beds.  They think that they can watch baby more closely, but this is the exact WRONG thing to do. It turns out that crib death, or Sudden Infant Death Syndrome (SIDS) is caused by baby smothering.  In adult beds, they smother in thick bed clothes, soft mattresses and pillows, or under heavily sleeping adults.  Also, no one should ever sleep on a couch with baby either, for the same reasons.  Baby is actually safer sleeping in their own crib, face up, with no thick blankets or pillows or stuffed animals.  So before you leave the hospital with your new baby, be sure to have a doctor to call and visit about your worries.  Read a book about new babies- the hospitals often have these to give out.  This way you can save the Emergency Department for emergencies, and not spitty babies.