Infant Growth Issues: Breathing Sounds and Muscle Tone Concerns

Baby growth issues

Hello doctor, my baby is currently 36 days old.
Since we returned home from the hospital, I have noticed that my baby has audible breathing, which occurs while feeding and even when lying down.
During the one-month check-up, the doctor said this is normal, but she not only has a sound like phlegm and a pig-like noise, but also a sharp wheezing sound.
Is this normal? Additionally, since her discharge, there have been two instances where she suddenly turned red in the face and cried while lying on her side, as if she was choking.
The first time was on the day of discharge, and she felt better after spitting out a thick drool; the second time was the day before yesterday, but there was no drool.
I took her to see the doctor, who said there was no problem.
Could this indicate a swallowing issue? Furthermore, in the past two days, when she exerts herself, only half of her face turns red.
Lastly, I would like to ask how to determine if she is a hypertonic baby.
When lying on her back, she loves to move; for example, when lying on her right side, her left arm and leg keep flailing, and her head keeps tilting back.
When I move her legs, she stretches them out and raises them high.
Could this indicate that she is a hypertonic baby? Thank you for your clarification.

Ann, 30~39 year old female. Ask Date: 2018/08/06

Dr. Xiao Kaiwen reply Pediatrics

The situation you described could be a normal phenomenon where the cartilage and soft tissues of a newborn are still soft and pliable, which will improve as they grow.
However, there may also be abnormal conditions that cannot be determined without a direct examination of the newborn.
It is recommended to take the infant to a pediatrician specializing in neonatology for evaluation.
Similarly, assessing whether there is hypertonia in the muscles also requires a direct examination of the newborn, which can be done by the neonatologist.
The key point is that if a newborn exhibits signs of muscle hypertonia, it is important to observe for any accompanying symptoms such as lethargy or loss of consciousness, as these could indicate seizures, which are definitely concerning.

Reply Date: 2018/08/06

More Info

It sounds like you have several concerns regarding your 36-day-old baby’s breathing sounds, potential swallowing issues, and muscle tone. Let’s address each of these points in detail.

Breathing Sounds
It is not uncommon for newborns to exhibit various breathing sounds, especially during the first few weeks of life. These sounds can include wheezing, grunting, or even snoring-like noises. In many cases, these sounds are due to the presence of mucus in the airways or the natural anatomical structure of a newborn's respiratory system. However, if your baby is making sharp, high-pitched sounds (like the "whoop" you described), it could indicate a condition known as stridor, which may require further evaluation.

While your pediatrician mentioned that the sounds are normal, it’s essential to monitor them closely. If the sounds become more pronounced or if your baby shows signs of distress (such as difficulty breathing, turning blue, or persistent coughing), you should seek immediate medical attention.

Swallowing and Gagging
The episodes where your baby turns red and appears to be gagging could be related to several factors, including normal reflexes or potential swallowing difficulties. Newborns have a natural gag reflex, which can sometimes cause them to appear as if they are choking. If your baby is able to clear her throat or spit up after these episodes, it may simply be a normal reaction.

However, if these episodes occur frequently or if you notice that your baby is having difficulty feeding, it would be wise to consult a pediatrician or a specialist in pediatric gastroenterology. They can assess whether there are any underlying issues with swallowing or reflux that need to be addressed.

Muscle Tone and Hypertonia
Regarding your concerns about muscle tone, it’s important to understand that newborns can exhibit a wide range of muscle tone variations. Hypertonia, or increased muscle tone, can manifest as stiffness or rigidity in the limbs. However, the behaviors you described—such as your baby moving her arms and legs vigorously—are typical for many infants and do not necessarily indicate hypertonia.

To assess whether your baby has hypertonia, a pediatrician would look for signs such as resistance to passive movement, unusual posturing, or a lack of flexibility. If your baby is moving her limbs freely and is able to relax them when at rest, it is likely that her muscle tone is within the normal range.

Conclusion
In summary, while it is common for newborns to have various breathing sounds and to exhibit certain reflexes, it is crucial to remain vigilant and consult with your pediatrician if you have ongoing concerns. Regular check-ups will help monitor your baby’s growth and development, and any unusual symptoms should be discussed with a healthcare professional.
If you notice any significant changes in your baby’s behavior, feeding patterns, or if you have persistent worries about her health, do not hesitate to seek medical advice. Early intervention can be key in addressing any potential issues and ensuring your baby’s healthy development.

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