Periodic breathing is a breathing pattern common in newborns where there are short pauses between breaths. It can occur in both full-term and pre-term babies. It does not change the baby’s heart rate or oxygen levels when it occurs.
A normal breathing pattern for a baby is 40 to 60 breaths per minute. This can sometimes slow to 30 to 40 breaths a minute when a baby is sleeping. A baby’s normal breathing rate is much faster than the normal breathing rate in older children or adults.
A baby normally uses a muscle called the diaphragm to breath. This is a muscle which separates the chest from the abdomen. This looks like “belly breathing.”
Periodic breathing occurs when a baby breathes fast several times, pauses breathing for less than 10 seconds, then resumes breathing. The first breaths after the pause may seem fast and shallow. After that, the infant goes back to a steady breathing pattern. Periodic breathing most often occurs during sleep and it can occur at any stage in the sleep cycle.
Periodic breathing occurs in newborns because the respiratory centre in the brain has not completed its development. The respiratory centre is in the brainstem. Its primary function is to regulate the act of breathing. It does this by assessing the body’s oxygen and carbon dioxide levels, then directing the lungs to take in more or less air. It also helps coordinate the muscles used for breathing.
For example, during exercise, the body needs more oxygen to meet the demands of the working muscles. In this case, the respiratory centre directs the lungs to breathe faster.
In an infant, especially a pre-term infant, the respiratory centre has not yet mastered its job. It may direct the lungs to breathe too fast or too slow for the levels of oxygen in the blood. This balancing act results in periodic breathing.
As the respiratory centre matures, it learns to fine tune breathing rate to changes in oxygen levels in the blood.
Periodic breathing occurs in both male and female babies. It is more common in:
The diagnosis of periodic breathing is made by watching the child and measuring their vital signs. If the baby’s heart rate, temperature, and oxygen levels are normal, the diagnosis is periodic breathing.
However, it is important to distinguish periodic breathing from other breathing conditions which require investigation. Some signs that point to a cause other than periodic breathing are:
There are no longstanding complications associated with periodic breathing. While there was previously concern that periodic breathing might be a risk factor for sudden infant death syndrome (SIDS), further research has found no link between the two.
Periodic breathing is harmless and goes away on its own by the time the child is six months old.