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How a newborn should breathe: problems of rapid breathing during sleep, delays and wheezing in a child without fever. Why do children hold their breath in their sleep and what to do about it

The birth of a long-awaited baby is a joyful event, but by no means in all cases childbirth ends successfully, not only for the mother, but also for the child. One of these complications is fetal asphyxiation, which arose during childbirth. This complication is diagnosed in 4 - 6% of newly born children, and according to some authors, the frequency of newborn asphyxia is 6 - 15%.

Definition of newborn asphyxia

In Latin, asphyxia means suffocation, that is, lack of oxygen. Asphyxia of newborns is a pathological condition in which gas exchange in the body of a newborn is disturbed, which is accompanied by a lack of oxygen in the tissues of the child and his blood and the accumulation of carbon dioxide.

As a result, a newborn who was born with signs of live birth either cannot breathe on its own in the first minute after birth, or he has separate, superficial, convulsive and irregular respiratory movements against the background of an existing heartbeat. Such children are immediately given resuscitation measures, and the prognosis (possible consequences) for this pathology depends on the severity of asphyxia, the timeliness and quality of resuscitation.

Classification of newborn asphyxia

By the time of occurrence, there are 2 forms of asphyxia:

  • primary - develops immediately after the birth of the baby;
  • secondary - it is diagnosed within the first days after childbirth (that is, at first the child breathed independently and actively, and then suffocation occurred).

According to the severity (clinical manifestations), there are:

  • mild asphyxia;
  • moderate asphyxia;
  • severe asphyxia.

Factors provoking the development of asphyxia

This pathological condition does not belong to independent diseases, but is only a manifestation of complications of the course of pregnancy, diseases of the woman and the fetus. The causes of asphyxia include:

Fruit factors

  • ) The child has;
  • Rh-conflict pregnancy;
  • anomalies in the development of the organs of the bronchopulmonary system;
  • intrauterine infections;
  • prematurity;
  • intrauterine growth retardation;
  • blockage of the airways (mucus, amniotic fluid, meconium) or aspiration asphyxiation;
  • malformations of the heart and brain of the fetus.

Maternal factors

  • severe, occurring against a background of high blood pressure and severe edema;
  • decompensated extragenital pathology (cardiovascular diseases, diseases of the pulmonary system);
  • pregnant women;
  • endocrine pathology (, ovarian dysfunction);
  • shock of a woman during childbirth;
  • disturbed ecology;
  • bad habits (smoking, alcohol abuse, drug use);
  • inadequate and inadequate nutrition;
  • taking medications contraindicated during gestation;
  • infectious diseases.

Factors contributing to the development of disorders in the uteroplacental circle:

  • post-term pregnancy;
  • premature aging of the placenta;
  • premature placental abruption;
  • pathology of the umbilical cord (cord entanglement, true and false nodes);
  • permanent threat of interruption;
  • and bleeding associated with it;
  • multiple pregnancy;
  • excess or lack of amniotic fluid;
  • abnormalities of labor forces (and discoordination, rapid and impetuous labor);
  • injecting drugs less than 4 hours before the completion of labor;
  • general anesthesia of a woman;
  • rupture of the uterus;

Secondary asphyxia is provoked by the following diseases and pathology in a newborn

  • impaired cerebral circulation in a child due to residual effects of damage to the brain and lungs during childbirth;
  • heart defects not identified and not immediately manifested at birth;
  • aspiration of milk or mixture after the feeding procedure or poor-quality sanitation of the stomach immediately after birth;
  • respiratory distress syndrome due to pneumopathies:
    • the presence of hyaline membranes;
    • edematous hemorrhagic syndrome;
    • pulmonary hemorrhage;
    • atelectasis in the lungs.

The mechanism of development of asphyxia

It does not matter what caused the lack of oxygen in the body of a newly born child, in any case, metabolic processes, hemodynamics and microcirculation are rearranged.

The severity of the pathology depends on how long and intense the hypoxia was. Due to metabolic and hemodynamic rearrangements, acidosis develops, which is accompanied by a lack of glucose, azotemia and hyperkalemia (later hypokalemia).

With acute hypoxia, the volume of circulating blood increases, and with chronic and subsequent asphyxia, the volume of blood decreases. As a result, the blood thickens, its viscosity increases, and the aggregation of platelets and erythrocytes increases.

All these processes lead to a disorder of microcirculation in vital organs (brain, heart, kidneys and adrenal glands, liver). Microcirculation disturbances cause edema, hemorrhages and ischemic foci, which leads to hemodynamic disturbances, disturbances in the functioning of the cardiovascular system, and as a consequence, all other systems and organs.

Clinical picture

The main symptom of asphyxia in newborns is a violation of breathing, which entails a malfunction of the cardiovascular system and hemodynamics, and also disrupts neuromuscular conduction and the severity of reflexes.

To assess the severity of the pathology, neonatologists use the Apgar score of the newborn, which is carried out in the first and fifth minutes of the child's life. Each feature is estimated at 0 - 1 - 2 points. A healthy newborn gets 8 - 10 points on Apgar in the first minute.

The degree of asphyxia of newborns

Light asphyxia

With mild asphyxia, the Apgar score for a newborn is 6 - 7. The child takes the first breath during the first minute, but there is a weakening of breathing, a slight acrocyanosis (cyanosis in the area of ​​the nose and lips) and a decrease in muscle tone.

Moderate asphyxia

The Apgar score is 4 - 5 points. There is a significant weakening of breathing, its disturbances and irregularities are possible. Heartbeats are rare, less than 100 per minute, cyanosis of the face, hands and feet is observed. Physical activity increases, muscular dystonia develops with a predominance of hypertonia. Tremor of the chin, arms and legs is possible. Reflexes can be either decreased or increased.

Severe asphyxia

The condition of the newborn is severe, the Apgar score in the first minute does not exceed 1 - 3. The child does not make breathing movements or makes separate breaths. Heartbeats less than 100 per minute, pronounced, deaf and arrhythmic heart sounds. A cry in a newborn is absent, muscle tone is significantly reduced or muscle atony is observed. The skin is very pale, the umbilical cord does not pulsate, reflexes are not detected. Eye symptoms appear: nystagmus and floating eyeballs, the development of seizures and cerebral edema, DIC syndrome (violation of blood viscosity and increased platelet aggregation) is possible. Hemorrhagic syndrome (multiple hemorrhages on the skin) increases.

Clinical death

A similar diagnosis is made when evaluating all Apgar indicators at zero points. The condition is extremely serious and requires immediate resuscitation measures.

Diagnostics

When making the diagnosis: "Asphyxia of the newborn", the obstetric history data, how the childbirth proceeded, the Apgar score of the child in the first and fifth minutes, and clinical and laboratory studies are taken into account.

Determination of laboratory parameters:

  • pH level, pO2, pCO2 (study of blood obtained from the umbilical vein);
  • determination of the deficiency of bases;
  • the level of urea and creatinine, urine output per minute and per day (work of the urinary system);
  • the level of electrolytes, acid-base state, blood glucose;
  • ALT, AST, bilirubin levels and blood clotting factors (liver function).

Additional methods:

  • assessment of the cardiovascular system (ECG, blood pressure control, pulse, chest x-ray);
  • assessment of neurological status and the brain (neurosonography, encephalography, CT and NMR).

Treatment

All newborns born in a state of asphyxia are given immediate resuscitation measures. The further prognosis depends on the timeliness and adequacy of the treatment of asphyxia. Resuscitation of newborns is carried out according to the ABC system (developed in America).

Primary care for a newborn

Principle A

  • ensure the correct position of the child (lower your head, placing a roller under the shoulder girdle and tilt it back slightly);
  • suck mucus and amniotic fluid from the mouth and nose, sometimes from the trachea (with aspiration of amniotic fluid);
  • intubate the trachea and scan the lower airways.

Principle B

  • carry out tactile stimulation - a slap on the child's heels (if there is no cry for 10-15 seconds after birth, the newborn is placed on the resuscitation table);
  • oxygen supply by jet;
  • the implementation of auxiliary or artificial ventilation of the lungs (Ambu bag, oxygen mask or endotracheal tube).

Principle C

  • performing an indirect heart massage;
  • administration of drugs.

The decision on the termination of resuscitation measures is carried out after 15 - 20 minutes, if the newborn does not respond to resuscitation actions (there is no breathing and persistent bradycardia persists). The termination of resuscitation is due to the high likelihood of brain damage.

Administration of drugs

Cocarboxylase diluted with 10 ml of 15% glucose is injected into the umbilical vein against the background of artificial ventilation (mask or endotracheal tube). Also, 5% sodium hydrogen carbonate is injected intravenously to correct metabolic acidosis, 10% calcium gluconate and hydrocortisone to restore vascular tone. If bradycardia appears, 0.1% atropine sulfate is injected into the umbilical vein.

If the heart rate is less than 80 per minute, chest compressions are performed with mandatory continuation of mechanical ventilation. 0.01% -adrenaline is injected through the endotracheal tube (possibly into the umbilical vein). As soon as the heart rate has reached 80 beats, the cardiac massage stops, mechanical ventilation is continued until the heart rate reaches 100 beats and spontaneous breathing appears.

Further treatment and follow-up

After the provision of primary resuscitation care and restoration of cardiac and respiratory activity, the newborn is transferred to the intensive care unit (ICU). In the PIT, further therapy for asphyxia of the acute period is carried out:

Special care and feeding

The child is placed in an incubator, where constant heating is carried out. At the same time, craniocerebral hypothermia is performed - the head of the newborn is cooled, which prevents. Feeding of children with mild and moderate asphyxia begins no earlier than 16 hours later, and after severe asphyxia, feeding is allowed every other day. The baby is fed through a tube or bottle. The attachment to the breast depends on the condition of the baby.

Prevention of cerebral edema

Albumin, plasma and cryoplasma, and mannitol are injected intravenously through the umbilical catheter. Also, drugs are prescribed to improve the blood supply to the brain (cavinton, cinnarizine, vinpocetine, sermion) and antihypoxants (vitamin E, ascorbic acid, cytochrome C, aevit). Hemostatic drugs are also prescribed (dicinone, rutin, vicasol).

Oxygen therapy

The supply of humidified and warmed oxygen continues.

Symptomatic treatment

Therapy is carried out aimed at preventing seizures and hydrocephalic syndrome. Anticonvulsants are prescribed (GHB, phenobarbital, relanium).

Correction of metabolic disorders

The intravenous administration of sodium bicarbonate continues. Infusion therapy is carried out with saline solutions (saline and 10% glucose).

Newborn monitoring

Twice a day, the child is weighed, the neurological and somatic status and the presence of positive dynamics are assessed, the inflowed and released fluid (diuresis) is monitored. The devices record heart rate, blood pressure, respiratory rate, central venous pressure. From laboratory tests, a general blood test with and platelets, acid-base state and electrolytes, blood biochemistry (glucose, bilirubin, AST, ALT, urea and creatinine) are determined daily. Blood clotting and tank indicators are also assessed. cultures from the oropharynx and rectum. Shown are chest and abdominal X-ray, ultrasound of the brain, ultrasound of the abdominal organs.

Effects

Asphyxia of newborns rarely goes away without consequences. To one degree or another, the lack of oxygen in a child during and after childbirth affects all vital organs and systems. Particularly dangerous is severe asphyxia, which always occurs with multiple organ failure. The prognosis for a baby's life depends on the degree of Apgar score. In the case of an increase in the score at the fifth minute of life, the prognosis for the child is favorable. In addition, the severity and frequency of the development of the consequences depend on the adequacy and timeliness of the provision of resuscitation measures and further therapy, as well as on the severity of asphyxia.

The frequency of complications after suffering from hypoxic conditions:

  • at I degree of encephalopathy after hypoxia / asphyxia of newborns - the development of the child does not differ from the development of a healthy newborn;
  • at the II degree of hypoxic encephalopathy - 25 - 30% of children later have neurological disorders;
  • with grade III hypoxic encephalopathy, half of the children die during the first week of life, and the rest in 75 - 100% have severe neurological complications with convulsions and increased muscle tone (late mental retardation).

After suffering asphyxia during childbirth, the consequences can be early and late.

Early complications

Early complications are spoken of when they appeared during the first 24 hours of a baby's life and, in fact, are manifestations of a difficult course of childbirth:

  • cerebral hemorrhage;
  • convulsions;
  • and hand tremor (first small, then large);
  • apnea attacks (respiratory arrest);
  • meconium aspiration syndrome and, as a result, the formation of atelectasis;
  • transient pulmonary hypertension;
  • due to the development of hypovolemic shock and blood thickening, the formation of polycythemic syndrome (a large number of red blood cells);
  • thrombosis (blood clotting disorder, decreased vascular tone);
  • cardiac arrhythmias, the development of posthypoxic cardiopathy;
  • disorders of the urinary system (oliguria, thrombosis of the renal vessels, edema of the interstitium of the kidneys);
  • gastrointestinal disorders (and intestinal paresis, dysfunction of the digestive tract).

Late complications

Late complications are diagnosed after three days of the child's life and later. Late complications can be infectious and neurological in origin. The neurological consequences that appeared as a result of the transferred brain hypoxia and posthypoxic encephalopathy include:

  • Hyperexcitability syndrome

The child has signs of increased excitability, pronounced reflexes (hyperreflexia), dilated pupils,. There are no convulsions.

  • Reduced excitability syndrome

Reflexes are poorly expressed, the child is lethargic and adynamic, muscle tone is low, dilated pupils, a tendency to lethargy, there is a symptom of "doll" eyes, breathing periodically slows down and stops (bradypnea alternating with apnea), a rare pulse, a weak sucking reflex.

  • Convulsive syndrome

Characterized by tonic (tension and rigidity of the muscles of the body and limbs) and clonic (rhythmic contractions in the form of twitching of individual muscles of the arms and legs, face and eyes) convulsions. Opercular paroxysms also appear in the form of grimaces, gaze spasms, attacks of unmotivated sucking, chewing and protruding tongue, floating eyeballs. Possible attacks of cyanosis with apnea, rare pulse, increased salivation and sudden pallor.

  • Hypertensive-hydrocephalic syndrome

The child throws back his head, fontanelles bulge, cranial sutures diverge, head circumference increases, constant convulsive readiness, loss of cranial nerve functions (strabismus and nystagmus are noted, nasolabial folds are flattened, etc.).

  • Syndrome of vegetative-visceral disorders

Characterized by vomiting and persistent regurgitation, disorders of intestinal motor function (constipation and diarrhea), marbling of the skin (spasm of blood vessels), bradycardia and infrequent breathing.

  • Movement disorder syndrome

Residual neurological disorders (paresis and paralysis, muscle dystonia) are characteristic.

  • Subarachnoid hemorrhage
  • Intraventricular hemorrhage and hemorrhage around the ventricles.

Possible infectious complications (due to weakened immunity after suffering multiple organ failure):

  • development ;
  • damage to the dura mater ();
  • the development of sepsis;
  • intestinal infection (necrotizing colitis).

Question answer

Question:
Does a baby who suffers from birth asphyxia need special care after discharge?

Answer: Oh sure. Such children need especially careful supervision and care. Pediatricians, as a rule, prescribe special gymnastics and massage, which normalize anxiety, reflexes in the baby and prevent the development of seizures. The child must be provided with maximum rest, giving preference to breastfeeding.

Question:
When is discharged from the hospital after asphyxiation of a newborn?

Answer: You should forget about early discharge (2 - 3 days). The baby will be in the maternity ward for at least a week (an incubator is required). If necessary, the baby and mother are transferred to the children's department, where the treatment can last up to a month.

Question:
Are newborns who have undergone asphyxia subject to dispensary observation?

Answer: Yes, all children who have suffered asphyxiation during childbirth must be registered with a pediatrician (neonatologist) and neurologist.

Question:
What consequences of asphyxia are possible in a child at an older age?

Answer: Such children are prone to colds due to weakened immunity, they have reduced school performance, reactions to some situations are unpredictable and often inadequate, psychomotor developmental delay, speech lag are possible. After severe asphyxia, epilepsy, convulsive syndrome often develop, oligophrenia is not excluded, and paresis and paralysis.

A person is alive as long as he breathes and as long as blood circulates in his vessels. That is why it is very important to know the peculiarities of breathing in children, as well as how and how the breathing of children differs from the breathing of an adult.

Respiration of the fetus

A person begins to breathe even before his birth, in the womb. But it is important to know the difference between intrauterine breathing of a child and his spontaneous breathing after birth.

After fertilization of the egg, the small embryo already needs oxygen. During the first ten weeks, the fetus receives oxygen from the mother's reserves, which are in the fertilized egg. Independent full respiration of the fetus appears with the appearance of the placenta and the birthplace, where the baby lives for almost all 9 months. This happens around the 10-12th week of a woman's pregnancy. Oxygen is actively absorbed by the villi of the placenta, which are attached to the mother's vessels, and from there they receive all the nutrients, including oxygen.

Breathing and childbirth

It is also interesting to know not only how the baby breathes in the womb, but also how his breathing changes during birth. At the time of the birth of the child, the baby for some time can be on double breathing - normal and breathing with the help of the mother through the placenta.

The baby's lungs begin to work most often after the obstetrician slaps the baby's bottom, which makes the lungs open and function fully. At the same time, the child can also receive oxygen through the mother's umbilical cord, if it has not been cut off (they try not to cut the umbilical cord while it is pulsating, that is, it is still working). After contraction of the uterus and rejection of the placenta by it or during the cutting of the umbilical cord by the doctor, the child completely switches to spontaneous breathing with the help of his own lungs.

Breathing of a child in the first months of life

Often, young parents may be concerned about the breathing of a newborn baby, namely, the frequency of breathing. It is important for new parents to know that the breathing of an infant is different from the breathing of an older baby, and even more so from the breathing of an adult.

Many parents may be concerned about the baby's breathing rate. The fact is that the respiratory tract of a newborn child is still undergoing a process of formation, therefore, the frequency and rhythm of the child's breathing may constantly change, not be stable. It is perfectly normal for a child to breathe frequently, take a deep breath, as if freezing and again begins to breathe frequently. These actions indicate that the child is still learning to receive oxygen correctly, and the respiratory rate compensates for the lack of oxygen in the baby during a normal respiratory rhythm. If an adult takes about 17-20 breaths per minute, a child - 25-30, then the respiratory rate in children of the smallest age can be up to 60 breaths per minute!

But it must be remembered that you need to constantly monitor the breathing of a newborn baby. On average, the baby's breathing should stabilize by the end of the first month of life. But everything is individual, if the child was born prematurely or with pathologies, this process may be somewhat delayed.

Breathing of a child in a dream

It is important for parents to monitor how the child is breathing in a dream. In a dream, a child can hide with his head and not receive enough oxygen, and in order to open up on his own, he is still small. It is also important to check the baby's breathing in the first months of life, as babies of this age can be susceptible to SIDS - sudden infant death syndrome - respiratory arrest for no apparent reason.

Mouth breathing

  • Young parents may also be concerned that their baby breathes through the mouth. In the first months of life, this is also normal, since the baby's nasal passages are not yet fully formed and may still be quite thin. Therefore, it can be difficult for a child to breathe through the nose, and for this he begins to use his mouth.
  • Also, the child can breathe through the mouth if his nose is clogged. To alleviate the condition of the child, it is necessary to drip the nose or gently clean it of foreign bodies with a cotton swab. The reason that the child's nose is clogged can be dry air in the apartment, therefore it is very important to monitor the humidity in the house in the first year of the baby's life. It should be 50-60% on average.
  • A child can also breathe through his mouth if he sleeps without a pillow, and his head is slightly thrown back. In this case, it is simply easier for the child to receive oxygen in this way. You can avoid this by placing a thin pillow under the baby's head.
  • Also, the child can simply sleep with his mouth open, and breathe with his nose. Therefore, parents, before taking action, need to make sure that the child breathes through the mouth. To do this, you just need to listen carefully to the baby's breathing.

How to breathe correctly?

Before you teach your child to breathe, you first need to understand how the child breathes. This can be chest, abdominal, or mixed breathing. With chest breathing, the chest actively works, with abdominal breathing, the child seems to be breathing through the belly. The mixed type combines the baby's chest and abdominal breathing. It is important for parents to remember that young children are practically all on abdominal breathing, so their clothes should not be tight or tight. This is necessary primarily for the baby's ease of breathing.

  • Exercise for proper abdominal breathing. The child should be laid on a flat surface on the back, the handles should be placed under the head, and the knees should be slightly bent. When inhaling, you need to inflate the stomach, like a ball, when exhaling, deflate it. So repeat 10-15 times. This exercise is intended not only to train your breathing, but also to strengthen your abdominal muscles.
  • Exercise for chest breathing. The child needs to take the sphinx position - lie on his stomach, put his hands on the floor from the elbow to the wrist, raise the chest. Take a deep breath, hold the air a little, exhale sharply. The exercise must be repeated several times.

The lungs are paired organs in a person that he needs to breathe air. The structure of these organs is very complex, and the shape is difficult to describe, because in most cases it completely depends on the phase of respiration. It is thanks to the lungs that we can transfer oxygen into the blood, and take back carbon dioxide and remove it from the body. The lungs are the main organs in the entire respiratory system. We will not be able to live without them, because if the body does not have enough oxygen, then life ends in just a few minutes. Of course, in order to provide the body with oxygen, it is necessary for other organs to work through which air must pass: the nose, nasopharynx, trachea, bronchi, pharynx and larynx.

The lungs are laid in a child at about the third week of development, and when he is born, their structure fully corresponds to the structure of the lungs in an adult. Throughout pregnancy, the baby's lungs do not perform any function and are filled with liquid in which the baby is located. But in order for the child to survive after birth, for nine months, the lungs are carefully prepared to perform their most important function, namely breathing. As soon as the baby is born, the liquid is replaced by air and the respiratory function of the body is automatically turned on.

If during pregnancy there were no complications and the childbirth was quite normal and in accordance with all the requirements, then the child begins to breathe immediately after birth. In addition, an interesting point is that oxygen deprivation stimulates the activation of the respiratory center for several minutes before birth. Gradually, the need for oxygen increases, and the amount of carbon dioxide in the blood increases. Accordingly, this is the irritant that makes the child cry as soon as he was born. By the way the baby cries, you can determine the degree of opening of the lungs. If the cry is strong, then the respiratory system is fully developed, and the airways are normally open. After about a minute, the natural breathing rhythm can be replaced.

If the child after birth did not begin to breathe on his own, then there is a risk of hypoxia. It is worth noting that the capacity of the lungs of a newborn child will constantly increase, while the entire respiratory system begins to develop very quickly. In some cases, the volume of the lungs increases too quickly, which disrupts the functioning of the diaphragm and as a result, problems with the herbal system appear. Initially, the baby's breathing will be quick and shallow, and the chest muscles will not be strong enough. But gradually all this will return to normal, and by the age of one year the child will breathe almost like an adult.

What pathologies can occur in the respiratory system of a newborn child

Probably everyone knows that in a person's lungs there are a huge number of alveoli - small sacs. In order for them to be in a straightened state, a special lubricant is needed, which accumulates throughout the pregnancy and by about the end of the 36th week it is enough for the child to breathe on its own. If the child was born earlier than this period, then when he exhales air, the alveoli will stick together and need to be inflated again. All this happens due to the fact that there is not enough lubrication. In addition, a secondary infection can enter the child's body, which also prevents the respiratory system from fully functioning. Doctors point out several factors that can affect the normal breathing of a newborn:
  • infections;
  • smoking by a woman during pregnancy;
  • cesarean section;
  • premature birth.

If a baby or newborn has a stuffy nose, you need to see a pediatrician. The doctor should examine the child and find out the reasons for the obstructed nasal breathing. It is strictly forbidden to use nasal vasoconstrictor drops without the appointment of a pediatrician.

Nasal congestion in infants only at first glance seems "commonplace". Newborns and infants should be closely monitored by health professionals. Perhaps the cause of a stuffy nose lies in improper care or is of a physiological nature. But still, it is better to clarify this issue with the doctor.

The importance of nasal breathing

If the baby's nose does not breathe, then there is no full-fledged moisturizing, cleansing, warming of the inhaled air. Such a baby will often get sick with ARVI. But there are other, even more serious consequences of difficulty in nasal breathing.

  • For a baby, normal nasal breathing is extremely important. Because he is not physiologically mature enough for full-fledged mouth breathing. In infants up to 6 months, the tongue pushes the cartilage of the larynx back and blocks the movement of air. Prolonged mouth breathing leads to hypoxia - a lack of oxygen, which negatively affects the overall development of the body. It is important to be aware of this and try to resume normal nasal breathing as soon as possible.
  • Neurological disorders. Hypoxia can provoke an increase in intracranial pressure, dysfunction of the central nervous system. The baby with difficulty in nasal breathing is capricious, does not sleep well.
  • Complications in the ENT organs. Swelling of the mucous membrane and nasal congestion impairs filtration and drainage functions, which leads to the multiplication of pathogenic microflora and inflammation of the middle ear, adenoids, and paranasal sinuses.
  • Weight loss. If the baby does not breathe through the nose, feeding turns into torment - the baby cannot suck without interruption, because it suffocates. As a result, the baby becomes restless, eats poorly and does not gain the required body weight. And this entails a number of other dangers in infancy.

Why is the baby's nose stuffy?

It is important to identify the underlying causes of nasal congestion in a nursing infant. This will help to take adequate relief measures.

  • Physiological formation of the nasopharyngeal mucosa. After birth, a mucous membrane forms within about 2-3 months. During this period, its swelling persists, the regulation of mucus is disturbed (sometimes there is too much, sometimes very little), and crusts in the nose quickly form.
  • ARVI. One of the first respiratory symptoms is a runny nose. Snot can be liquid and flow out of the nose, then nasal breathing is difficult, but still persists. Or there may be thick snot, then the baby has a stuffy nose, the baby grunts, sniffs, gets nervous during feeding. Read more about the treatment of a cold in infants in our other article.
  • Dry and hot indoor air. This is especially true during the heating season, when in most residential premises the air temperature rises above 22 ° C, and the average humidity is 30%. These parameters are especially harmful for the delicate and sensitive nasopharyngeal mucosa of infants. With such air, mucus quickly dries up in the nose, crusts form, which make it difficult to breathe through the nose.
  • Overheat. In infants, the thermoregulation system is not formed: babies quickly freeze and quickly overheat. A child who is dressed too warmly has increased sweating. This leads to frequent drying out of the mucous membranes of the nasopharynx.
  • Nasal congestion during teething. In the process of teething, the mucous membrane of the oral cavity and nasopharynx swells, becomes easily permeable, inflamed. Also, during this period, the child's immunity is weakened, and it is easier for him to catch ARVI, a runny nose and all the ensuing consequences. Therefore, during the period of teething, it is recommended to limit the contact of the baby with other people in order to reduce the risk of infection.
  • Household allergens. They have been talked about a lot lately, but few parents attach great importance to the hygiene of the room. In everyday life, a person is surrounded by various types of allergens. This is also house dust, in which dangerous mites live. These are household chemicals, washing powders, hygiene products, and animal dander.
  • Pathology of the nasal passages. Congenital anomalies and narrowing of the nasal passages are fortunately rare. However, they also cannot be ruled out. One of the most common congenital abnormalities is the closure, fusion of the choana (exit from the nose into the nasopharynx). In this case, complete or partial nasal obstruction occurs.

To exclude pathologies of the nose and nasopharynx, it is necessary to consult a pediatric otolaryngologist. The first preventive examination at the ENT is recommended after 3 months, then it is repeated at 1 year. But if there are constant signs of obstructed nasal breathing in a newborn or baby up to three months of age, you cannot wait for a planned visit to a specialist.

Why does a baby grunt and sniff when breathing

The respiratory rate in babies is up to 40 times per minute (for example, in an adult - 16 times per minute). Babies breathe irregularly, besides, they snore and even snore. This is a normal physiological phenomenon, which is explained by the swelling and narrowness of the nasal passages. Many mothers get anxious when a nursing baby grunts his nose. But in most cases, the answer is comforting: the baby will grow up, the nasal passages will expand, and the baby will breathe soundlessly and rhythmically.

Why there is nasal congestion without snot

Why does the baby have a stuffy nose, but no snot? This is one of the topical, frequently asked questions. There may be several reasons.

  • Allergic rhinitis. The absence of snot may indicate an allergic reaction in the baby. Seasonal allergic rhinitis is caused by flowering plants. Household allergens and food allergies can cause persistent nasal congestion.
  • Congenital pathologies. Nasal congestion without snot can be associated with the various anomalies of the nasal passages and nasopharynx mentioned above.
  • Inflammation of the adenoids. Adenoiditis in infants, although in rare cases, still occurs. Only examination and special diagnostics can confirm this diagnosis.
  • Sinusitis. Inflammation of the sinuses occurs as a complication after ARVI, influenza, measles, bacterial infections. In newborns and infants under one year old, ethmoiditis is a type of sinusitis, in which the ethmoid sinus becomes inflamed. The disease progresses and is difficult to treat.

With constant nasal congestion, without signs of acute respiratory viral infections, it is necessary to contact an allergist-immunologist.

Is it necessary to clean the nose of a baby and how to do it

Earlier, nasal cleaning was on the list of must-have and daily hygiene procedures. Today you can find the opposite opinion: once again, do not touch your nose at all if it breathes normally. Even if the baby grunts his nose, this does not mean that the procedure should be carried out immediately. After all, the mucous membrane is a self-cleaning system. On the epithelium of the nasal mucosa, tiny cilia grow, which push out dust and excess mucus. If the air in the room is sufficiently humid and cool, the mucous membrane does an excellent job of cleansing.

Correct cleaning algorithm

With dry and hot air, the baby will immediately form crusts in the nose. They can only be removed mechanically. How to do it correctly?

  1. A piece of cotton wool must be twisted into a tube (turundochka, flagellum) about 5 cm long.
  2. One end of the turundochka should be wide, and the other narrower.
  3. Lightly moisten a cotton ball with boiled water.
  4. With the narrow end, insert the turundochka into the nasal passage, carefully turn it and pull it out.
  5. If one turundochka is not enough, you need to use the next one.
  6. For the other nostril, we make a new turundochka and do the same.
  7. If the nasal passages are blocked by dried mucus, you need to drop 2 drops of saline into the nostril, and then clean the nasal passage with a cotton tube.

Instead of boiled water, you can use pharmacy saline solutions or prepare them yourself at home. Also turundochki can be moistened with boiled vegetable oil (olive, peach, almond and others).

What cannot be done?

  • Use cotton swabs to cleanse your nose. They are long and wide enough for a small nose. They can injure the mucous membrane and disrupt the structure of the nasal passages.
  • Apply concentrated saline solutions. To prepare a homemade solution, you need 1 liter of boiled water and 1 teaspoon of salt. Concentrated solutions can burn and dry out mucous membranes.
  • Spray into the nose with aerosols. These drugs are not suitable for small children. Under pressure, the sprayed liquid from the aerosol will enter the middle ear through the auditory tube, which can cause otitis media. Also, small children can not rinse their nose, you can only bury it.
  • Observe the depth of entry into the nasal passages. It should not exceed more than 2 cm.

What to do if a baby has a stuffy nose? If this is a symptom of ARVI, the doctor will prescribe appropriate medication and, as an "ambulance" - nasal vasoconstrictor drops. Read more about nose drops for children under one year old in our other article. If the reason is dry air, overheating of the baby or household allergens, then the responsibility lies with the parents.

Nasal congestion in infants is often explained by a banal everyday problem: dry air leads to the formation of crusts in the nose, which makes it difficult to breathe through the nose. But there are also more serious reasons: thick snot with ARVI, complications after viral and bacterial infections, swelling of the mucous membrane with an allergic reaction, pathology of the nasal passages. Only a specialist can assess the condition of the baby and identify the cause of the obstructed nasal breathing.

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Realizes how a child breathes in the womb. Some expectant mothers are very interested in this question, and sometimes alarming, therefore it is better to understand in advance the peculiarities of gas exchange of the fetus and the role of the placenta and umbilical cord in this process.

Fetal respiration process

Breathing is a process of gas exchange in a living organism, in which carbon dioxide is removed from the cells and oxygen is supplied, which is necessary for the full functioning of all body systems.

Therefore, the notion that a child does not breathe and a pregnant woman breathes for two is wrong. Since the process of breathing does not imply mechanical inhalation and exhalation, but gas exchange in the cells of the body. The fetus begins to breathe in the womb, but this process has distinctive features from the usual breathing for us.

It is quite simple to understand how a child breathes in the womb. This process occurs through the placenta, which not only provides the ability to breathe, but is also a conductor of nutrients from the mother to the fetus and a means of removing waste products and metabolic processes from the fetus.

In addition to these functions, the placenta also serves as a separator, preventing the mixing of maternal blood and lymph with the biological fluids of the fetus.

How does a baby breathe in the womb

Oxygen is transferred from the mother's body through the umbilical cord to the placenta. In the opposite direction from the placenta, metabolic products and carbon dioxide, which is a product of fetal cellular respiration, move.

Waste gas with blood enters the pulmonary arteries of the mother and is excreted through the respiratory system, and gas exchange occurs in the alveoli of the lungs. This process occurs endlessly, allowing the mother and fetus to saturate with the oxygen necessary for life.

Knowing how a child breathes in the womb, one can easily conclude that pregnancy is a heavy burden on the female body, since it literally works for two, providing the developing baby with all the necessary trace elements and vitamins and oxygen necessary for life.

The role of the umbilical cord in breathing

The body of the mother and the child is connected not only by the placenta, but also by the umbilical cord, which is a dense tourniquet consisting of two arteries and one vein. As the baby grows, the umbilical cord grows in size, and after birth it is the same length as the baby.

Through the umbilical cord, metabolic products are removed from the fetus's body, from a vein in the umbilical cord they enter the mother's bloodstream and are excreted from her body. From the mother through the umbilical cord, nutrients and oxygen are supplied to the placenta. How a child breathes in the womb can only be understood by understanding the very root of this issue and understanding the features of the breathing processes.

The value of fresh air during breathing

To provide for her own body and the body of the baby, a pregnant woman needs to spend a lot of time in the fresh air, since a lack of oxygen can cause not only dizziness and loss of consciousness in the mother, but also hypoxia in the fetus, which negatively affects its development.

Therefore, to understand the importance of fresh air, you need to know how a baby breathes in the womb. A photo of the fetus in the womb makes this process more visual and understandable.

Since the child's lung tissue matures only at the 34th week, after exposure to a special substance - a surfactant. If a baby is born prematurely, it is connected to a ventilator until the lung tissue matures in the baby's body. Modern medicine has learned to synthesize a surfactant, allowing the lungs to mature and allowing the child to breathe on their own.

The way a baby breathes in the womb is significantly different from the process of spontaneous breathing, which requires the opening of the alveoli of the lungs. Therefore, a pregnant woman needs to walk enough in the fresh air and try to stay in stuffy rooms as little time as possible in order to avoid the development of oxygen starvation and premature birth.