Baby Nostrils Flaring, Should I Be Concerned? – 5 Important Insights

Respiratory distress in newborns is a common occurrence and is often due to challenges in their respiratory system as they transition from the womb to the outside world. Baby nostrils flaring is one visible sign of this distress, along with audible grunting sounds from the infant.

Nasal flaring should be taken seriously as it may indicate an underlying issue that requires attention. In this article, we will provide valuable information on nasal flaring. Let’s explore what you need to know about this condition…

Respiratory diseases, while often minor in adults and children, can be life-threatening for neonates. Respiratory distress is a leading cause of mortality in newborns, especially premature infants. It can occur in approximately 7% of neonates, and prompt action is crucial to save lives.

An important fact is that neonates are obligate nasal breathers, meaning that if they cannot breathe through their nose, they typically do not open their mouth to compensate. This can quickly lead to dangerous hypoxia. Emergency medical service (EMS) professionals and healthcare providers should carefully monitor neonates, particularly those with infections.

Recognizing The Signs Of Baby Nostrils Flaring Is Vital. Here Are Some Key Indicators To Watch For:

1. Retractions:
   When a neonate is not receiving adequate oxygen, the intercostal muscles around the ribs work harder, leading to retractions. This can be observed as the skin around the ribs collapses, making the ribs visible and the muscles appear strained with each breath.
2. Nasal Flaring:
   Since newborns primarily breathe through their nostrils, inadequate oxygen supply often causes their nostrils to flare. Nasal flaring should never be disregarded, especially when accompanied by other symptoms of respiratory distress.
3. Loud Breathing:
   Similar to adults and children, loud and raspy breathing sounds may indicate respiratory distress in neonates. In newborns, loud breathing can be a sign of a slow transition or meconium aspiration. In older newborns, it is commonly associated with respiratory infections, such as respiratory syncytial virus.

Also,

1. Blue Color:
   A blue color, along with a pale or ashen appearance, indicates oxygen deprivation. Check the nail beds, lips, and tongue as they tend to turn blue or white first. Healthy newborns should quickly turn pink after birth and maintain that color. Persistent paleness always warrants concern.
2. Rapid Breathing:
   Newborns have a faster breathing rate than adults and children, normally ranging from 40 to 60 breaths per minute. Therefore, rapid breathing can be quite noticeable and may produce audible sounds. If a newborn’s breathing exceeds 60 breaths per minute, it is a sign of respiratory distress.
3. Increased Pulse:
   To compensate for inadequate oxygenation, the heart beats faster. A typical newborn pulse ranges from 120 to 160 beats per minute. Any pulse rate higher than this suggests respiratory distress. When accompanied by rapid breathing or changes in color, it may indicate a hypoxic state in the neonate.
4. Altered Consciousness:
   Detecting altered consciousness is more challenging in newborns compared to adults and children. Newborns sleep frequently and cannot express themselves verbally, making signs of altered consciousness easy to miss. Look for excessive sleepiness, feeding difficulties, lethargy, and difficulty waking up. A newborn who does not respond to gentle stimulation, such as stroking their cheek or foot, may be in respiratory distress.
5. Feeding Difficulties:
   Neonates experiencing respiratory distress may struggle to feed, particularly breastfed infants who require more effort to suckle compared to bottle-fed babies. These feeding difficulties can exacerbate other symptoms, leading to increased lethargy. A baby who has not eaten for several hours or cries of hunger but refuses to eat may be experiencing pain or respiratory distress.

It is crucial to seek immediate medical attention if any of these signs are observed in a newborn. Timely intervention can significantly improve outcomes and ensure the well-being of the infant.

Additionally

Treating respiratory distress in newborns often requires rapidly suctioning the airway. The right equipment is critical to the success of this mission because neonates’ airways are inherently fragile and prone to injury. 

Moreover, prompt emergency suctioning can save lives, especially in the event of meconium aspiration. First responders must have neonate-sized equipment and a portable emergency suction machine ready.

Baby’s Nostrils Flaring

When a child is congested, you may notice flaring of your baby’s nostrils in and out with each breath. Nasal flaring may be seen in children with colds. It may also turn out to be a sign that he or she is having breathing problems.

How To Know If Your Baby Is Experiencing Flaring Of The Nostril

• Your baby’s nostrils widen as he or she breathes (nasal flaring) for longer than a few minutes.

• Your baby makes grunting sounds with each breath; this lasts longer than a few minutes.

• The skin around your baby’s ribs or at the base of the throat pulls in sharply with each breath.

Breathing Problem

When examining the chest of a child experiencing retractions or breathing difficulties, you may notice a skeletal appearance. The skin appears to be pulled inward and outward between each rib with every breath, making the ribs more visible. These breathing problems in children can be indicative of respiratory illnesses or a blocked airway.

In cases where the child is overweight, it may be challenging to identify retractions around the chest wall. However, an alternative method is to observe the neck and collarbone area. If you can see the skin being pulled downward toward the collarbone or notice the child straining their neck muscles while breathing, they are likely experiencing significant breathing difficulties.

How To Help A Child With Breathing Problem

If you observe significant retractions in which nearly all of the child’s ribs are visible from a few feet away, it is crucial to call 911 immediately. This indicates that the child is experiencing severe respiratory distress, and contacting emergency services is the fastest and safest way to seek help.

In cases where there is minimal retracting, but the child has no history of wheezing or using inhalers or nebulizers, it is important to seek medical attention promptly. If the child is awake and alert, it is generally safer to drive them to a healthcare facility yourself. However, ensure that someone else is present in the car and keep a cell phone accessible in case the situation worsens.

If there is minimal retracting and the child has an inhaler or nebulizer available, administering a breathing treatment can be considered to assess if the retracting improves. If the retracting resolves after the treatment, it is advisable to contact your child’s healthcare provider to receive further instructions for ongoing management.

Causes Of Babies Flaring Nostrils

Nasal flaring in babies can have various causes, ranging from non-serious to potentially life-threatening conditions. It is important to be aware of the potential seriousness of this symptom and seek appropriate medical attention.

In young infants, nasal flaring can be an indication of respiratory distress, a condition that hinders the adequate flow of oxygen into the lungs and bloodstream.

The following conditions may contribute to nasal flaring:

1. Asthma exacerbation: When asthma is not well-controlled, it can lead to episodes of increased difficulty breathing and nasal flaring.
2. Lung problems: Infections or long-term damage to the lungs can cause nasal flaring as the body attempts to compensate for compromised respiratory function.
3. Bronchiolitis: This condition involves swelling and mucus buildup in the small air passages of the lungs, leading to breathing difficulties and nasal flaring.
4. Transient tachypnea of the newborn: A breathing disorder that affects newborns, causing rapid breathing and potentially nasal flaring.
5. Croup: Characterized by a barking cough and difficulty breathing, croup can contribute to nasal flaring in affected infants.
6. Blocked airway: Any obstruction in the airway, such as foreign objects or anatomical abnormalities, can result in nasal flaring as the body tries to increase airflow.
7. Epiglottitis: Swelling or inflammation of the tissue covering the windpipe can impede normal breathing and lead to nasal flaring.

If you observe nasal flaring in your baby, it is essential to consult a healthcare professional for a proper evaluation and appropriate management.

Possible Effect Of Nasal Flaring If Left Untreated

Nasal flaring is a symptom of breathing difficulties or an attempt to widen the nasal opening to reduce airway resistance. In most cases, these difficulties will worsen until the cause is diagnosed and treated.

Nasal flaring can be serious, especially in children, and may require emergency medical treatment. Nasal flaring that’s treated using medications or inhalers typically has no long-term consequences.

How Can I Help My Child With Flaring Of The Nostril?

The first thing you should do if you notice flaring of your baby’s nostrils is to try suctioning the nose out with saline drops and a bulb syringe. (If your child is old enough, you can alternatively just have them blow their nose)

Using a drop or two of saline in one nostril, gently suction the congestion out, then, repeat these steps in the other nostril. This may help clear up the nasal flaring. If it does not, contact your child’s doctor or seek medical attention right away.

Nationwide Children’s explains the fact stated here in Suctioning the Nose With A Bulb Syringe

When To Seek For Professional Help

Call a professional if you observe:

• Any persistent, unexplained nasal flaring, especially in a young child.

• A bluish color develops on the lips, nail beds, or skin – this is a sign that breathing difficulty is severe. It may mean that an emergency is developing.

• You think that your child is having trouble breathing.

Seek emergency help right away if you observe the above-listed signs your child may have.

A professional will perform a physical exam and ask about the symptoms and medical history. 

Questions may include:

• Are they getting better or worse?

• When did the symptoms start?

• What other symptoms are there, such as sweating or feeling tired?

• The provider will listen carefully to the breath sounds. This is called auscultation.

• Is the breathing noisy, or are there wheezing sounds?

• Do the muscles of the stomach, shoulders, or rib cage pull inward during breathing?

Tests that may be done include:

• ECG to check the heart

• Arterial blood gas analysis

• Pulse oximetry to measure blood oxygen level

• Complete blood count (CBC)

• Oxygen may be given if there is a breathing problem.

• X-rays of the chest

Tips On What To Expect In Babies First Few Days After Birth

1. Breathing: Your baby’s breathing patterns can vary, with periods of shallow and rapid breathing, as well as times of deep or slow breathing. It is normal for breathing to pause for up to 20 seconds intermittently.
2. Color: Within the first 24 hours, it is common for your baby’s hands and feet to appear blue or purple. They may also develop red and blotchy skin when exposed to cold temperatures or during crying. Mild jaundice, characterized by a yellowish tint on the face, can also occur after the initial 24 hours.
3. Temperature: A normal temperature range for your baby is approximately 36.5°C to 37.4°C (97.7°F to 99.3°F) when measured in the armpit.
4. Feeding: After the first day, your baby should typically be fed every two to four hours, totaling 8 to 12 feedings per day. During feeding, your baby should spend a minimum of 20 minutes nursing, although longer feeding sessions are common. A contented baby will naturally detach from the breast when finished. It is worth noting that babies may exhibit cluster feeding (frequent feeding in succession) followed by longer intervals without feeding.
5. Diapers: During the initial stages, the diaper output may vary. Expect one wet diaper on the first day, two wet diapers on the second day, and three wet diapers on the third day. Initially, your baby’s stool will be dark and greenish (known as meconium) until your colostrum transitions to mature milk. Once mature milk is established (around the third to fifth day), your baby should have around six to eight wet diapers per day and two or more liquid stools, which can range in color from yellow to green or brown.

Conclusion

Nasal flaring in babies occurs when their nostrils widen while breathing, often indicating difficulty breathing or respiratory distress. This condition is more commonly observed in infants and young children. Various factors can contribute to nasal flaring, and while many are not serious, some can be life-threatening.

All parents must seek immediate emergency assistance if they or their child exhibits signs of breathing difficulties. Regardless of the severity, it is important to ask questions and promptly contact a healthcare provider when any of these symptoms manifest. By doing so, you can ensure timely medical attention and appropriate guidance. Remember, proactive communication with healthcare professionals is key to safeguarding your child’s well-being.