Nasal flaring in newborns

Nasal flaring in newborns: An alarming sign

Nasal flaring during breathing is a symptom that always indicates the child is having difficulty breathing. It is one of the classic signs of respiratory insufficiency in infants, and it should never be ignored. It is a visible sign that the baby is exerting significant effort to inhale enough air.

What happens during this process?

Normally, during quiet breathing the nostrils remain still. When the body lacks oxygen, it reflexively engages accessory respiratory muscles, including those that widen the nasal alae. By expanding the nostrils, the infant instinctively tries to reduce airflow resistance and "draw" more air into the lungs.

This symptom rarely occurs in isolation. It is usually part of a cluster of signs of respiratory insufficiency, which also includes:

• Tachypnea (rapid breathing): Resting breathing rate exceeds 60 breaths per minute.
• Retraction of chest wall areas: Skin sinks between the ribs, under the rib arch, or above the clavicles.
• Grunting breathing: Characteristic sound on exhalation.
• Cyanosis: Bluish discoloration of the skin and lips.

Possible causes and parental actions

Nasal flaring can be triggered by any condition that makes breathing difficult:

• Newborn respiratory distress syndrome, especially in preterm infants, associated with surfactant deficiency.
• Transient tachypnea of the newborn (the so‑called "wet lungs").
• Pneumonia.
• Congenital heart or lung defects.
• Severe nasal congestion, which hinders the child’s breathing.

If you notice your child breathing with nasal flaring, it is a reason for immediate medical attention. Do not wait for it to "just pass". Only a physician can assess the degree of respiratory insufficiency and determine its cause. Read more about breathing problems in our dedicated section.