Snoring in newborns

Grunting (moaning) in newborns: When is it normal and when is it not?

Newborns make a multitude of strange sounds, and grunting, moaning, or "grunting" (grunting) are among the most common. In most cases these sounds are completely harmless and are related to the adaptation of the respiratory and digestive systems. However, sometimes grunting can be a serious symptom of respiratory insufficiency.

Benign causes of grunting

• Breathing adaptation. The baby is learning to coordinate breathing and the work of the vocal cords. Grunting may occur when it tries to breathe with a closed glottis.
• Bowel activity. This is the most common cause. Newborns are not yet able to relax the pelvic floor muscles simultaneously with abdominal muscle tension for defecation. They strain, which raises intra‑abdominal pressure, and reflexively close the glottis, producing the grunting sound. This phenomenon is so common that it has been called "infant dyschezia" and does not require treatment.
• Residual mucus. The infant’s narrow nasal passages may be filled with mucus, and grunting is a way to "clear" them.

Grunting as a sign of respiratory insufficiency

There is a very important distinction. Dangerous grunting (moaning) occurs on every exhalation and indicates that the baby is having difficulty breathing. It is the body's attempt to maintain pressure in the lungs and prevent the alveoli from "collapsing" at the end of exhalation. This is one of the key signs of respiratory distress syndrome.

This type of grunting is always accompanied by other signs of respiratory insufficiency:

• Very rapid breathing (over 60/min).
• Retraction of the chest’s soft areas.
• Nasal flaring.

If you hear a rhythmic moan on every exhalation, especially together with other concerning symptoms, it is a reason for immediate emergency call. Read about other breathing problems in our dedicated section.