Breathing Issues in a Newborn After Feeds
Our son was welcomed into the world on June 7, born at 32 weeks and 6 days, and adjusted to an age of 36 weeks and 2 days as of now. We brought him home from the hospital last Saturday, and while he has been thriving with bottle feeding, recent developments have raised some concerns. In the past day and a half, he has shown signs of congestion and has been frequently clearing his airways. Today, I visited our pediatrician's lactation specialist to discuss his latching during breastfeeding, and I noticed something alarming. As he latched, he appeared to choke momentarily, ceasing to breathe for a few seconds. It seemed as if he was dazed, and soon after, he began grunting and clearing his throat. At one point, I noticed his skin was slightly bluish, especially around his lips. The lactation consultant promptly fetched a doctor. Fortunately, he rebounded quickly on his own, but they did observe the congestion, suggesting it could either be due to a common cold or a reaction to reflux. We received a prescription for famotidine and were instructed to head to the emergency room should his fever increase. Feeling anxious, I rummaged through our belongings for the Owlet monitor that someone had gifted us and attached it to him. He seemed stable until his last feeding. After consuming his meal, he burped, spat up, and then began choking, struggling to cough properly. The monitor alarmed due to low oxygen levels, and I noticed his complexion darkening. His oxygen saturation plummeted into the 60s and it required several minutes for it to gradually rise back above 90. During this episode, he experienced nasal flaring and retractions, but thankfully, he is okay now. He hasn’t had a fever, and his heart rate and oxygen levels are within normal ranges. As a nurse, I feel somewhat at a loss, especially since this is my first child. I’m left wondering if this situation warrants a trip to the hospital. If it were to recur tonight, should we return to the pediatrician for advice?
Answers (1)
7/3/2025, 2:40:43 AM
OpenHealth AI
I'm glad to hear that your son is home and thriving, especially after his early arrival. From your description, it sounds like there are a few concerning signs, but it’s excellent that he seems to recover quickly after each episode. The challenges you're facing can understandably be anxiety-inducing, especially as a new parent. Here's a structured response to your concerns:
Main Points
- Monitor for Symptoms: Keep an eye on his breathing patterns, especially after feeds.
- Use of Medication: Follow up on the famotidine prescription and monitor its effect.
- Assessing Emergency Needs: Be prepared to act quickly if symptoms worsen, particularly if breathing difficulties or bluish skin recur.
Explanation
Your newborn, being born preterm, may have immature lungs and reflexes that can contribute to issues like choking or congestion. The signs you're observing—like grunting, nasal flaring, and temporary drops in oxygen saturation—can be concerning, particularly if they happen after feeding. The prescription for famotidine suggests that the pediatrician might suspect reflux, which can cause feeding difficulties and airway challenges. Monitoring congestion and using the Owlet monitor can be helpful, but you must differentiate between normal newborn behavior and signs that require urgent medical attention.
Next Steps
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Immediate Monitoring:
- Continue to monitor his breathing closely, especially after feeds. Observe for signs like nasal flaring, retractions, or persistent congestion.
- Keep the Owlet monitor on him to track his oxygen levels, but remember that occasional dips can happen. However, if his oxygen saturation drops significantly or stays low, seek help immediately.
-
Medication Management:
- Administer the famotidine as prescribed. This may help with reflux symptoms, but keep a watch for any side effects or changes in his condition.
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Emergency Plan:
- Have a plan in place: if your son shows signs of severe breathing problems, excessive choking, or a significant drop in oxygen saturation again, go to the emergency room immediately. It's vital to trust your instincts as a parent; if you feel something isn’t right, seek help.
- If the choking episodes continue or worsen, reach out to your pediatrician to discuss additional management strategies or possible referrals to specialists, such as a pediatric gastroenterologist or pulmonologist.
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Seeking Support:
- Don’t hesitate to reach out to the pediatrician or an urgent care service for guidance, especially if you feel overwhelmed or anxious about his condition. It’s better to ask and get reassurance than to wait if you're feeling uneasy.
Your experience as a nurse is valuable, and your observations as a parent are crucial. Trust your instincts, and please don’t hesitate to reach out for help when needed. You're doing an incredible job caring for your little one!
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