Why Most Babies Can’t Breathe Through Their Mouth

Ever wonder why babies are typically nose breathers? There are many reasons why that we are going to dive into today. With our founder being a pediatric ENT, he gets asked this question a lot, so we wanted to make sure that we provided more clarity on the topic.

Why Most Babies Can’t Breathe Through Their Mouth

When your baby is born they haven't had any practice breathing yet. As soon as they come out of your womb we suction their nose and then suction their throat. There has been a lot of recent press and interest in nasal breathing and nasal breathing is necessary for babies and we wanted to set the record straight.

At birth the orientation of the voice box or larynx with the soft palate or uvula are interdigitated. That means that they are arranged in a way in which babies can breathe and eat at the same time. As your baby grows the voice box or larynx descends and simultaneous eating and breathing becomes less frequent.

As a pediatric ENT doctor I am often called to the neonatal intensive care unit to see and assess babies that can't breathe through their nose. There are several medical conditions including choanal atresia as well as Nasolacrimal duct cyst formation that completely obstruct the nasal cavity and babies have severe problems breathing at birth. If they have these two conditions they have significant breath-holding spells with their oxygen levels dropping critically low, but then they cry and can breathe and get oxygen. However when they stop crying and try to breathe again through their nose their oxygen levels drop severely.

If babies can’t breathe properly, they can’t eat

As you might imagine, if these babies can't breathe then they can't eat. Many times we'll have to put a breathing tube end and then perform surgery to open up the back of their nose. These two clear cut examples of complete nasal blockage or obstruction demonstrate the necessity of nasal breathing in your baby after birth.

Swallowing

Swallowing is a complex choreographed movement that happens naturally in babies and is mostly reflexive. On your prenatal ultrasounds oftentimes your baby can be seen moving their tongue in a rhythmic swallow so that by the time they're born they have already practiced swallowing with the amniotic fluid. However once they're born they have to get oxygen from breathing and this occurs primarily through their nose. If your baby has a lot of nasal congestion at birth particularly when they've had a C-section and there has not been compression of the facial structures it may take a day or two for them to be able to breathe through their nose sufficiently to get swallowing managed appropriately.

Oftentimes lactation consultants or speech pathologists may help families whose babies are having trouble coordinating their swallowing, particularly if they had nasal congestion. Once you go home and swallowing coordination is good with primary nasal breathing because their mouth is occupied with a bottle or their breast they will eat and breathe simultaneously and grow quickly.

The role that RSV plays

One of the biggest concerns in the first year of life for your baby is that they could get an illness particularly respiratory syncytial virus that may cause severe nasal congestion. Many times babies have to be admitted to the hospital when they have this infection solely for nasal suctioning and nasal hygiene. Without the appropriate nasal suctioning and hygiene they are unable to breathe very well and therefore unable to eat very well because they are completely congested and can't even breathe at the same time.

Nasal suctioning in the hospital

When infants are in the hospital we often use nasal suctioning just prior to feeding to ensure that they can be hydrated and maintain their continued growth in development by receiving calories. Many parents expressed to us frustration of being hospitalized solely for the purpose of nasal suctioning and nasal hygiene. There are occasions in which the virus gets deeper into the lungs and cause inflammation and secretions there in your baby could potentially also have to have a breathing tube in that instance.

Remember: every child is different

The dependence on nasal breathing while eating gradually shifts during the first year of life and as a pediatric ENT doctor I do not see as many patients who have severe complications of nasal breathing as they get towards their first birthday as I do in the first weeks or months of life.

Obviously every child is different therefore what your child experiences with nasal breathing may be different than somebody else's child. However, in total, babies are dependent on nasal breathing primarily particularly at a younger age and therefore nasal hygiene with saline as well as suctioning is important to discuss with your medical care provider. If your baby is born with a congenital difference completely obstructing their nasal cavity then there is a high likelihood that they will need surgery to open up their noses so they can breathe adequately and then feed adequately.

If your baby is born with one of these conditions you should also ask your physician to consider the possibility of additional findings as the complete obstruction of the nasal cavity is often associated with other concerns particularly as it relates to the heart and the brain. As your baby grows they will be able to breathe more and more out of their mouth however all humans are designed to predominantly breathe from their nose because it plays such an important part of your respiratory system.

The nose acts as a filter to prevent foreign objects in pollen and dust from getting deep into your lungs as well as it humidifies the air. So even though you or your child may be able to breathe adequately out of your mouth, nasal breathing is crucial to health and wellness both as an infant, toddler, and older child, adolescents, and adults.

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If you have any other questions on this topic, feel free to reach out to us on Instagram and we will make sure it’s answered immediately. As always, you can consult with your pediatrician and this blog post should not be substituted for medical advice.

If you are looking for more studies on this topic, you can refer to the links below:

When your baby is born they haven't had any practice breathing yet.

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