From the Guidelines
Moaning and grunting in newborns can be caused by respiratory distress, which requires immediate medical attention, as evidenced by studies showing that grunting is a significant warning sign for severe respiratory disease 1.
Causes of Moaning and Grunting
Moaning and grunting in newborns are common sounds that can have several causes, ranging from normal to concerning. Normal causes include general communication, as newborns use various sounds to express needs or discomfort. During sleep, newborns may make grunting noises as part of their normal breathing patterns or dream states. Grunting can also occur during bowel movements as babies learn to coordinate abdominal pressure.
Concerning Causes
However, persistent grunting, especially during breathing, may indicate respiratory distress and requires immediate medical attention. This respiratory grunting happens when babies exhale against a partially closed glottis to maintain lung pressure and prevent alveolar collapse, as described in a study on signs of severe respiratory distress 2. Other concerning causes include pain, infection, or neurological issues.
Warning Signs
Parents should seek immediate medical care if grunting is accompanied by:
- Fast breathing (more than 60 breaths per minute)
- Flaring nostrils
- Chest retractions
- Blue discoloration
- Fever
- If the baby appears ill A study on the diagnosis and management of bronchiolitis highlights the importance of assessing risk factors for severe disease, such as age less than 12 weeks, a history of prematurity, underlying cardiopulmonary disease, or immunodeficiency 3.
Importance of Medical Attention
While occasional grunting is normal, persistent respiratory grunting is a significant warning sign that should never be ignored. A study on the challenges in the diagnosis of pediatric pneumonia in intervention field trials recommends that WHO guidelines amend their danger signs for pneumonia to include signs of severe respiratory distress, such as grunting, nasal flaring, head nodding, tracheal tugging, intercostal retractions, severe tachypnea, along with hypoxemia and moderate to severe malnutrition 1.
From the Research
Causes of Moaning and Grunting in Newborns
- Moaning and grunting in newborns can be symptoms of respiratory distress, which is a common condition in newborns 4, 5.
- The causes of respiratory distress in newborns can vary, but common causes include: + Transient tachypnea of the newborn + Respiratory distress syndrome (RDS) + Meconium aspiration syndrome (MAS) + Pneumonia + Sepsis + Pneumothorax + Persistent pulmonary hypertension of the newborn + Delayed transition + Congenital heart defects + Airway malformations + Inborn errors of metabolism 4, 5
- Grunting is a specific symptom that can be associated with respiratory distress, and it is often accompanied by other symptoms such as tachypnea, nasal flaring, and retractions 4, 5.
- The diagnosis of respiratory distress in newborns is based on a thorough history, physical examination, and radiographic and laboratory findings 5.
- Treatment of respiratory distress in newborns depends on the underlying cause, but it often involves respiratory support and noninvasive methods, such as oxygen therapy and nasal continuous positive airway pressure 4.