Is it common for newborns to make snorting or snoring sounds while breathing?

Snorting and Snoring Sounds in Newborns: Normal Respiratory Patterns

Yes, snorting and snoring sounds are common in newborns and typically represent normal respiratory patterns due to their unique anatomical and physiological characteristics.

Why These Sounds Are Normal in Newborns

Anatomical Factors

• Newborns are obligate nasal breathers during the first 3-4 weeks of life, meaning they breathe primarily through their noses rather than their mouths 1
• The nasal passages in newborns contribute to approximately 50% of total airway resistance, making them particularly susceptible to noisy breathing even with minor congestion 1
• The immature chest wall in infants under 2 years is nearly 3 times more compliant than their lungs due to incomplete bone ossification, creating a mechanically disadvantageous breathing state that can produce audible respiratory sounds 1

Common Benign Causes

• Snoring occurs in 11.8% of infants at least 2 days per week and in 5.3% at least 3 days per week, representing a normal variant in otherwise healthy infants 1
• Minor increases in nasal congestion from common conditions like upper respiratory infections can create near-total obstruction and noisy breathing due to the narrow nasal passages 1
• Mildly increased upper airway resistance from nasopharyngeal inflammation alone can cause audible breathing sounds without representing true respiratory disease 1

When to Be Concerned: Red Flags Requiring Evaluation

While most snorting and snoring is benign, certain features warrant immediate medical attention:

Signs of Respiratory Distress

• Grunting: Repetitive "eh" sounds during early expiration, representing attempts to maintain lung volume 1
• Nasal flaring: Consistent outward movement of the nostrils during inspiration 1
• Intercostal retractions: Tissue between ribs pulling inward during breathing 1
• Head nodding: Head moving up and down with breathing, especially in infants with limited head control 1
• Severe tachypnea: Breathing ≥70 breaths/minute in infants 2-11 months old 1

Associated Symptoms Requiring Evaluation

• Witnessed apnea: Pauses in breathing, gasping, or significant snorting during sleep 1, 2
• Feeding difficulties: Poor oral intake, difficulty feeding, or failure to thrive 1, 2
• Cyanosis or color changes: Periodic respiratory distress with blue discoloration 1
• Persistent symptoms: Noisy breathing that worsens over time rather than improving 3

Clinical Pitfalls to Avoid

• Do not dismiss habitual snoring (≥3 nights per week) in infants, as this may indicate obstructive sleep apnea syndrome (OSAS) rather than benign primary snoring 2, 4
• Snoring may be absent in younger infants with OSAS, particularly those with micrognathia, so absence of snoring does not rule out significant airway obstruction 1
• Bilateral choanal atresia presents as a neonatal emergency with periodic respiratory distress and cyanosis relieved by crying, requiring immediate airway management 1
• In infants under 3 months with concerning symptoms, consider laryngomalacia as the most common cause of chronic noisy breathing and stridor 3, 5

When Subspecialist Referral Is Indicated

• Infants under 12 months with habitual snoring should be referred to pediatric otolaryngology or pediatric sleep medicine for comprehensive evaluation, as this age group is at high risk for complications if intervention becomes necessary 2
• Polysomnography is the gold standard for distinguishing benign primary snoring from OSAS and should be arranged through specialist referral 2, 6
• Untreated OSAS can lead to serious complications including neurocognitive impairment, failure to thrive, and cardiovascular complications 2, 6, 4