From the Guidelines
Babies are obligate nose breathers for the first few months of life, typically up to 3-6 months of age, as they have not yet developed the neurological coordination to automatically switch to mouth breathing when their nasal passages are obstructed. This physiological characteristic is crucial to understand, as nasal congestion in young infants can be particularly concerning and may require prompt attention 1. The nasal passages contribute to 50% of the total airway resistance in newborns, and any minor increase in congestion can create near-total obstruction 1.
Key Points to Consider
- Nasal congestion in infants can lead to fatal airway obstruction, especially in those under 2-6 months of age 1.
- The most common acquired anatomic cause of nasal obstruction in infants and children is adenoidal hypertrophy, which can result in mouth breathing, nasal speech, and snoring 1.
- Maintaining clear nasal passages is essential for an infant's comfort and health, especially during feeding, as their oral cavity is occupied during nursing or bottle feeding.
- Saline drops and gentle nasal aspiration with a bulb syringe can help relieve nasal congestion in infants 1.
Clinical Implications
- Parents should be vigilant about keeping their baby's nasal passages clear, especially during illnesses.
- Understanding the physiological characteristic of obligate nose breathing in infants helps explain why they may become distressed when congested and why maintaining clear nasal passages is important for their health.
- The diagnosis and management of rhinitis and other conditions that may cause nasal obstruction should take into account the unique physiological characteristics of infants and young children 1.
From the Research
Definition of Obligate Nose Breathers
- Obligate nose breathers are individuals who breathe exclusively through their nose, and are unable to breathe through their mouth.
- This concept is often associated with newborn babies, who are thought to be obligate nose breathers due to their underdeveloped oral cavity and inability to breathe through their mouth 2.
Studies on Newborn Babies' Breathing Habits
- A study published in 1985 found that infants are not obligatory nasal breathers, as they can breathe through their mouth by detaching the soft palate from the tongue, thus opening the oropharyngeal isthmus 3.
- Another study published in 2012 suggested that mammalian neonates, including human newborns, are considered to be obligate nose breathers, and that abnormal oral respiration can affect their oral competence and systemic adaptation 4.
- A study published in 1985 found that newborn infants may use the oral airway for ventilation, both spontaneously and in response to complete nasal occlusion, although the distribution of tidal volume was mostly nasal 5.
Implications of Nasal Congestion in Newborn Babies
- Nasal congestion can lead to serious consequences, such as respiratory distress or discomfort, altered sleep cycle, increased risk of obstructive apnoea, and feeding difficulties 2.
- A review of nasal congestion published in 2000 highlighted the importance of addressing nasal congestion, as it can lead to sequelae such as sinusitis, otitis media, and sleep disturbances 6.
- The use of saline nasal lavage is recommended as an adjunct therapy for rhinosinusitis and allergic rhinitis, and in most cases of nasal congestion or obstruction in newborns, infants, and children 2.