I am writing this because reading other parent’s experiences as I was searching for my own answers was helpful and made me feel less crazy. I hope this informs parents looking for possible reasons to why their baby is making weird gasping spasm noises. That being said, this is *not* meant to take the place of medical advice. I am not a medical expert. Take videos of your baby’s issues. Take detailed notes. And TALK TO YOUR PEDIATRICIAN, not people on the internet, to help diagnose issues.
Primary video I showed our pediatrician and pulmonologist:
Summary (tl;dr)
Our baby had silent reflux and his stomach contents were coming back up after feeding, occurring only during sleeping and causing scary-sounding gasping/breathing spasms. Instead of regular reflux where boatloads of spit-up comes out, our baby only had spit-up coming up partway. A pulmonologist determined his lungs were trying to stop the milk from aspirating, an effort that led to the spasmy gaspy breathing. Our issues were resolved by not overfeeding the baby (he was breastfed, but still eating a LOT), holding the baby up 20-30 minutes after every feed to give his stomach time to digest, and giving Ranitidine to help calm stomach acid as well. We weaned off the medicine at 6 months, and I stopped holding him upright after every feed by 7 months. We’re all good now, at 8 months old.
The Whole Story
I recorded my son’s first weird breathing episode when he was two months old. It was after a long, dream feed in the middle of the night, and I was holding him up cuddling afterwards when the gasping started.
A few weeks after the first incident, he started the gaspy breathing after a fairly similar pattern — after a feed and while sleeping — but now during the day and laying down. I often let him fall asleep nursing, and held him stay horizontally in my arms to keep sleeping.
He was a normal weight at birth (7 lbs 8 oz), but quickly gained and GAINED until he was in the 90th percentile. Our pediatrician wasn’t worried and commented that perhaps my breastmilk had a lot of fat in it.
Every breathing episode occurred during (or at least started) sleeping.
Note these episodes of gasping did not happen after a period of crying. I have heard kids have spasm-y breathing after crying. I’ve even heard this same baby (now older) have sort of gaspy, spasms while breathing after a good hard cry. The issue I am writing about happened when he was still a newborn until about six months old, and never after he had been crying. This is a different issue than post-crying gasping/hiccups.
Gasping Breathing Epidsodes – First Diagnosis
When he hit two months old, the episodes became more frequent. Every week, then a couple times a week, then once per day.
He also had some really big/loud swallows during and after episodes randomly, which in retrospect was probably him swallowing milk coming back up, but I didn’t count it as a symptom or clue at the time.
What really concerned me was when his gaspy breathing continued after he woke himself up.
Video of continued issues after waking up:
There were a couple times he would wake up and not breath for some time (5-7 seconds I estimate), and then continue with gasps. He would also look scared and have piercing cries — weird cries that were different than any other cry I’d heard from him. I called his pediatrician pretty quickly when this happened, and they had me come in that night.
I went to the appointment armed with video evidence. The baby didn’t even leave his car seat for this visit. I showed the video to the pediatirician, explained when it was happening (while he slept, after eating typically), and the doctor immediately said it was tracheomalacia. Basically it meant his airway was collapsing and making a sound as air tried to go through. (Definitely not panicking after hearing that, nope…)
His advice? “Tilt his chin up.” That’s it. Tilt his chin up when this is happening to straighten up the airway.
This, as you may have guessed, did not work. As soon as you try move a sleeping baby’s head, they move it back. They thrash around because you touched them. They’re already uncomfortable because of their gaspy breathing and trying to simply tilt a head back and have it stay in that position was impossible.
I called the pediatritican back the next day and reported he’d had another episode, and simply said the head tilting didn’t work.
Pulmonologist and Detailed Tracking
I got a referral and an appointment with a pulmonologist – a lung/breathing expert.
Between the pediatrician visit and the pulmonologist appointment, I kept extremely detailed notes of the episodes. I was already tracking nursing (total minutes, breaks between switching sides, etc.) and sleeping down to the minute. Thankfully my tracking app also allowed me to add notes to any entry and add my own categories. So I added a category for “Breathing Episode” and referred back to nursing/sleeping records to create the whole story whenever an episode occurred. My notes captured if he was upright or laying down when the episode started, how long he’d been asleep, how long since the end of his last nurse, how long he had nursed the time before, etc. I put everything into a chart to see if I could find any patterns, and gave a copy to the pulmonologist to help a diagnosis.
Here’s what it looked like:
After watching the video the pulmonologist agreed it was tracheomalacia, but said “Now we have to figure out why.” Aha! So it wasn’t a random physical defect. We just needed to get at the root issue.
His determination was milk coming back up out of the stomach, but not so far to make it out the mouth. Once the milk reached the lungs (I’m probably not giving an entirely accurate medical description here…), the lungs would react with a spasm to stop the milk from aspirating (or entering the lungs).
Being asleep and being so young were the combo triggering the breathing reaction. A baby’s airway is apparently soft cartilage (or some similar stuff), which gets stiffer as they get older. And as everything relaxes while sleeping. So it seems that combination and milk coming up lead to the breathing spasms.
The pulmonologist suggested that we address the “too much milk” issue by reducing feeding time and holding the baby upright following feedings. He also prescribed Ranitidine. We filled the prescription, but waited a week until we had another appointment with his pediatrician.
In retrospect I would have also liked to visit a gastroenterologist, since this issue seemed to be stemming from the stomach.
The Solution: Nursing Protocol and Medicine
We ended up with a two-part solution to address two different (but related) symtpoms.
- Since he was such a huge baby and clearly gaining plenty of weight, I began cutting him off of nursing so he didn’t overly full. I also made sure he stayed upright for 20-30 minutes after feeding. Yep. Every time. Even in the middle of the night. (To stay awake while holding him, I watched every season of The Great British Baking Show, only during the night, in his first few months of life.)
- We started him on Ranitidine to help the pain as food was coming out of his stomach.
From what I understand, the medicine does *not* address the breathing issue (so why did the pulmonologist prescribe it originally to deal with the breathing?? I don’t know). The medicine is only to neutralize the stomach acid so it doesn’t hurt coming up. It doesn’t actually stop it from coming up. So reducing the feeding time and holding him up helped stop milk from coming back up and triggering the breathing episodes, and the medicine stopped it from hurting when it did.
The pulmonologist was also very reassuring regarding the severity of this issue. He said (almost with a shrug), “he’s still breathing. He’s getting air.” It sounded horrible and definitely wasn’t normal, but no airway was blocked. He explained this wasn’t a situation where his airway would collapse or he would just stop breathing from his particular issue. Which I think was my biggest fear deep down, that somehow the baby would be overwhelmed by this at night when I wasn’t watching him. I was so thankful to have answers, a plan, and a diagnosis that was manageable.
Side Note: Worries about Ranitidine
I had a fair amount of hand-wringing about the medicine because I had read medicines for gastrointestinal issues that change the stomach acid have been linked to higher rates of allergies in kids who take them. I was very apprehensive about giving a baby medicine for a theoretically short-term problem that would end up causing him life-long issues with allergies. Our pediatrician suggested he begin the medicine since it seemed like he was truly in pain, based on his sharp and sudden cries that accompanied/followed a breathing episode. (Stomach contents coming up >acid coming up > liquid reaching the lungs > lungs reacting to prevent aspiration.)
It was something we discussed together as parents after leaving the pediatrician, and we decided to alleviate his pain (happening daily) and take the possible allergy risk. To note, at the time of this writing the baby is 8 months old and hasn’t had any issues with peanuts or eggs.
On the Other Side – Everything is Ok!
At around 8 months I declared the “all clear” and we haven’t had any issues. He’s now a happy baby, nurses as long as he wants to again (typically doesn’t go over 15 minutes total even when dream feeding), and I put him down to sleep immediately after feeding him at night.
Feel free to share your own experiences or ask questions in the comments. I’m always happy to share our own experiences and give encouragement in seeking answers.
As another reminder, please talk to your pediatrician as your first point of contact for any medical questions. This post is not meant to give any medical advice or diagnose/treat any medical issue.
