Conclusions All grunting infants should be carefully observed, but because nearly all otherwise healthy term or near-term infants will stop grunting and have a benign course, other interventions can be postponed for 1 or 2 hours to give the newborn a chance to stop grunting or show other signs of respiratory illness.
In , Silverman and Andersen 1 included grunting as part of their 5-part "retraction score," with 0 indicating no grunting; 1, "expiratory grunt heard with stethoscope only"; and 2, "expiratory grunt heard with naked ear. The authors had observed that grunting in these first hours appeared to be relatively common in term and near-term newborns and that many such newborns did not progress to significant respiratory illness or distress. To characterize the frequency and significance of grunting, we designed a study with the following objectives: 1 to determine the frequency and duration of grunting in term and near-term infants admitted to a well-baby nursery; 2 to determine the peripartum characteristics associated with grunting respirations; and 3 to compare the short-term outcomes of grunting newborns with those of newborns without grunting.
We hypothesized that grunting would be relatively common, but that most newborns who demonstrated grunting without other signs of disease would have a good outcome. The nursery provides initial care for all newborns with a gestational age of 34 weeks or more unless complications are anticipated.
In , newborns were admitted to the well-baby nursery. No infants were excluded. The period was chosen to accommodate the availability of one of us G. The standard postpartum procedure at the University of Utah Health Science Center is as follows: After birth and contact with the mother in the delivery or birthing room, the newborn is observed for a 4-hour "transition" period in the nursery before rooming-in with the mother. Vital signs and other relevant observations are recorded in a flow sheet by a nurse assigned for this purpose.
This nursing care flow sheet for the first 4 hours of life contains a column for the nurse to indicate whether grunting is present.
These nursing records were used as the primary data source for this study. In addition to the presence or absence of grunting, the following information was extracted from the complete medical records of all mothers and infants: birth weight; gestational age; mode of delivery; the presence of maternal fever, prolonged rupture of the membranes, or sustained fetal tachycardia; group B streptococcal culture results; use of intrapartum antibiotics; evidence of meconium at delivery; and the presence of a nuchal cord.
One- and 5-minute Apgar scores, the presence of infant tachypnea, and the type of resuscitation, if any, were also noted. Short-term outcomes included transfer to a neonatal intensive care unit NICU , length of stay, and discharge diagnoses. This sample of infants served as the primary data set for comparison. Data for the grunting and for the initial nongrunting infants were recorded in minute time blocks for the first 4 hours. In addition to grunting, maximum respiratory rate, oxygen saturation, need for supplemental oxygen, laboratory studies performed capillary blood gas, complete blood cell count, blood glucose level, or hematocrit , and the initiation of antibiotic treatment were recorded.
P values greater than. Grunting respirations beginning at some time during the first 4 hours of life were recorded for 81 The duration of grunting is shown in Figure 1. The onset of grunting occurred during the first of the 8 time blocks for all but 3 of the infants, 1 who began grunting at the end of the second minute period about 1 hour of age and 2 in whom grunting was first noted at 2 hours of life.
Five infants had grunting that lasted 90 minutes. Four of these 5 had begun grunting during the 0- to minute period. The fifth began grunting at 1 hour of age and continued into the sixth minute interval. One infant who began grunting during the first 30 minutes of life continued for the next minutes before stopping.
Six infants had grunting that lasted 3 hours or more; 5 of these began in the first 30 minutes of life, while the sixth began at about 2 hours of age. Maternal characteristics evaluated for possible association with grunting respirations in the newborn are shown in Table 1. Infant characteristics examined for differences between grunters and nongrunters are shown in Table 2.
Only the use of bag and mask ventilation during initial resuscitation was significantly associated with grunting respirations. Table 3 displays differences in treatment and outcomes of the 2 groups of infants. More laboratory tests were ordered for grunting infants than for nongrunting ones.
Chest radiographs, complete blood cell counts, and blood cultures were all more likely to be ordered for grunting infants. Of the 11 chest x-ray films obtained in the grunting cohort, 4 were read as normal, 3 were read as showing transient tachypnea of the newborn, 2 had abnormal cardiac shadows, 1 had a small effusion, and 1 was read as showing prematurity vs pneumonia.
Of the 10 chest x-ray films obtained in the nongrunting cohort, 8 were read as normal, 1 as showing transient tachypnea of the newborn vs atelectasis, and 1 as showing consolidation. White blood cell counts between the grunting and nongrunting cohorts did not differ. Three blood cultures in the study were positive, 2 from the grunting cohort.
All were considered to be contaminants 2 Staphyloccocus epidermidis and 1 Propionibacterium acnes. Three of the 81 grunting infants were transferred to the NICU.
One, an infant of 38 weeks' gestation who had grunting respirations for 1 hour, continued to evidence respiratory distress after grunting ceased and was transferred to the NICU for presumed meconium aspiration. Another infant of 38 weeks' gestation grunted for 2 hours and stopped but, because of a continued oxygen requirement, was transferred to the NICU for respiratory distress and possible sepsis. The third infant transferred to the NICU was an infant of 39 weeks' gestation who grunted continuously for the first 4 hours of life and had persistent tachypnea with an increasing oxygen requirement.
This could make them more willing to try new things…. Homemade baby food recipes offer a host of benefits the jarred stuff doesn't have. Here are five recipes anyone…. And the community is stronger than ever before…. Health Conditions Discover Plan Connect. Medically reviewed by Karen Gill, M. Causes Treatments When to seek help Takeaway Is it normal? The cause of newborn grunting. The remedies. When to be concerned. Other signs of respiratory problems include: blue tongue or skin weight loss fever lethargy nasal flaring pauses in breathing.
The takeaway. And treat grunting with every breath as a medical emergency. Parenthood Baby 06 Months. Read this next. Gripe Water vs. Single Dad Goals vs. Single Mom Goals The expectations we place on single dads are so much lower than those we place on single moms. The Best Mom Blogs of Motherhood is wonderful. So if baby isn't showing any of these signs, speak with your doc.
Giving birth is a tough job, plain and simple. But remember, it's not just you doing all the work down there. Baby's working overtime to get down that birth canal.
And after that journey, it's no wonder he came out all purple and swollen-looking. Since baby's little head is soft and malleable in the beginning, squeaking his way past your pelvic bone can definitely cause some flattening to occur.
If it doesn't happen during delivery, baby could also get some flat spots later on from lying on his back too much. If you notice this, try holding baby in your arms more, or as Dr.
Levine suggests, increase tummy time when baby's awake, and alternate where you place his toys, so he doesn't favor any one side. When to worry: If you've tried everything and baby's head still seems flat in some places, talk to your doc.
He may need to wear a temporary helmet to correct the shape of his head. Helmets are most affective if worn as early as four to six months, though, so don't wait too long to speak up if you feel like something's wrong. There's no delicate way to say this. If you've just given birth to a newborn boy, you may notice his little man parts are significantly larger than you'd probably expect. Specifically, the testes. So what's up? Baby can be affected by hormone exposure in your belly just before birth.
Or, there could be extra fluid build-up in the sac around his testicles. But don't worry, he'll flush it out with his pee in a few days. Same goes for your baby girl, who may have swollen labia for a few days after delivery.
Either way, the puffiness should go down with a little time. Speaking of, here's a fun fact for you: Baby will shed so much fluid in the first few days of life that they'll actually drop around 10 percent of their original body weight. When to worry: If the swelling doesn't go down within a few days after delivery, you should probably get it looked at, particularly if you've got a baby boy on your hands.
Boys can develop a condition called hydrocele, which can actually take up to a year to correct on its own. Spotting even the tiniest trace of blood in baby's diaper is enough to freak out any new parent; but the truth is, it's not always cause for alarm. There are tons of legit reasons why it may be happening, all of which are temporary. If you've just had a baby girl, she may be experiencing some extra side effects from being exposed to your hormones in utero. Have no worries, a "mini-period" is actually pretty common among infant girls going through a little estrogen withdrawal in the days following delivery.
The hormones will even out soon enough. Other potential causes: a particularly rough BM may have caused a little scratch or cut on the way out, but the bleeding should fade fast. Was your baby recently circumcised? The blood may be from his healing wound. Make sure to apply Vaseline whenever necessary to ease his pain and be extra liberal about moisturizing it. Same goes if baby has a nasty case of diaper rash. When to worry: Though it's probably totally normal, we're going to give you an out on this one.
For the sake of your own sanity, just go ahead and call your doc to be sure. Rare is the new parent who can see blood in their newborn's diaper and actually manage to get some sleep that night. What the deal is: In the beginning, a slight case of wonk-eye in baby is to be expected. She's still trying to sort out all her newfound abilities, one being her sense of sight, and it will take some time for her to gain a little muscle control and hone her focusing techniques.
But believe it or not, sometimes even when baby's eyes may look like they're crossed, they may not be.
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