Generally, it is enough to count the ups and downs of the sick child's chest and abdomen. Breathing and pulse are best measured at the same time, because there is a certain proportional relationship between them, that is, the time of a breath is about three to four pulse beats. When measuring breathing, you should not only count the times per minute, but also observe whether the breathing speed is consistent, whether the depth is uniform, and whether there is breathing difficulty. Normal breathing is even, balanced and regular, and the inhalation time is slightly longer than the exhalation time. The speed and depth of neonatal breathing may be uneven, which is not necessarily a sign of disease.
Children of different ages breathe differently, and the younger they are, the more they breathe. The normal children's breathing times per minute are: neonatal journal 35-45 times, one year old 30-40 times, 2-4 years old 25-30 times, 5- 10 year old 20-25 times,1-65438+. Breathing is accelerated when you have a high fever, lung disease, heart disease and anemia; Some drugs poisoning, brain disease, breathing will slow down. Breathing too fast or too slow, different shades and different speeds are all aggravating manifestations.
Three methods to judge whether the newborn has abnormal breathing.
1, the frequency of breathing
The mother can observe the number of breaths per minute of the baby. The breathing frequency of a normal baby is about 35-45 breaths per minute within 1 month after birth, and it often fluctuates within 2 weeks after birth, and even increases to more than 80 breaths per minute in a short time, which is a normal phenomenon of newborns. As the baby grows up, the breathing frequency will gradually decrease, and the breathing frequency of infants will drop to 20-30 beats/minute. If the baby's breathing frequency exceeds the following times, it is faster.
2. For babies within two months, the breathing frequency is ≥60 times/minute; For babies aged 2- 12 months, the breathing frequency is ≥50 beats/min; 1-5-year-old baby, breathing frequency ≥40 beats/min.
Of course, if the baby's breathing is slow or even apnea, it is also abnormal breathing.
3. The rhythm and depth of breathing
In a quiet state, the baby breathes steadily and regularly, with a certain depth. If you see the baby breathing irregularly, breathing difficultly, nose flapping, panting and breathing, or even seeing the lower part of the baby's chest wall sag when inhaling, it is abnormal breathing.
The sound of breathing
Under normal circumstances, the baby breathes without sound. When the baby has abnormal breathing, the sound of breathing will become loud and noisy, and even wheezing can be heard.
Abnormal breathing of a baby is different from snoring.
1, the baby sleeps on his back (face up) and snores easily. Because his face is up, the base of his tongue falls backwards due to gravity, and half of it blocks the breathing passage at his throat. Changing sleeping position is not morbid, but mothers should pay attention. In the long run, it will have an impact on the baby's health. The key to eliminating the problem is to try to change the baby's posture. Usually the baby sleeps, but also develop the habit of sleeping on the right side.
2, the baby's breathing channels, such as nostrils, nasal cavity, oropharynx are relatively narrow, and it is easy to block with a little secretion or mucosal swelling. Therefore, babies within half a year old often have nasal sounds, stuffy noses or miscellaneous sputum sounds in their throats.
3, when the baby's cold causes throat swelling, tonsil inflammation, and increased secretions, it is more likely to cause airflow and snoring.
4. Prevention and treatment of children's snoring.
Children snoring should be found and treated as soon as possible, while paying attention to a balanced diet and keeping a regular schedule. If the child is found to be snoring or breathing poorly during sleep, parents should carefully observe the child's condition and take him to the hospital for special examination if necessary. If necessary, surgical treatment, such as tonsillectomy, gland curettage, maxillary and mandibular plastic surgery, nasal surgery, etc., are all effective measures to treat children's respiratory disorders.
To prevent children from snoring, we should also pay attention to maintaining a balanced nutrition, preventing obesity due to overnutrition, ensuring regular work and rest, and reducing strenuous activities at night. At the same time, we should pay attention to strengthening children's physique, reducing the probability of suffering from various acute and chronic respiratory infectious diseases, and avoiding upper respiratory tract obstruction caused by inflammation.
How to judge whether the baby is breathing abnormally?
Method 1: Count the breathing times of 1 min.
The mother can count the baby's breathing times within 1 minute to determine whether the baby's breathing is fast or slow. You can count the baby's breathing times when he is quiet or asleep, because if the baby is afraid, coughing, crying or angry, it will affect his breathing, so you can't count the baby's breathing times correctly. The methods of counting breath are:
1, observe the ups and downs of the baby's abdomen or chest. Take a breath with your baby's abdomen or chest. Under normal circumstances, even if the baby is wearing clothes, you can clearly see the ups and downs of his abdomen or chest. If you can't see clearly, parents can lift the baby's clothes before observing, or they can gently put a hand on the baby's abdomen or chest to feel the baby's ups and downs.
2. Observe the back and forth movement of cotton fiber. Squeeze tiny cotton fibers from the cotton on the cotton swab with a cotton swab, put the cotton swab at the baby's nostril, and count the back and forth movement of cotton fibers. One back and forth is a breath.
In addition to the above two methods, if there is a stethoscope at home, the mother can also put the stethoscope directly on the baby's chest, listen to the breathing and count the number of breaths.
Method 2: Observe the chest depression.
Observe the lower part of the baby's chest wall (lower ribs). If the baby's chest wall sinks when inhaling, it means that the baby has a chest depression. If the baby has a chest depression, it will always exist. If you only see a chest depression when your baby is crying or eating, you can't think that your baby has a chest depression. Pay attention to the following points when observing chest depression:
Uncover the baby's clothes and observe.
The baby's body must be straight. If the baby does not straighten his body, it is difficult to see the movement of the lower part of the chest wall.
Method 3: Listen to your throat and gasp.
Laryngeal wheezing occurs when the baby's throat, trachea or epiglottis becomes edema. Babies who can hear their throats wheezing when they are quiet are seriously ill and should be sent to the hospital immediately; If the baby only hears the throat wheezing when crying, it means that the baby's condition is not very serious. When listening to the baby's throat breathing, the mother should pay attention to the following points:
Inhale and listen. The wheezing the baby hears when he exhales is not laryngeal wheezing.
Keep your ears close to your baby's mouth, because it's hard to hear the wheezing in your throat.
When the baby's nasal cavity is blocked, you should clean it before listening, because when the baby's nasal cavity is blocked, you will hear the sound of poor ventilation, which may cover up the wheezing of the throat.
When observing the baby's breathing, the mother should also pay attention to whether the baby's breathing rhythm is regular, whether the breathing depth is consistent, whether the breathing activities on both sides of the chest are symmetrical, whether there is abnormal smell when breathing, whether there is irritability, tangy nose and blue lips.
Danger of abnormal breathing to infants
When the baby has abnormal breathing, the most terrible thing is to cause respiratory failure or inability to breathe, and then lack of oxygen, leading to organ damage and even death. This danger may develop into respiratory failure with the deterioration of the disease, or suddenly become respiratory obstruction (such as sputum obstruction), or apnea, unable to breathe. If brain damage is caused in the process of hypoxia, the future nerve development may also be affected to varying degrees.
Three phenomena of neonatal respiratory abnormality
1, dyspnea.
The early manifestations of neonatal dyspnea are increased breathing times, shallow and fast breathing, and then flapping nose. In severe cases, three signs of depression can be seen (that is, supraclavicular fossa, suprasternal fossa and intercostal fossa are depressed at the same time). At the same time, the child's face and mouth are blue, and in severe cases, there are moaning-like breathing, word-like breathing or apnea, all of which indicate that the condition is getting worse.
The newborn's condition changes rapidly, so it is necessary to find and treat it early. If the condition worsens, you should be sent to the hospital for emergency treatment in time.
2. Apnea.
Normal newborns sometimes have irregular breathing, and sometimes the interval between two breaths is 5~ 10 second, but it is not accompanied by changes in heart rate and complexion, which is called periodic breathing. Apnea means that breathing stops for 10~ 15 seconds or more, while the heart rate slows down to less than 100 times per minute, resulting in cyanosis and decreased muscle tension. Apnea can be divided into primary and secondary.
Cause: Premature infants are prone to primary apnea. In fact, the gestational age is small, the function of respiratory center is poor and the incidence of apnea is high. The younger the gestational age, the more likely it is to happen. Apnea is related to sleep and often occurs during rapid eye movement sleep; In addition, the functions of temperature receptors in the face and trunk of newborns are opposite, and apnea is easy to occur when the face temperature is higher than the trunk temperature. When the central nervous system fails to control the movement of laryngeal muscles, it is easy to cause obstruction and obstructive apnea when inhaling. A few infants' apnea is the manifestation of convulsion. Premature infants may also have apnea due to hypocalcemia, hypoglycemia, intracranial hemorrhage, intracranial infection, sepsis, etc. There are many reasons for secondary apnea, such as intracranial hemorrhage, patent ductus arteriosus, pneumonia, asphyxia, coronary heart disease, hypoglycemia, hypocalcemia, sepsis and so on.
What to do: When finding the above situation, you should inhale high-concentration oxygen in time, give artificial respiration, try to avoid actions that can induce apnea, gently insert the stomach tube, and pay attention to the amount of milk, the speed and posture of feeding, so as to avoid apnea caused by reflux of gastric juice. For frequent apnea, mask oxygen supply and mechanical assisted breathing can be used. At the same time, we should treat the primary disease and correct hypoglycemia and hypocalcemia.
3, suffocation.
After the delivery of the fetus, if there is no breathing or only irregular, intermittent and shallow breathing for 65438 0 minutes, it can be judged as neonatal asphyxia.
Cause: The main causes of neonatal asphyxia are respiratory center inhibition, injury or airway obstruction. Severe intrauterine hypoxia or too long time can damage the respiratory center; Or the fetal head is compressed for too long, and the brain tissue is congested, edematous and intracranial pressure is increased; Or intracranial hemorrhage involves oxygen supply to the life center of the medulla oblongata; Or improper application of general anesthesia or sedative drugs before delivery, so that the fetal respiratory center is blocked; Or take a deep breath during childbirth and inhale amniotic fluid, mucus and meconium into the respiratory tract. All these can promote the primary apnea or respiratory insufficiency of newborns after birth.
What to do: keep the respiratory tract unobstructed, and do artificial respiration and oxygen supply. After treatment, the condition of most children can be improved rapidly and their breathing becomes normal, but their breathing and general condition should still be carefully observed and they should keep warm, so that the future development of most children will not be affected. However, if the degree of suffocation is serious, the child will still be pale after the rescue, unable to breathe normally, and his limbs will be slack. The survival rate of such children is low, and survivors often have different degrees of motor or mental retardation.
In order to prevent neonatal asphyxia, pregnant women should receive regular prenatal examination, find abnormalities in time and give corresponding treatment. Abnormal fetal sound suggests that the fetus is hypoxic, so the parturient should be given oxygen in time and choose the appropriate delivery mode. Maternal mood should be stable during labor, because apnea after hyperventilation can reduce fetal oxygen partial pressure to a dangerous level. In addition, pregnant women must strictly control the quality and dosage when using anesthetics, analgesics and sedatives.
How to prevent abnormal breathing?
1, careful observation is the best policy.
Breathing is the basic ability to sustain life. Parents don't need to make a fuss, but they must definitely grasp the principle of careful observation. Especially for newborns, it is necessary for many parents to understand the abnormal situation, find the abnormality and deal with it in time.
2. Prevention begins during pregnancy.
During pregnancy, pay attention to proper intake of allergic food to reduce the chance of your baby suffering from asthma. In addition, don't take drugs casually, and be sure to quit smoking.
3. Thinking about the mode of production
Choose to give birth in a hospital that has the ability to deal with neonatal first aid, and give the baby the best protection at the first time. It is the best natural process for the baby to have a ripe melon, but choosing another day for cesarean section may be self-defeating. After the baby is born, the mother should breastfeed as much as possible to provide the baby with a natural source of antibodies to increase the body's resistance and reduce the occurrence of allergic diseases.
Abnormal breathing and sudden infant death
Sudden infant death (Sudden infant death) is a big killer of infants and has always been one of the three major causes of infant death (especially within 1 year). At present, the medical community still can't explain the specific causes of sudden infant death, nor can it know why there is inexplicable apnea. Possible risk factors include premature infants, low birth weight infants, lethargy, smoking by parents, infection and so on.
Therefore, please attach great importance to two main clinical manifestations related to breathing, namely abnormal sleep movement and snoring during sleep. If the baby is breathing intermittently and his hands and feet are moving during sleep, he should be alert in time. In addition, don't let the baby suck the nipple when sleeping, keep the correct sleeping position and tilt the head slightly.