Q: My baby has been making a gasping sound for over 2 weeks. Is it just reflux or something more serious?

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Question:

My 4-month-old son has been making a gasping, gurgling sound for over two weeks. He had a mild cold a few weeks ago which resolved with medication, but this breathing sound started about two weeks ago.

It sounds like post-nasal drip, sometimes with a 'gurgling' or 'rattling' noise when he breathes. He's started feeding less and takes frequent breaks, seeming uncomfortable. He sneezes often, but has no fever, cough, or runny nose. Our pediatrician suggested it might be reflux and prescribed medication. The sound has slightly improved, but it's still there.

He was hospitalized for adenovirus gastroenteritis last month and recently had his third round of vaccinations. I'm worried if we should just continue the reflux medication or if we need to see a specialist at a larger hospital for a chest X-ray and a full respiratory evaluation. What should I do?

Answer:

It must be very worrying that your 4-month-old has had this breathing sound for over two weeks.

[Summary of the Current Situation]

• A sound like post-nasal drip + gurgling/rattling noise for over 2 weeks

• Decreased milk intake + taking breaks during feeding

• Frequent sneezing, but no fever, cough, or runny nose

• Slight improvement after taking reflux medication

• Recent history of hospitalization for adenovirus gastroenteritis, 3rd round of vaccinations completed

[Urgent Warning Signs]

If you observe any of the following, go to the emergency room immediately today:

• Lips or fingernails turning blue

• The area below the ribs or above the neck sinking in with each breath

• Breathing sounds are high-pitched like wheezing or stridor (a harsh vibrating noise)

• Getting out of breath or sweating frequently during feeding

• More lethargic or less responsive than usual

• Respiratory rate is over 60 breaths per minute (standard for infants under 4 months)

[What You Can Do at Home Now]

1. Use saline nasal spray and an aspirator to clear your baby's nose (before feeding and before sleep).

2. Maintain indoor humidity at 40-60% and remove irritants like tobacco smoke and scented products.

3. Hold your baby upright for 30 minutes after feeding and slightly elevate his upper body during sleep (to alleviate reflux).

4. Keep a log of feeding amounts, breathing patterns, and changes in the sound (note when it gets worse).

[When to Consider a Specialist Visit]

First, contact your current pediatrician and discuss the following:

• "His feeding volume is still decreasing and he takes frequent breaks. Is the reflux medication alone sufficient?"

• "Since the breathing sound has persisted for over two weeks, is a chest X-ray or a consultation with an ENT (Ear, Nose, and Throat) specialist necessary?"

• "What is the possibility of a structural issue like laryngomalacia or tracheomalacia?"

If your current pediatrician cannot perform a further evaluation, or if the symptoms worsen, ask for a referral to a hospital with a pediatric pulmonologist or ENT specialist.

[For Your Reference]

• Infants under 4 months are obligate nose breathers, so even a small amount of secretion can cause loud noises.

• The fact that the reflux medication helped suggests that reflux may be a contributing factor. However, symptoms lasting over two weeks combined with decreased feeding warrants further evaluation.

For now, start with the home care tips above and call your current pediatrician tomorrow to discuss your concerns. Please let us know immediately if any new symptoms appear (fever, bluish skin, severe fussiness).

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us