Baby Hold Breath and Bears Down while Sleeping

[bragabit]

My 12 month old baby has been having some very strange breathing while sleeping.  When he is first asleep he starts holding his breath (about 6 seconds) and then when he exhales he bears down sometimes even grunting.  He does this for almost an hour after he first falls asleep.  It seems like he labors very hard to breath during this time.  I watched him very closely last night and I did not see his nostrils flaring and his coloring was good.   Once he gets into a deep sleep he is fine.  I have taken him to the pediatrician.  The ordered an xray and it came back clear, his tonsils were normal sized, he is not congested but the doctor said that he could 'hear' some upper respitory stuff.  When this first started my son would wake from these spells choking and gasping.  He hasn't been waking from them lately.  It scares us to death.  When he was first born he was an ABO baby and was in the NICU.  He would desaturate when he slept.  I worry that he has inhaled something....but that would show on an xray right?  What could this be?  Who could we follow up with...maybe an ENT?  We have excellent insurance (90%) coverage and I am willing to try anything.

Another thought that I had, is that he always drinks about 8oz of formula right before going to sleep if that is relevent at all.

[bragabit]

Just wanted to respond and update. I am going to time line it:

Wednesday:  Called friends who are Pediatric Parmedics to come over during a spell and they call an ambulance due to the poor coloring of my baby.  ER sends us home because once baby is awake coloring is good.  Baby has a temp of 100 at ER.  Er doc thinks its reflux.  He also thinks the baby has an ear infection and prescribed Z-pac.  Baby has fine rash on back but no one pays any attention to it.

Thursday:  Still having episodes and in the middle of the night I video tape an episode.  Baby does not come out of last episode very well.  Pale, lethargic and cold to touch.  We rush to ER and the doc watches the tape and orders xrays and bloodwork.  ER doc finds viral pneunomia and thinks its reflux and tells us to take the tape to the pediatrician first thing in the morning.

Friday:  Take baby to Pediatrician he watches the tape and is instantly very concerned, he pulls up the xrays and bloodwork online and says he agrees with the ER doc.  He starts us on Prevacid and Avix.  Sends us home with sleep apnea moniter.

Saturday: My husband gets sick with the most horrible sore throat.  He doesn't show any other symptoms and when sleeping starts making the SAME sounds as the baby.  At the same time my baby has only had one minor episode.  I take baby off the prevacid and axid.

He hasn't had an episode in 48 hours.  In retrospect I can see now that he must have what my husband has.  My husband has spent this last week taking turns cradling him.  In retrospect my baby was clearing his throat a lot during the day and eating a lot less than normal.  My husband is on day 3 of being sick and the sore throat is so bad that no OTC medicine even touches the pain.  I honestly think my baby had strep.  We all missed it.  I was worried he had aspirated a toy/peanut.  Doctors thought it was reflux (he has never had reflux!).  I really would like to post the video here.  If I can figure how to get it off my digital camera I will do it because I think it could help someone else.  Now I guess...I am assuming now, that the z-pack will cure strep right?  My husband is going to the doctor tomorrow for his sore throat.  I guess he can ask then.

I appreciate everyones responses and look forward to any comments on the most recent developments.

[Quixotic1]

Hi, I was a pediatrician in my former life (pre-MS) and what you are describing sounds like "grunting."  This is often a sign of respiratory distress.  I would suggest that you video your son doing this, with sound, and play it for your son's pediatrician.   That is a great way to show a doctor exactly what you are seeing.  

But, I agree with Dr. Park that growing babies have the perfect way to show us that all is well.  If they continue to grow and develop well, then things are usually fine.

It's possible that your son is drinking too much right before you put him down and the full tummy is pushing against his efforts to breathe a bit.  An hour later his tummy has emptied and he can sleep more comfortably.  You might try feeding him 45 minutes to an hour before putting him down and see if this changes the "grunting."

Just some thoughts.

Quix

[Steven Y Park, MD]

As long as he's improving over time, I wouldn't worry. If he's developing normally, that's what's important. Young infants have various breathing issues that resolve slowly over time. As long as your pediatrician says he's OK, then just be patient. Worse case scenario, if his condition doesn't improve you should take him to a pediatric ENT.

[bragabit]

Still waiting, if anyone has any help on this!