Periodic Breathing in Newborns: Normal Pauses vs When to Call
Periodic breathing in newborns is a normal pattern: a short pause in breathing, usually 5 to 10 seconds, then a burst of quick breaths, then steady breathing until the cycle repeats. The AAP says skin colour does not change during these pauses. It usually happens in sleep, is most common around 2 to 4 weeks, and fades by about six months. Call 911 if a pause lasts longer than 10 seconds, your baby’s lips or skin turn blue, grey or pale, or you cannot wake them. If anything about the breathing worries you, call your pediatrician.
I make my living in this industry, and I am not a clinician. Breathing is not a sleep-coaching topic, so this post sticks to what the medical pages say, plus how to stop a 2am scare from rewriting your baby’s sleep.
What periodic breathing looks like
The AAP’s HealthyChildren page on newborn sleep phases places it in active (REM) sleep. Breathing “may stop for 5 to 10 seconds—a condition called normal periodic breathing of infancy—then start again with a burst of rapid breathing at the rate of 50 to 60 breaths a minute for 10 to 15 seconds”, followed by regular breathing until the cycle repeats. The baby’s “skin color does not change with the pauses”, and “there is no cause for concern (in contrast with apnea).” Babies generally outgrow it by about the middle of the first year.
Cleveland Clinic’s periodic breathing page adds that the cycle can run “three or more times in a row”, is “most likely to happen when your baby is 2 to 4 weeks old”, and is “normal up to 6 months of age”, in premature and full-term babies alike. So the shape to recognise is pause, burst, calm, repeat, with colour unchanged throughout.
The 10-second line, and why sources differ
The sources agree on the normal pause and differ slightly on when to act:
- Normal pause: 5 to 10 seconds (AAP, Cleveland Clinic), or “up to 10 seconds” in a patient handout published by ECU Health.
- Apnea: breathing that stops for 20 seconds or longer. Cleveland Clinic says a shorter pause also counts if it comes with a slow heart rate or low blood oxygen.
- When to act: Cleveland Clinic says to call 911 if a baby stops breathing for longer than 10 seconds. ECU Health says to call the doctor right away for pauses over 10 seconds, or ones that are longer or more frequent than usual.
Twenty seconds defines apnea; it is not a threshold to wait for at home. Some pages, Betteroo’s active-sleep guide among them, name 20 seconds as the point to call a pediatrician. I would use the more cautious 10-second line.
When to call 911, and when to call the pediatrician
A summary of the pages linked here, not a substitute for them or for your judgement:
| What you see | What the sources say to do |
|---|---|
| Pause of a few seconds, burst of fast breaths, then calm. Colour unchanged, baby feeding and waking normally | Usually periodic breathing. Ask about it at the next check-up if you want reassurance |
| Breathing stops for longer than 10 seconds | Call 911 (Cleveland Clinic) |
| Lips, tongue or skin turn blue, grey, pale or blotchy | Call 911 (999 in the UK) |
| You cannot wake your baby | Call 911 |
| Working hard to breathe: grunting, flaring nostrils, sucking in the chest or tummy | Call 911 (NHS, Nationwide Children’s) |
| Pauses longer or more frequent than usual, fever of 100.4°F (38°C) or more, sleeping more than usual or missing feeds | Call the doctor right away (ECU Health) |
| Periodic breathing still happening after about six months | Tell your pediatrician (Cleveland Clinic) |
On colour: Cleveland Clinic says lighter-skinned babies may turn blue, while darker-skinned babies may look grey, yellow-grey or white. The NHS page on when to get urgent help for children under 5 says that on black or brown skin the change may be easier to see on the palms or the soles of the feet.
That NHS page lists “pausing when breathing, or their breathing is irregular” among signs of serious illness, in a child who is unwell. A well baby who feeds and wakes normally, with pauses that fit the pattern above, is a different picture from a baby with a fever who is unusually sleepy. Context is half the assessment.
Cleveland Clinic’s bottom line: “If you’re ever in any doubt, pick up the phone and call for help.” And ECU Health warns never to shake a baby to try to restart breathing.
The one exception to my “pause before you go in” rule
On this site I tell parents to give active-sleep noise a few minutes before going in; my post on why babies cry in their sleep explains why. That advice is about crying and grunting. It has never applied to breathing. If the breathing looks wrong, go in now.
How a scary night changes sleep
In consults, the pattern I see after a breathing scare is understandable and slow to undo: the baby moves into the adult bed so someone can watch, every grunt gets a pickup, and weeks later the baby only falls asleep on a person. Some of that carries risk of its own:
- Watch from a safe space. The ECU Health handout says to put babies on their backs on a firm, flat surface without an incline, not to share a bed, and to keep the crib in your room, recommended for at least six months. Room sharing gives you the closeness without the bed.
- Mind the head and neck. The same handout says to keep a lying baby’s head and neck straight, because bending too far forward or back can limit breathing.
- Split the night between adults so one person is rested.
- If a frightening pause has passed, call your pediatrician that day. The Merck Manual says that after an alarming episode a doctor asks what you saw: breathing, colour, muscle tone and how long it lasted. It also recommends caregivers learn infant CPR, which is worth doing whether or not anything ever happens.
Once your pediatrician has reassured you, work back toward your usual routines. If days and nights are still upside down, Betteroo’s guide to newborns who mix up day and night covers the gentle cues that fit this age. It is about rhythm only. Neither it nor any app watches breathing.
What about a monitor?
The AAP’s safe sleep guide says not to use home cardiorespiratory monitors as a way to reduce the risk of SIDS, and that there is no evidence consumer heart-rate and pulse-oximetry devices decrease SIDS risk. My post on smart sock baby monitors covers what they can and cannot tell you. Whether your baby needs medical monitoring is a pediatrician decision, especially for a premature baby, where apnea of prematurity is a separate diagnosis. My post on preemie sleep and adjusted age covers that side.
What I’d tell a client
What you saw is very likely the normal pattern, and it usually fades by six months. Learn the 10-second line and the colour signs, and call 911 without hesitating if you ever see them. Book an infant CPR class. Then let your pediatrician, not a gadget or a sleep plan, tell you everything is fine.
FAQ: periodic breathing in newborns
Is it normal for a newborn to stop breathing for a few seconds?
Within limits, yes. The AAP describes pauses of 5 to 10 seconds in active sleep, followed by fast breathing and no colour change, as normal periodic breathing of infancy.
How long can a newborn pause breathing before it is a problem?
Cleveland Clinic says to call 911 if a baby stops breathing for longer than 10 seconds. Apnea is defined as 20 seconds or more, but do not wait that long to act.
When does periodic breathing stop?
Usually by about six months. Cleveland Clinic says it is most common at 2 to 4 weeks; tell your pediatrician if it continues past six months.
Is periodic breathing the same as sleep apnea?
No. Periodic breathing is an expected pattern of short pauses. Apnea is a medical diagnosis with longer pauses, or shorter ones with a slow heart rate or low oxygen. Only a doctor can tell them apart.
