No, chest retractions in newborns usually signal labored breathing and warrant prompt medical evaluation.
Seeing the skin around a baby’s ribs or neck pull inward with each breath can stop any parent in their tracks. Those inward pulls are called retractions. They point to extra work of breathing. Some patterns in newborn breathing are harmless, like short pauses and quick catch-up breaths. Retractions aren’t in that bucket when they persist or appear with other warning signs.
What Retractions Look Like In A New Baby
Retractions show up as visible dips in the soft areas of the chest or neck during inhalation. You may notice the skin sucking in between the ribs, just above the breastbone, or at the base of the neck. The movement repeats with each breath and often pairs with fast breathing, flaring nostrils, grunting, or color change around the lips.
Quick Visual Map Of Retraction Areas
Use this table to match what you see with common locations. It’s a guide for triage at home, not a diagnosis.
| Location | What You Might See | Suggested Urgency |
|---|---|---|
| Intercostal (Between Ribs) | Skin sinks in between rib spaces with each breath | Call your pediatrician now; ER if paired with fast rate or color change |
| Subcostal (Below Ribs) | Indent along the belly just under the rib line | Call your pediatrician now; urgent care if worsening |
| Suprasternal (Above Breastbone) | Dip at the top of the chest near the throat | ER now, especially with noisy breathing or poor feeding |
| Supraclavicular (Above Collarbones) | Hollows at the base of the neck pull in on inhale | ER now; often signals heavy work of breathing |
Normal Newborn Breathing Patterns You May See
Babies breathe faster than adults. Short pauses under 10 seconds can appear, followed by a few quick breaths. This pattern is called periodic breathing and often fades by a few months of age. During these brief pauses the baby stays comfortable and pink. There’s no pulling in at the ribs or neck.
How To Tell The Difference At Home
- Count breaths for one minute. Up to the high 50s per minute can appear in sleep or after crying. Steady counts above 60 at rest deserve a call.
- Watch the chest and neck. Dips that repeat with each inhale point to extra effort.
- Listen for sounds. Grunting on exhale, a tight wheeze, or a harsh gasp are red flags.
- Check color and alertness. Blue or gray around the lips, poor feeding, or unusual sleepiness raise urgency.
For a plain-English checklist of danger signs, see the AAP breathing trouble guidance. It lists retractions as a reason to seek care right away.
Are Chest Retractions Normal For New Babies: What Clinicians Watch
In clinical settings, steady or deep retractions are treated as a sign of increased work of breathing. Teams look at where the skin pulls in, how fast the baby is breathing, oxygen level, and any added sounds. The pattern, location, and triggers help narrow causes and guide next steps.
Common Causes Tied To Retractions In The First Weeks
This list isn’t exhaustive, but it covers frequent culprits seen in newborn care.
- Transient fluid in the lungs after birth can make breathing harder in the first day.
- Respiratory distress syndrome in preterm babies stems from low surfactant and stiff lungs.
- Bronchiolitis from viral infections can narrow lower airways and raise effort.
- Pneumonia can add fever, poor feeding, or lethargy along with chest findings.
- Airway malacia can cause noisy breathing and effort, especially when agitated or feeding.
- Meconium aspiration at or near birth can lead to fast breathing and retractions.
For a neutral reference on retractions as a sign of breathing problems, see MedlinePlus intercostal retractions.
When To Seek Immediate Care
Use a low threshold with young infants. Breathing issues can turn quickly. Go to the ER now if any of the following show up:
- Steady retractions in the neck, ribs, or under the ribs
- Grunting, loud wheeze, or a harsh noise on inhale
- Breaths above 60 per minute at rest
- Blue or gray tone around lips or tongue
- Feeding poorly or not waking to feed
Step-By-Step Home Triage Before You Leave
If retractions are present and you’re heading for care, these steps keep things orderly while you go:
- Keep baby upright. A semi-upright hold can ease effort better than flat on the back.
- Avoid over-bundling. Cool, comfy layers reduce heat and breathing load.
- Pause feeding attempts. If breathing is hard, skip feeds until a clinician checks.
- Note the timeline. When it started, feeding amounts, wet diapers, any fever, and contacts with sick relatives.
What Clinicians May Do In The ER Or Nursery
Expect a focused assessment first. Teams watch the pattern of breathing, look for retractions, and measure oxygen. A chest X-ray or viral testing may follow, based on the exam. Preterm babies or those with clear distress may receive oxygen, positive pressure, or surfactant if needed. Term babies with mild signs may only need monitoring and supportive care.
What “Mild” Versus “Severe” Looks Like
Severity scales look at work of breathing, rate, oxygen level, and signs like head bobbing or nasal flaring. The deeper and higher on the chest the retractions, the greater the concern. Continuous dips above the collarbones or breastbone suggest a heavier load than faint belly pulls after crying.
Why Retractions Happen In Tiny Chests
Newborn ribs are flexible, and the chest wall is soft. When airways narrow or lungs are stiff, the diaphragm pulls down but the bendable chest gives way, creating those visible dips. That’s the body trying to move more air with each breath. It’s a mechanical sign, not a diagnosis on its own.
Normal Pauses Versus Work Of Breathing: A Side-By-Side View
Use this comparison to sense the difference between periodic breathing and signs that need attention.
| Situation | What You See | Action |
|---|---|---|
| Periodic Breathing During Sleep | Brief pause under 10 seconds; baby stays pink; no chest dipping | Watch calmly; mention at next routine visit |
| Post-Crying Catch-Up | Fast breaths for a short spell; settles quickly; no repeated retractions | Monitor at home |
| Persistent Retractions At Rest | Neck or rib dips each breath; fast rate; noise or color change | Seek care now; ER if severe |
Practical Tips While You Monitor At Home
- Watch the whole baby, not just the number. A single count can swing with crying, feeding, or sleep.
- Film a short clip in good light. A clear video helps your clinician see the pattern you’re describing.
- Time symptoms. A two-minute log with breath counts and cues like grunting or flaring speeds triage.
Feeding And Hydration During A Breathing Scare
Hard breathing and full feeds don’t mix. Milk can pool if a baby has to pause for air. With mild sniffles and no retractions, shorter, more frequent feeds can help. If extra work of breathing is clear, pause feeds and head in. In the hospital, teams may adjust feeding plans until breathing is steady again.
What Recovery Looks Like
Once the cause eases, retractions fade. The chest moves more evenly, the rate settles, and feeding improves. Sleep stretches lengthen. Care teams may share home care steps like saline and suction for stuffy noses, hand hygiene for contacts, and smoke-free air.
How This Guide Was Built
This article draws on pediatric sources that describe retractions as a sign of increased work of breathing, reinforce normal patterns like periodic breathing, and outline urgent signs that call for care. Two good starting points for parents are the AAP breathing trouble guidance and MedlinePlus intercostal retractions. Clinical manuals and hospital pages echo the same message: repeated retractions in young infants deserve prompt medical attention.
Bottom Line For Parents
Brief pauses with quick catch-up breaths can be normal in young infants. Repeated dips at the neck or ribs are not normal at rest. If you see retractions, fast rate, noisy breathing, blue tone, or poor feeding, get hands-on care without delay. When in doubt, err on the side of a check.