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Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Tachypnoea in neonates is an abnormal respiratory rate at rest above 60 breaths per minute. It is important to observe the baby's breathing (as part of the initial assessment of the baby's condition after birth and thereafter) when he or she is at rest and when active. The midwife should always start by observing skin colour and then carry out a respiratory inspection, taking into account whether the baby is making either an extra effort or insufficient effort to breathe.

Increased work of breathing

  • Tachypnoea is an abnormal respiratory rate at rest above 60 breaths per minute.
  • Note any inspiratory pulling in of the chest wall above and below the sternum or between the ribs (retraction).
  • If nasal flaring is also present, this may indicate that there has been a delay in the lung fluid clearance or that a more serious respiratory problem is developing.
  • Grunting, heard either with a stethoscope or audibly, is an abnormal expiratory sound. The grunting baby forcibly exhales against a closed glottis in order to prevent the alveoli from collapsing.

These infants may require help with their breathing, either by intubation or continuous positive airway pressure (CPAP) ventilation.


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