# Infant with rapid breathing.



## leafwood

Not sure if this is best posted here or in H&H, but I'll start here.
Ds was born 2 weeks ago. Perfect unmedicated vaginal delivery. Apgars were 9 and 9. He was diagnosed with IUGR at 35wks gestation, but weighed 6-15 at birth and MW said it was likely an error in ultrasound to begin with. No vax, but he was circumcized. He got down to 6-10, but regained his birthweight by 4 days old. He's BF.

About a week ago I noticed that he was breathing more rapidly than I remember dd. We counted about 80-85 breaths per minute and called the ped last Mon evening. They had us bring him in the next morning. While sleeping she got 56 bpm. We had a chest x-ray which was normal. She said to come back Friday and take him to the ER if he turns blue.







:

I got a second oppinion the next day from a family friend. That doc got 80 bpm, but his blood oxygen levels were great (96-99.9%), temp was normal rectally, heart rate normal, no murmers, and he was still gaining weight. He referred us to a ped cardiologist who did an EKG and echo which were both completely normal. Ds isn't retracting or flaring his nostrils. Both cardiologist and second oppinion dr think it's a varation of normal infant periodic breathing and just represents an immature respiratory system, and that he'll grow out of it. We felt better.

Yesterday back to the original ped. Now she gets 79bpm and is all worried, just when we're feeling better! She does all sorts of blood work and a blood culture. The bloodwork came back completely normal, blood culture will take longer but should be fine also.

Ped is now recommending we consult with a pediatric pulmonologist. Dh had worked at Columbia in NYC and we have some calls in to see someone there (the cardiologist we saw was affiliated there as well).

So, I am just wondering if anyone else has experienced this. Everything else is going perfectly well. No indications of anything wrong. He's nursing like a champ, tons of wet and dirty diapers, sleeping OK. His color is perfect and he does have times when his bpm are in the 40's and 50's, but still has times in the 80's.

Any info or suggestions are much appreciated!
TIA!


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## Thalia

I have no advice but didn't want to read without posting. Normally if everything seems fine, I wouldn't worry. But lung issues are scary to me. That's just me, though. Sorry I can't be of more help!


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## mama_y_sol

Same as Thalia, no advice here, but I couldn't read without posting.








Leafwood, the stress of being a parent...


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## leafwood

Thanks so much ladies. At this point, I'm just trying to enjoy my new little guy and wait to see the pulmonologist next week. Dh's classes start this week (he's a prof) and he's talking to his chair to be able to come to any appointments we may have, so that makes me feel better.


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## MGBoutique

When my now 6 1/2 year old daughter was born, we had a very similar situation. I noticed a few days after she was born that she was breathing very rapidly. (She was maybe 4 days old?). I took her to our ped's office, and at first he wasn't concerned. Then I showed him that her fingernails and toenails were blue and that she was retracting a bit. (Her breath rate was around 90 most of the time.) He immediately got very worried and scared the pants off of my dh and me. He even called us at home every night until she stopped doing it. However, he didn't have us go through tons of tests or anything. He said she sounded perfect, and she was gaining weight, having the right wet/poopy dipes, etc...He had me hold her though-all the time. He told us not to put her down or away from us for a minute if we could help it. It was tough, but since we're so attached anyhow it was just a bit *more* attachment. She slept on my chest every night (I sat up in a recliner with her), she was held during every moment of her life by either her daddy or me, until the rapid breathing went away.

We never did find out why it was happening or if there was a cause, but doctor felt it was just immature breathing system even though she was a term baby. (BTW, she was born in a hospital but with a completely drug-free birth, so it wasn't drugs there that could've caused anything.)

My new little guy also went through a few days of fairly rapid breathing-from 85-90 bpm and we just kept a close eye on him, held him at night, etc...and it's already resolved itself. He is now just past 6 weeks. He never had the blue nails or the retracting chest, though.

I hope this helps you to feel better to know that some babies *do* just breathe fast for no apparent reason and are totally fine later. Hang in there, I hope your little one is completely healthy.


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## leafwood

MGBoutique.....your response really makes me feel better! I haven't been able to find any info on this type of thing happening in a perfectly healthy infant and then just going away (even though that's what the doctors think). Ds is only 2 weeks old, so hopefully within a short time it will resolve.

We are currently co-sleeping and he does spend a bunch of time sleeping on dh's chest at night. He's held a lot during the day unless we're in the car and then I'm constantly checking on him.

It's scary for us, but with everything else going so well it's encouraging. And again, your post really helps me feel better!

Thanks again.


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## wendylady

I have no experience with this, but just wanted to send you some support. It sounds scary, but also that everything's fine. Keep us updated.

Hugs!


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## Jilian

I'm so happy to hear that you've seen a cardi already and the echo, ekg, and chest x-ray looked good. DS2 had fast breathing (up to 90 bpm) and a cough that got worse and worse and ended up having a rare heart defect. But once they did a chest x-ray it showed "cracked glass" lungs and the echo showed congestive heart failure. So if you've already had these tests it is a good sign!

How do you feel? Do you feel that the baby is ok? There is something called a PDA that can sometimes close slowly in the heart and cause rapid breathing. It is a small passageway between right and left heart that all babies have, its a sort of bypass for in utero before the lungs are working. Most close very shortly after birth, but for some babies it can take a few weeks. But the echo should show it and it usually comes with a murmur.

Just keep a close eye on the baby. Watch for retractions and blueness in the fingernails and toenails. Rapid breathing sometimes is ok, if it gets progressively worse then it could be a warning.


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## leafwood

The only thing that showed on the echo was a PFO which is a small opening between the left and right atria that usually closes shortly after birth. The cardio said that about 75% of babies ds's age would still have the opening, and that it is completely benign and has nothing to do with the breathing. The aorta is what he was most concerned about and it is perfect, as was all the general heart function and size. They will see ds at 6m just to make sure the PFO is closed, but they said not to worry. No murmers either, by ear or echo.

My gut tells me he is fine. The rapid breathing isn't becoming more common, and in fact I notice more times when he is breathing slower, especially when resting.

I will hopefully feel even better after seeing a pulminologist this week. I'll keep you posted!


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## Jilian

Quote:


Originally Posted by *leafwood* 
The only thing that showed on the echo was a PFO which is a small opening between the left and right atria that usually closes shortly after birth.

I will hopefully feel even better after seeing a pulminologist this week. I'll keep you posted!

Have they checked the pulmonary veins? Just as a precaution, have the pulminologist take a peek at the pulmonary veins. They are so hard to see because they go behind the heart. DS2 had a defect called Total Anomolous Pulmonary Venous Return or TAPVR for short. It is when the pulmonary veins do not connect at all to the left side of the heart. He also had a PFO. While PFO is completely normal, it is also extremely common in babies with heart defects, it is the lifeline. Once it started to shrink DS went into serious distress and that is why it took 2 weeks for us to find out anything was even wrong.

I don't want to scare you, I just want to share the info and hope that you don't need it. Please keep us updated and feel free to PM me if you want to hear more.


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## monocyte

wow, I could have written this exact post (right Jill?)

We have the exact same story, rapid breathing, xray, echo fine. Ours was a combo of extreme periodic breathing and a slow to close pda. He also did have a murmur, which was undetectable last time we were at the pedi's.

I remember being really scared, even though DS wasn't in distress (no blue, retraction, etc.)

Silly question, but he's not congested in his nose at all? Im sure your pedi or cardio tried it, but we attempted saline up the nose to see if he had any mucus that might have been causing him to breath more if air was being blocked from coming in. Didnt work for us...but, thought I'd throw it out there.

It can't hurt to get worked up.








mama, I've been there.


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## leafwood

Thanks again for the continued replies. As far as the pulmanary veins, I'm pretty sure the cardiologist did a through check b/c he thought he heard a slight murmur in ds's pulmanary artery. I will definately discuss it with the pulmonologist though.

As far as congestion, we haven't tried the saline, but he does not seem congested at all. I will give it a go later though. Can't hurt!


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## leafwood

Just wanted to add that he is tounge-tied, not so his tounge is heart shaped, but just so that he can't extend it all the way out. Both peds said it's not a big deal, but someone else just informed me that a posterior tounge tie can cause rapid breathing! Something I will look into for sure.


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## MCKH

I pretty much could have written your post, except for that my son does have a heart murmur. The pediatrician didn't even catch it at the first or second appt. He says it is super quiet and if he weren't specifically listening for one, he'd have missed it. We have an appt. with the pediatric cardio. on Friday. From where the murmur can be heard, the pediatrician says it is likely either.... narrow pulmonary arteries (which is benign and will be outgrown), PDA or an ASD, which is also usually no big deal. He has never been blue or had retractions and is gaining well and seems happy enough (for a 5-week-old.) Things don't seem to be getting any worse. but really aren't better either. The pediatrician is not worried but I don't see how he can't be when babies just don't breathe this way for 5 weeks.

My son has breathed fast from birth. When he's asleep it's in the 40s-50s (even the 30s when he's really out on his stomach - the breathing seems very dependent on what position he's in, the carseat is the worst) but when awake it can reach into the 80s. If he gets really worked up it can be near 100. It scares the crap out of me, and I've been a fiend on the internet searching for everything and scaring myself to death with the possibilities. I have been pretty much a basket case for 5 weeks.

It's hard because you read online that anything over 60 is a "medical emergency" but then the pediatricians don't seem too worried when we take our kids in. I am such an anxious mom and I am pretty scared, although at this point I just want to know what the deal is. A PDA is not the worst thing in the world, and if that's what it is we need to take care of it.

Good luck at the pulmonologist! Please let us know how it goes. Maybe your baby "just breathes fast" and there really is absolutely nothing wrong. Here's hoping!


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## Jilian

*Leafwood*, My DS2 is slightly tongue tied too! I had no idea it could cause rapid breathing. Aroung 6 mos nursing got better and now he can extend his tongue past his gums a bit.

*MCKH,*







It is scary. I hope your appointment with the pedi cardi goes well. We love our pedi cardi team, they are awesome when it comes to kids. I hope you get some answers soon, please post after your appointment so we know how it went.


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## MCKH

Thanks, Jilian. It is very scary but after 5 weeks I am ready for some answers. It is hard especially since everyone tells me "oh, so and so has a murmur" or "heart murmurs are so common and usually are nothing." They don't understand that that usually isn't the case in an infant. Did they not catch a murmur when your son was born during his first pediatric visits? We had a homebirth but went to the ped at 3 days, 6 days, 2 weeks, 2.5 weeks and 3.5 weeks and, I am not kidding here, it took all 5 appts. before I forced the doctor wait until my kid was quiet and listen for a LONG time. And then he heard it.

I am so glad your son is doing well. He's adorable.


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## MCKH

Well, we had our appointment and his heart is fine. EKG and echo normal


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## Jilian

Quote:


Originally Posted by *MCKH* 
Well, we had our appointment and his heart is fine. EKG and echo normal









I'm so glad it went well. I just saw your last question. DS2 was born at home too. MW did not notice a murmur at birth, at the 2 day check, and the pedi did not notice it when he was 5 days. Unfortunately our beloved pedi was out and we had to take her backup. The HB MW came over when he was 2 weeks old and heard the murmur then. ER staff missed it, but when they finally called in the on-call pedi from the Children's hospital she heard it too.

From what I've heard most babies have a mild murmur at birth and sometimes for a few days- to a week after. It is when the murmur gets louder that is an issue.


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## paranoidprego

its so weird that you posted this today. i have a 5 week old ds who has rapid breathing when awake. last night he kinda scared me because he sounded junky and wheezy. we co-sleep and i found that i have to get up and feed him in the glider during the night because that is the only way i will remember to burp him. he has to be burped and when i feed him in bed, i am so tired that i fall asleep and wake up because he is sputtering or crying because he needs to be burped. he is fine when he is sleeping. he looks fine in every way, maybe very slight retractions under his ribs when he is breathing fast.
i sat next to the phone contemplating calling the pedi. i called two days ago and he said he sounded fine but would see him if i wanted to. after last night i thought i should call, but i still haven't because he is back to his normal self today. still breaths fast while awake. we pay out of pocket for all our visits so i am reluctant to go if he is fine.
i don't hear any murmur (i'm embarrassed to say that i am a NICU and have a stethoscope). but i dealt with sick newborns not older babies.
keep us posted on how your little guy is doing. i'm hoping my little one will grow out of it in the next few weeks.


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## Jilian

Mama, if there are retractions please bring him in to be checked. My son showed no other signs except occasional fast breathing, junky cough, and very minor retractions. Retractions are a big warning sign. It could be nothing, but in your case you might want to look to rule things out. Watch for nostril flaring, that happenes in the later stages breathing distress. DS2 was doing that before his heart surgery.


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## MCKH

Quote:


Originally Posted by *Jilian* 
From what I've heard most babies have a mild murmur at birth and sometimes for a few days- to a week after. It is when the murmur gets louder that is an issue.

Yeah, the DA closes within 72 hours, normally, so there's typically that murmur at birth and it should be gone within a few days. Our murmur is caused by a very slight pulmonic artery stenosis - which is common and normal in newborns. It will be outgrown and is not causing the fast breathing. He had a very tiny PFO, .24 mms, but the doctor said that is absolutely normal and is only a problem when it is 3 mm or more. He was super cool. I can't believe how these guys can see everything on those echos. Now I am not sure what else to pursue as far as the breathing goes... We will have blood work done to check for acidosis this week and then I don't know.


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## leafwood

MCKH-I am so glad that your appointment went well and that you know his heart is fine. What a relief I'm sure!

Ds is still breathing rapidly, but it seems to be getting slightly better. We were back to the ped on Friday. She said that she felt ds was breathing much slower just by looking at him. He went from 7-11lbs last Fri to 8-5lbs this Thurs so she was thrilled with that. The ENT clipped his tongue on Thursday as well and said he felt it had nothing to do with the breathing, but decided on it anyway.

Ped suggested we keep our appointment with the pulmonologist this Thursday just to be safe. It's going to be a trek going into the city with a newborn, but I'd rather get him looked at by the docs at Columbia than wonder later on.

I will update again when we have more news, until then just trying to enjoy my new little guy and fighting the urge to constantly time his breaths


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## MCKH

Quote:


Originally Posted by *leafwood* 

I will update again when we have more news, until then just trying to enjoy my new little guy and fighting the urge to constantly time his breaths









I know EXACTLY what you mean, unfortunately... Please let us know how it goes with the pulmonologist.

How is breastfeeding going for you? My baby is gaining well but sometimes nursing is a challenge with the breathing. He tends to choke on the letdown and have to take pauses to catch his breath. He certainly doesn't "luxuriate" at the breast like some babies do. It's frustrating.


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## leafwood

Quote:


Originally Posted by *MCKH* 
How is breastfeeding going for you? My baby is gaining well but sometimes nursing is a challenge with the breathing. He tends to choke on the letdown and have to take pauses to catch his breath. He certainly doesn't "luxuriate" at the breast like some babies do. It's frustrating.

Ds does the same thing as far as choking when my milk lets down. I never equated this with the breathing b/c dd also had this issue. Since day one with ds I have been block feeding (only offering on side per 2 hour period). An LC suggested it with dd and it was a saving grace. After the initial choke, ds is usually able to relax and can handle any subsequent let down much more efficiently. I feel better about his nursing b/c the cardiologist actually sat with me during a 10 minute feed and said it was typical and that the breathing was not interfering.

I had wanted to ask what the link between the breathing and acidosis is? Did you get that blood work done?


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## MCKH

People with acidosis (low blood ph) breathe rapidly to get rid of excess C02 in the bloodstream. It is the body's attempt to increase blood ph to normal. Acidosis can be caused by a lot of things, including infection, kidney disease, lung disease, metabolic disorders, diabetes, poisoning, etc. Our cardiologist wanted us to look into it. We had blood work done at 1 week of age and all was normal, but we are doing it again today or tomorrow to make sure.


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## leafwood

Thanks MCKH. I just checked the blood work that the ped did on ds two weeks ago and they did not test for Ph, just did a CBC and a blood culture. I think I will ask them to do it at the pulmonologist for peace of mind.


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## MCKH

Ph can only be checked by an arterial sample. If they did a blood chemistry, and her CO2 was normal, then all is fine.


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## leafwood

They did do an arterial sample (from his arm) but the only info on the printout was the general CBC (white/red blood cells, platelets, etc.). I didn't see anything about CO2 and I really wish they would have just done it while they had the chance. Oh well, I'll see what the specialist says on Thursday. Dh just told me that he can come to the appointment as he was able to rearrange 2 of the classes he teaches. I am very thankful that he will be there!

I'll keep you posted. As for now, I think ds is in a growth spurt. He's eating a ton and sleeping for good 2-3 hour stretches at night. Yeah!


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## MCKH

It would be very unusual for them to take an arterial sample unless they were doing blood gasses. So, if you know for sure they did an arterial sample chances are good that's what they were looking for Usually they use a vein for routine bloodwork like a CBC.


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## leafwood

Just wanted to update....ds went to the pulmonologist last Thursday. She said he is perfectly fine (blood O2 levels were 100%) and that she sees this all the time in healthy babies. She said she expects him to outgrow it within a month and gave us her email to keep in touch. We made a plan to do blood gasses, electrolytes and thyroid functiong testing in a month if ds is still breathing fast, but dh and I feel so much better!

It was a great relief to see her examine him and comment on how strong and healthy he is. She said that the babies who have metabolic issues causing rapid breathing look ill, vomit very frequently and have difficulty gaining weight. So I feel much calmer now and more confident that he's just getting used to life on the outside!

How is everyone else doing?


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## Jilian

I'm so happy to hear it went well!!


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## MCKH

That's so good to hear!


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## Banana731

I don't have any of the issues you moms have had to deal with, but I couldn't read this thread and not comment. I am so glad that all your babes are doing well! This was a very informative thread.


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## becoming

Quote:


Originally Posted by *paranoidprego* 
its so weird that you posted this today. i have a 5 week old ds who has rapid breathing when awake. last night he kinda scared me because he sounded junky and wheezy. we co-sleep and i found that i have to get up and feed him in the glider during the night because that is the only way i will remember to burp him. he has to be burped and when i feed him in bed, i am so tired that i fall asleep and wake up because he is sputtering or crying because he needs to be burped. he is fine when he is sleeping. he looks fine in every way, maybe very slight retractions under his ribs when he is breathing fast.
i sat next to the phone contemplating calling the pedi. i called two days ago and he said he sounded fine but would see him if i wanted to. after last night i thought i should call, but i still haven't because he is back to his normal self today. still breaths fast while awake. we pay out of pocket for all our visits so i am reluctant to go if he is fine.
i don't hear any murmur (i'm embarrassed to say that i am a NICU and have a stethoscope). but i dealt with sick newborns not older babies.
keep us posted on how your little guy is doing. i'm hoping my little one will grow out of it in the next few weeks.

Mama, you need to take him in if he's retracting. That's a big warning sign that something isn't working quite right with his lungs or heart, usually the lungs. DS2 has very severe asthma/reactive airway disease/possible cystic fibrosis (we don't have a diagnosis yet), and we have been told to bring him immediately if he begins retracting.


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## Jilian

Quote:


Originally Posted by *becoming* 
Mama, you need to take him in if he's retracting. That's a big warning sign that something isn't working quite right with his lungs or heart, usually the lungs.

I agree, the ER staff FREAKED OUT when DS2 started retracting. That is when they called a med flight. IMO, there is never really a case where retractions are harmless. Please update us when you can!


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## leafwood

Just wanted to check in and see how our little breathers are doing now in March?
Ds is getting better, but still has times when he's fast. We go back to the ped tomorrow for his 2m and I just emailed the pulmonologist with an update to see if she wants to draw blood gas levels.
Otherwise, he is doing really well...cooing, rolling, smiling a ton and trying to stand up every chance he gets! Nursing is going great too so I'm still feeling better.
How is everyone else?


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## Jilian

Can I check in too? My rapid breathing heart baby is doing really well. He is 9 mos old today and it has been 8.5 mos since his heart surgery. He still breathes fast and here there and sweats while nursing still, but continues to do well. I hope all of the other fast breathing babies are doing well!


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## leafwood

Jilian...so glad to hear you are making progress as well!


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## becoming

Glad to hear everyone's good updates!

My Gavin is doing MUCH better. He does not have cystic fibrosis (big relief!), and our doctor thinks now that it's just asthma since all the other tests came back negative. I hate to say this because I don't want to jinx him, but I really believe he's slowly growing out of his problems. He still gets junky/wheezy when he has a cold, but on a normal day, he doesn't have any breathing issues anymore, which is such a huge improvement from where we were 2 months ago.


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## leafwood

Hi mamas...andother update here. Ds was to the pediatric pulmonologist this past Thursday and she released him from her care saying he's officially grown out of the rapid breathing business! It was such a great visit. She had a medical resident trianing with her and it's a huge children's hosp....she told the resident to pay careful attention while examining ds becasue she will rarely see an infant so healthy in the field. I was so relieved to hear that. She counted his resp rate at 50 and was impressed with his weight gain and how well he was holding himself up and rolling over at 3 1/2m.

While we were there I was reflecting on how I felt when we went the first time in late Jan. He's come such a long way! I just wish there were more resources so other parents who have the same experience can get some more info at the start. I guess you just have to wait it out and run the tests and make sure everything is fine before really resting easy.

I hope everyone else is doing well!


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## Jilian

I'm so happy to hear that he's doing well! That must have been such great news to hear! I wish there were more resources too. I wish they talked more about things like this before discharging new babies from the hospitals after birth. I'm thinking of starting a campaign to have a handout distributed to new moms with warning signs of a heart defect - just in case. While I HATE spreading hysteria, I hate even more to hear that 50% of babies with heart defects die within the first year of life and many of the heart defects aren't even diagnosed until after birth.


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## Mr5h

Hi, I just wondered if anyone from this thread is still active here and how things turned out? I have a three month old with rapid breathing (I'm in the uk) - he has had ECG, chest X-ray, echo, blood tests, blood gas. His oxygen sats are always 98-100. He's also had 12 hour monitoring at the hospital. He's a big, healthy, thriving boy. Can anyone advise? Xxx thanks xxx


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## camilaparker

Children with frequent breath problem should be immediately taken to child doctor, it might be some serious problem.


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