When Do Babies Start Breathing Through Their Mouths? A Comprehensive Guide for Parents

Newborns are naturally nose breathers, especially right after birth. Breathing through the nose is normal for babies, particularly during the first few months of life. This helps them breathe easily while feeding and sleeping. However, many parents start to wonder when babies start breathing through their mouth, particularly if they spot it during sleep or feeding. It can be a short-term response to something simple, or it might signal a problem that needs attention. Knowing when this happens and what triggers it can help parents respond with more confidence.

The Natural Preference for Nasal Breathing in Newborns

Newborns have a respiratory pathway that is different from an older baby’s respiratory pathway. Newborns are designed so they can breathe comfortably while feeding. Newborns primarily breathe through their noses, except when crying. Nasal breathing helps prevent aspiration of milk while feeding. In fact, young babies - until around age 3 to 4 months - haven’t yet developed the reflex to breathe through their mouths, unless they’re crying. Researchers explain that mouth breathing during sleep may develop in response to some type of blockage in the upper airway, like the nose or throat.

Transition to Mouth Breathing: When and Why

In the early weeks, babies rely mostly on their nose to breathe. Around 3 to 6 months of age, many babies begin to breathe through their mouth occasionally-especially when their nose is blocked. Once babies are developmentally able to breathe through their mouths AND their noses, they will seamlessly alternate between the two.

Common Causes of Mouth Breathing

Baby mouth breathing usually happens if there is a blockage or obstruction of airflow through the nostrils. A stuffy nose is not always associated with an illness but is often a normal and expected finding in newborn nose breathers. If your baby is breathing through their mouth during a cold or after crying a lot, it’s usually due to stuffy nasal passages. Once the congestion clears, they often go back to nose breathing. However there are some situations where babies almost exclusively breathe through their mouths. Mouth breathing is often a completely natural response if your child is crying or has a stuffy nose. But if a child relies solely on mouth breathing, there may be other factors at play.

Potential causes of mouth breathing include the following:

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Mucus: Your baby may be breathing through their mouth out of necessity if their nose is stuffy or blocked with mucus. They may have recently had a cold or might be allergic to something in their environment. Babies can’t easily clear mucus on their own, so they may compensate with mouth breathing.
Illnesses: A common cold or flu can leave your child with a stuffy or blocked nose. When their tiny nasal passages are overwhelmed, mouth breathing becomes more necessity, than choice. In some instances the nasal congestion can be caused by respiratory infections.
Allergies: Allergens like dust, pet dander, or pollen can cause nasal swelling. Undiagnosed allergies can create breathing difficulties for your child, causing them to breathe through the mouth.
Sleep apnea: Mouth breathing is also a sign of sleep apnea, which basically means that your baby’s upper airway is obstructed in some way. With babies and children, this is usually due to enlarged tonsils or adenoids.
Anatomical Challenges: Sometimes, the reason behind mouth breathing can be structural, like a deviated septum. If your little one’s nasal passages are blocked, they might switch to mouth breathing as a backup option. One of the most common anatomical problems that lead to mouth breathing is a significantly deviated septum, typically caused by birth trauma. This means that the cartilage and bone separating your baby's nostrils from one another are in abnormal positions. The result is breathing difficulties that cause your child to breathe through their mouth instead.
Habit: And some babies may just get in the habit of breathing through their noses after sickness or for some other reason.

Identifying Mouth Breathing in Babies

Mouth breathing in babies and young children can be easy to miss at first, especially if it only happens during sleep or illness. It's not unusual for babies to mouth-breathe from time to time, particularly if they've got a cold. But if it's persistent, then it's likely worth taking notice. If you’re worried that your baby may be mouth breathing there are a few signs to look out for, beyond the more obvious mouth breathing while awake or asleep.

Here are some key signs to watch for:

Noisy Breathing or Snoring While Sleeping: Snoring, noisy breathing, or gasping while sleeping may indicate that your baby is a mouth breather. If your child snores while sleeping, it's not because snoring is normal.
Dry Mouth or Chapped Lips: Breathing through the mouth can dry out the tongue and lips.
Feeding Difficulties: Babies who mouth-breathe can have difficulty nursing or bottle-feeding. Babies who cannot breathe easily through the nose have trouble nursing or bottle-feeding.
Facial Changes Through Time: In babies and older toddlers, habitual mouth breathing may lead to a shift in jaw position, a receding face shape, or an underdeveloped nasal bridge. Ideally, your child's jaw should be U-shaped. This structure allows space for teeth to grow and align properly.

If you notice one or more of these signs consistently, it’s worth discussing with your pediatrician or an ENT specialist.

Potential Complications of Chronic Mouth Breathing

Occasional mouth breathing during a cold isn’t usually harmful. But when it becomes a long-term habit, especially in babies and young children, it can lead to several issues. Chronic long-term mouth breathing has been linked to some concerning health issues in children like behavioural issues, dental abnormalities, and slower growth. Regardless of when it happens, mouth breathing is a risk for young and developing brains.

These complications may affect sleep, feeding, development, and overall health:

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Poor Sleep Quality: Mouth breathing can lead to snoring, nighttime awakenings, and light sleep. Babies and kids who breathe through their mouths during sleep often don’t sleep as deeply as those who breathe through their noses.
Feeding Difficulty: Babies who cannot breathe easily through the nose have trouble nursing or bottle-feeding.
Speech and Oral Development Problems: Chronic mouth breathing also has implications on the posture of the tongue and the jaw.
Facial Structural Changes: Early childhood mouth breathing can lead to the face becoming longer and the upper jaw becoming narrower. Ideally, your child’s jaw should be U-shaped and wide. However, it’s now a common occurrence for jaws to be smaller, leading to overcrowding of the teeth and crooked smiles. They also lead to slack-mouth overbites, and bites that seem to be out of position. The result is V-shaped jaws that cause a high and narrow palate and lead to obstructed nasal passages.
Dry Mouth and Risk of Infection: Mouth breathing dries out the oral tissues and can diminish saliva. When your child breathes through their mouth, fewer toxins are filtered, which can inhibit circulation. This affects the transfer of oxygen throughout the body. Without saliva, bacteria grows in your child’s mouth, teeth are ‘eaten’ (tooth decay), and tooth enamel is eroded (demineralisation).
Orthodontic problems: Mouth breathing can cause poor jaw development, leading to teeth crowding.
General health problems: Mouth breathing can contribute to problems like high blood pressure, sleep disorders, and allergies.

There’s actually a link between mouth breathing and symptoms typically associated with attention deficit hyperactivity disorder (ADHD). In fact, some kids diagnosed with ADHD may instead be dealing with issues from the sleep deprivation resulting from - that’s right - mouth breathing. The signs of both disorders are similar.

Addressing Mouth Breathing: Solutions and Treatments

If mouth breathing continues beyond a short illness, it’s important to check for underlying causes. Treating mouth breathing starts with finding out what’s causing it. In many cases, it’s something simple like a stuffy nose. But if it becomes a long-term habit, treatment may involve more than just clearing congestion. The goal is to help your baby return to comfortable, natural nasal breathing.

Home Remedies and Preventative Measures

Saline Nasal Sprays: If the mouth breathing is due to a cold or stuffy nose, use a saline spray or drops to loosen mucus. Follow with a soft nasal aspirator to gently clear the baby’s nose. A good option is the Momcozy 2-in-1 Spray & Suction Electric Nasal Aspirator, which first softens mucus with a fine mist spray, then clears it with hospital-grade suction-all in one quiet, easy-to-clean device. One of the easiest ways to do this is lubricating the nasal passages with saline spray and suctioning the mucus with a nasal aspirator or removing mucus with a nose picker.
Allergy Management: Allergens like dust, pet dander, or pollen can cause nasal swelling. Use a HEPA air purifier, wash bedding in hot water weekly, and avoid strong fragrances or smoke near the baby.
Humidifiers: Adding moisture to the air can help stuffy noses. A cool mist humidifier is most appropriate for babies and young children to avoid burn risk. If you don’t have a humidifier, you might consider sitting with your baby in the bathroom while you run a hot shower to create steam.
Hydration: Make sure your baby is drinking plenty of breast milk or formula to avoid dehydration and keep the mucus flowing.
Elevate Head: Keeping your baby’s head slightly elevated during sleep may help them breathe more easily through their nose.

Professional Medical Interventions

ENT Referral: If mouth breathing continues after illness or allergy triggers are ruled out, ask your pediatrician for an ENT referral. Conditions like enlarged adenoids or a deviated septum may need to be evaluated. Medications, like Flonase or Rhinocort, may help with ongoing allergies or in more mild cases of sleep apnea. In other cases, your doctor may recommend surgery to remove the tonsils and/or adenoids or correct other issues, like a deviated septum, that are causing breathing problems.
Speech Therapy: If you notice mouth breathing alongside trouble feeding, delayed speech, or unclear sounds, ask your doctor whether a speech-language pathologist or feeding specialist is needed.
Addressing Sleep Apnea: Treatment options for sleep apnea include things like positive airway pressure therapy with CPAP and BPAP machines. These devices work by blowing air slowly through a mask that your child wears to sleep. The air helps to keep your little one’s airway stay open. As your child gets older, there are also certain mouthpieces and other oral devices that may or may not help. Rest assured that needing these kinds of interventions for children is rare.
Airway Assessment: An airway assessment is the best way to determine the cause of mouth breathing.

Additional Factors Influencing Mouth Breathing

Stopping Breastfeeding Early: Babies are at risk of mouth breathing if they stop breastfeeding before they are three months old. Even breastfeeding once a day can help your baby reduce the risk of regularly breathing through their mouth. Breastfeeding promotes nose breathing and makes the child’s mouth and tongue muscles engage. The pressure on the child’s palate also enhances bone growth of the jaw, causing it to widen. This leads to a more open airway.
Tongue-Tie: If your child’s tongue frenulum is tight, they’ll have trouble latching and breastfeeding properly. In the long-term, this can also lead to problems with eating, swallowing, and speech in some cases. A tongue-tie also prevents orofacial development, which can potentially lead to partial airway blockage at night.
Thumb-Sucking and Pacifiers: The pressure your baby causes on the palate when sucking their thumb or pacifiers forces the jaw to stay narrow.
Enlarged Tonsils: Inflamed and swollen tonsils can partly block the airways. This will cause your child to breathe through the mouth when sleeping.

Monitoring and Prevention

Track Breath Patterns: Staying in tune with your baby’s natural breathing rhythms can help parents detect changes or irregularities in their baby’s breathing pattern. Whether you’re a first-time parent or an experienced one, tracking your baby’s breathing motion with Nanit is one easy way to notice patterns and help you identify any change that may warrant monitoring or communication with your pediatrician. An ideal time to monitor breathing motion patterns is while your baby sleeps. The Nanit Breathing Band monitors your baby’s breathing motion pattern during nap times and at night when paired with the Nanit Pro Baby Monitor. The camera App reports the time your baby fell asleep, their breaths per minute, the room temperature, and more. If breathing motion is no longer detected, you’ll receive real-time notifications right to your smartphone as well as an alarm sound from the camera itself.
Safe Sleeping Habits: Always place babies on their backs to sleep on a firm mattress. While you must avoid pillows and loose bedding, you can buy special items designed for safe sleep, like a wearable blanket or sleep sack, and always keep their sleeping area smoke-free.
Myospots: As parents, one of our greatest responsibilities is guiding our children towards developing healthy habits. Myospots are small, flavored pads, designed to stick to the roof of your mouth. They naturally guide your tongue to rest in the correct position, against the roof of your mouth.

When to Seek Professional Advice

Occasional mouth breathing isn’t a big concern, but if it becomes constant-even when your child seems well-it’s best to seek medical advice. And if you catch your little one breathing through their mouth somewhat regularly, it’s a good idea to talk to your pediatrician.

Please remember, if at any point you are concerned that your baby might be struggling to breathe, it's critical to consult a healthcare professional immediately. Signs of breathing difficulties in your little one may include a blue tint to their skin, a faster breathing rate, or their chest moving unusually while breathing.

Protective Reflexes and Safe Sleeping

Yes, most babies will naturally wake up or shift position if they’re having trouble breathing during sleep. Infants are born with protective reflexes for the continuation of breathing. If their nostril is obstructed or they're not getting sufficient air, they will move, cry, or make an effort to open the airway. But in some unusual circumstances-particularly in infants who are sick or under particular sleeping conditions-those reflexes might not respond fast enough. That's why it's so crucial to practice safe sleep habits.

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