Grunting Baby Syndrome (Causes, Do’s & Don’ts)

Does your newborn make interesting noises? As a Family Support Worker, I am often asked by nervous parents to reassure them their child is healthy. The different noises a newborn can make may leave you wondering if you are correctly interpreting their communication. It will be a long time before your child will be able to articulate their needs. In the meantime, they will use a variety of noises to get your attention. Check out this great article on the variety of sounds you will hear.

In the first few months, especially with your first child, you may hear noises you are not sure how to interpret. There are the fun noises of squeals and cooing, but grunting is a sound that is harder for new parents to interpret. Is your baby in pain or sick? Grunting, by itself, is a normal, healthy expression for your newborn.

How Do I Know if my Baby is Grunting?

This is what grunting usually sounds like, though each infant will have their own expression. Your baby might grunt at night or during the day. They might grunt while awake or asleep. They might grunt for a few minutes or all the time. Each baby is different.

Should I be Concerned?

Grunting noises can be heard from most newborns. Most of the time, it is a completely normal stage of development. The type of grunting that you hear from a newborn is a physiological side effect of maturing muscles and organs.

As a newborn your baby will communicate most life-threatening situations with crying. That is why they cry to get food, warmth, comfort and attention. They will also cry to express pain. Grunting, without crying, in absence of illness or breathing difficulties, is completely normal.

What is GBS (Grunting Baby Syndrome)?

GBS is a term used to describe the developmentally appropriate grunting behavior most newborns display in their first few months. Normal grunting behavior lasts for about five to ten minutes prior to a bowel movement but can also occur during sleep periods. This behavior will begin in the first few days, around time of first bowel movement, and dissipate after a few months.

What Does GBS Have to do With Bowel Movements?

Newborns are not born with the ability to move solid waste through their intestinal tract. This is a complex skill that involves the combination of pushing with their abdominal muscles while simultaneously relaxing their pelvic floor or anus. Newborns have weak abdominal muscles, so when they push, they use their diaphragm, which is a stronger muscle.

It is this pressure on the diaphragm that creates the grunting sound. This can also cause hiccups. It is also normal for their face to turn purple and strain while grunting. After the bowel movement your baby should relax.

It is common for babies to get frustrated with their own lack of progress and you may hear their frustrated cry. Babies do experience some discomfort with bowel movements, as we all do at times, and that make bring some tears as well. This is a natural process for all babies, and they are not be harmed by the process.

Like the video above, you can see the baby is slightly frustrated, but is not crying in pain. It can be hard to watch and listen but be assured baby is not in distress – just working hard.

What Can I Do to Help?

Do’s

With baby on their back, hold their feet, assisting them to bend at the knees, then push towards their chest. Repeat this movement during the time your child is trying to push. This will help them to relax their pelvic muscles and put pressure on their abdominal muscles. Here is a short video to demonstrate.

Rub baby’s tummy or put a warm cloth on their tummy to assist with any discomfort they are having.

Don’ts

Grunting behavior is usually not a symptom of constipation so do not use laxatives (medicinal or natural) without permission from your doctor. This could lead to diarrhea.
Do not use an anal stimulation, such as a thermometer in the anus. This may help with this abdominal movement but does not teach them how to do it on their own.
Baby alarms – there are many baby alarms on the market. You can purchase alarms to tell if baby is breathing properly, has stopped moving, and other physiological symptoms. The best advice is to keep baby in the same room. Your presence is the best protection against any potential issues.

Alarms are advertised to create a sense of peace for parents, but in my experience, it does the opposite. Babies are pretty dysfunctional units when they arrive. It will take months for your baby’s respiratory, homeostasis, and digestive systems to mature. It is common for babies to have abnormal breathing patterns and fluctuations in their body temperature. These alarms can tend to overreact.

Their loud, piercing shrieks and flashing lights have the potential to scare both of you into breathing distress. This is not a recipe for relaxation. Get yourself an audio baby monitor, or even one with video, if you can not be in the same place as your baby and trust the process.

Safe sleep protocols should always be used regardless of the amount of grunting your baby does. Safe sleep should include:

On their back – lay baby flat on their back on a flat surface. It might be convenient to keep them in their car seat, but they will sleep safest in their crib especially for the first few months.
In the same room – whether you are in the kitchen or in bed, have your baby near you. Bed sharing is not recommended; a bassinette or crib is best.
No obstacles in their bed – no stuffed animals, blankets or crib padding in baby’s bed.
Do not overheat – babies are not able to moderate their own temperature. Moms worry about baby getting cold but being too warm can cause issues with breathing. Use the one-layer-up method. If you are comfortable in the room in a t-shirt and jeans; baby is good in a footed sleeper; no need to add a blanket. If you do use a blanket, tuck in the edges and have the top edge stop at baby’s chest.

Are There Other Reasons for Grunting?

Blocked Nasal Passages – this usually occurs when baby has a head cold. If nasal passages are blocked, your baby might grunt with the extra effort of breathing. Best treatments for blocked passages are the use of a nasal aspirator to remove excess mucous. You can also use steam from a shower or humidifier to moisten nasal and throat passages.

Dreams – your baby might make grunting noises in their sleep. This could be in response to a dream your baby is having; this is not uncomfortable for baby.

Tension release – babies experience frustration just like anyone else. They have limited ability to communicate their stress and often use grunting noises to express this tension. Stress can be caused by illness, feeling overtired, being over-stimulated, hunger, pain, or fear. Your child may use grunting until they learn other ways to communicate their frustration. Your best response is to comfort and console. Identify the reason for the frustration and provide a solution.

Constipation is rarely the problem with breastfed babies but can be more common with formula-fed babies. An immature digestive system can cause grunting which sounds like your child is straining. It is common for parents to misinterpret this as constipation. Here is what to look for when deciding if constipation is the problem:

Normal bowel movements: After the first week, with breastfed babies, bowel movements should be yellow and have the consistency of mustard. Breastfed babies may have a bowel movement daily or as infrequently as once or twice a week. For formula-fed babies, after the first week, their stool will be brown and once daily is recommended. Babies vary widely in this, so you do need to learn your own child’s natural rhythms.
Constipation is when your child has great difficulty or is unable to pass stool. Symptoms include small, hard, ball-like stools, irregular bowel movements, decreased appetite, blood in the stool, hard stomach muscles, pain, and crying during a bowel movement. Treatment is best prescribed by a doctor to ensure the correct diagnosis. You can use the tips for GBS above in addition to any treatment prescribed by your doctor.

Can Grunting be a Symptom of Other Health Issues?

Grunting is usually normal. In some instances, grunting can indicate other health issues.

Premature babies might take longer to develop their digestive system. This can lead to grunting and ineffective pushing continuing past the two-month mark. These babies just need time to complete the development that was supposed to happen in utero before they can start on more advanced skills.

Immature Organ Development usually occurs in premature births but can be seen in full-term babies as well. Immaturity of any organ can cause grunting behavior.

Reflux/GER (gastroesophageal reflux) – some babies have trouble with milk backing up into their esophagus after meals. This leads to vomiting, colic behavior, and can include some pain (heartburn). The discomfort can cause grunting behavior. It is usually not serious, and most babies outgrown GER in their first year. You can alleviate the symptoms by:

keeping baby upright after a feed.
elevating their head and upper chest with a small pillow while sleeping.
elevate baby during a feed by keeping their feet lower than their stomach and keeping their head raised.
If formula feeding check to make sure the bottle you are using is not allowing baby to eat too fast. Position baby so that they have to work to get milk rather than gravity feed.
Changing formulas is another option and often quite effective.
Most breastfed babies are not experiencing digestion issues from your milk itself but if you find that changing your diet makes a difference discuss it with your doctor.
Some sites recommend giving your baby smaller portions. I do not recommend this strategy. Feeding on demand is still the best for you and your baby. The only caution is with milk flowing too quickly from a bottle. This can lead to overeating. Limiting food intake is not recommended unless your doctor prescribes.

Is There Ever a Reason to Be Concerned?

There are rare situations when grunting behavior can indicate a medical emergency for your baby. If you notice any of these symptoms, contact your doctor or emergency room immediately. These symptoms are cause for concern whether your baby is grunting or not.

Distress crying in addition to grunting – A baby in pain sounds different from a baby who is frustrated or has a small stomach ache.
Fever, lethargy, or weight loss.
Respiratory distress could be caused by a cold, virus, premature development of lungs or other stress on the body. Grunting after every breath, blue lips, labored breathing, long pauses between breathes, are all signs your baby needs immediate medical attention.

It is normal to be overly concerned about your newborn. You love them so much and you know they are fragile. Remember that most grunting behavior is an indication of a normal, healthy developing baby.