Usually, newborns grunt when they learn how to pass stool. However, this grunting can occasionally indicate a health issue, such as trapped mucus, gastroesophageal reflux or irregular breathing.

In this article, we explore the reasons that newborns grunt. We also discuss accompanying symptoms, home remedies, and when to see a doctor.

When newborns grunt, it can sound like they are in pain, but this is not usually true. Most often, it means that they are learning how to pass stool.

In other cases, the grunting can point to an underlying problem, and it is important to be aware of any other symptoms. The presence of these can help to determine whether the grunting is a cause for concern.

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Causes of newborn grunting may include having a bowel movement, irregular breathing patterns, and dreaming.

Newborns tend to grunt as they get used to having bowel movements. Doctors sometimes refer to this as grunting baby syndrome.

To pass stool, an adult often relaxes their pelvic floor and uses the stomach muscles to apply pressure which helps to move the stool through the gut.

At first, a newborn's stomach muscles are not strong enough to do this, so they use the diaphragm muscle to move their bowel. As they exercise the diaphragm, it can put pressure on the voice box, resulting in grunting.

Other causes of newborn grunting include:

  • Irregular breathing patterns. Newborns may grunt as they develop control over their breathing patterns.
  • Trapped mucus. Mucus can collect in a newborn's narrow nasal passages.
  • Dreaming. Grunting during sleep can indicate dreaming or a bowel movement.
  • Gastroesophageal reflux (GER). Also known as acid reflux, this occurs when stomach contents rise into the food pipe. It can cause discomfort, and the baby may grunt.

When a newborn grunts because they are passing stool, they may also:

  • strain for several minutes
  • cry
  • turn red or purple in the face

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A reduced appetite can be a symptom of constipation in a newborn.

Grunting baby syndrome is not the same as constipation. A newborn who grunts usually passes soft stools.

Symptoms of constipation in a newborn can include:

  • small, dry, pellet-like stools
  • fewer than three bowel movements per week
  • reduced appetite
  • a hard stomach
  • crying, discomfort, pain, or irritability before passing stool
  • foul-smelling gas and stools

The following strategies can help:

  • changing formula
  • changing the diet of the adult, if breast-feeding
  • feeding more often, to increase hydration
  • massaging the baby's stomach

A number of home remedies can help with newborn grunting. Depending on the cause, they include:

Learning to pass stools

When a newborn is learning to pass stools, grunting is usually normal and does not require treatment.

The grunting often stops when the newborn learns to relax their pelvic floor and the stomach muscles strengthen. This usually happens at a few months of age.

If the baby seems to have trouble passing stool, rubbing petroleum jelly on their anus can help. However, doing so too often can prevent the baby from learning to pass stool on their own.

Irregular breathing

Irregular breathing patterns are not usually a cause for concern, unless the newborn shows signs of breathing difficulties.

A baby monitor can help a caregiver to check for indications of abnormal breathing when the newborn is asleep. Some people also use movement monitors, which sound an alarm if the baby stops moving for longer than usual.

Trapped mucus

A nasal aspirator can help, if a newborn is grunting because mucus is trapped in their airways.

GER

The following home remedies can help to address GER in newborns:

  • feeding the baby little and often
  • feeding the baby more slowly
  • avoiding bottle nipples with large holes, which can cause too fast a flow
  • adding a little oatmeal to thicken milk or formula, but check with a doctor first
  • burping the baby more often

If these home remedies do not help, the newborn may have a condition called gastroesophageal reflux disease (GERD).

Doctors tend to test for GERD if the newborn's digestive symptoms show no improvement, if they are not gaining weight, or if they have symptoms that can indicate lung problems. Some of these symptoms are listed below.

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It is essential to seek urgent medical attention if the newborn seems distressed, has a fever, or pauses between breaths.

Grunting may indicate a problem if the newborn:

  • seems distressed
  • regularly grunts at the end of a breath
  • has a fever
  • has a blue tinge in the lips or tongue
  • pauses between breaths
  • flares their nostrils
  • draws in their chest as they breath

These symptoms can indicate difficulty breathing. If the newborn has any of these symptoms, seek urgent medical attention.

The doctor will most likely use an X-ray when making a diagnosis. In 2016, researchers reported that chest radiography is essential in determining the cause of respiratory distress in newborns.

Below, we describe other severe issues that can cause newborns to grunt. If a newborn has any of the following symptoms, seek medical attention right away. They may require emergency treatment.

Meningitis

In addition to grunting, symptoms of meningitis in a newborn can include:

  • fever
  • vomiting
  • floppiness of the body
  • skin blotches or a rash
  • an unusual cry

Sepsis

Sepsis is commonly described as blood poisoning. In addition to grunting, symptoms in a newborn can include:

  • fever
  • irritability
  • breathing problems
  • confusion
  • floppiness of the body
  • pauses of more than 10 seconds between breaths
  • reduced urination
  • jaundice

Heart failure

In addition to grunting, symptoms of heart failure in a newborn can include:

  • inability to gain weight
  • shortness of breath
  • falling asleep during feedings or being too tired to feed
  • coughing and lung congestion
  • sweating

Newborns tend to grunt when they are developing the muscle strength needed to pass stool.

The grunting is usually not a cause for concern. However, if it accompanies certain symptoms, the grunting can indicate an underlying condition.

If a newborn is grunting and has any of the more severe symptoms listed above, seek urgent medical care.