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#1 of 41 Old 01-19-2008, 05:18 PM - Thread Starter
 
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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!

Happy Mommy to one amazing girl (6y) and one sweet boy (2y), and wife to DH since 7/03 : :
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#2 of 41 Old 01-19-2008, 06:15 PM
 
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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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#3 of 41 Old 01-19-2008, 07:30 PM
 
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Same as Thalia, no advice here, but I couldn't read without posting.

Leafwood, the stress of being a parent...

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#4 of 41 Old 01-19-2008, 09:01 PM - Thread Starter
 
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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.

Happy Mommy to one amazing girl (6y) and one sweet boy (2y), and wife to DH since 7/03 : :
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#5 of 41 Old 01-19-2008, 09:29 PM
 
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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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#6 of 41 Old 01-19-2008, 09:43 PM - Thread Starter
 
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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.

Happy Mommy to one amazing girl (6y) and one sweet boy (2y), and wife to DH since 7/03 : :
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#7 of 41 Old 01-19-2008, 11:22 PM
 
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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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#8 of 41 Old 01-20-2008, 01:15 AM
 
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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.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#9 of 41 Old 01-20-2008, 01:28 PM - Thread Starter
 
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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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#10 of 41 Old 01-20-2008, 02:57 PM
 
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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.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#11 of 41 Old 01-20-2008, 03:11 PM
 
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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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#12 of 41 Old 01-20-2008, 05:25 PM - Thread Starter
 
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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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#13 of 41 Old 01-20-2008, 06:05 PM - Thread Starter
 
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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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#14 of 41 Old 01-21-2008, 10:47 PM
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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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#15 of 41 Old 01-21-2008, 11:03 PM
 
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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.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#16 of 41 Old 01-21-2008, 11:21 PM
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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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#17 of 41 Old 01-25-2008, 04:47 PM
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Well, we had our appointment and his heart is fine. EKG and echo normal
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#18 of 41 Old 01-25-2008, 05:25 PM
 
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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.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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#19 of 41 Old 01-25-2008, 05:33 PM
 
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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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#20 of 41 Old 01-25-2008, 05:36 PM
 
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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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#21 of 41 Old 01-26-2008, 02:27 PM
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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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#22 of 41 Old 01-26-2008, 05:58 PM - Thread Starter
 
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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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#23 of 41 Old 01-26-2008, 08:27 PM
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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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#24 of 41 Old 01-28-2008, 02:44 PM - Thread Starter
 
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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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#25 of 41 Old 01-28-2008, 02:59 PM
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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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#26 of 41 Old 01-29-2008, 11:42 AM - Thread Starter
 
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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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#27 of 41 Old 01-29-2008, 12:00 PM
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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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#28 of 41 Old 01-29-2008, 07:44 PM - Thread Starter
 
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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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#29 of 41 Old 01-30-2008, 02:11 PM
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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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#30 of 41 Old 02-04-2008, 05:33 PM - Thread Starter
 
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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?

Happy Mommy to one amazing girl (6y) and one sweet boy (2y), and wife to DH since 7/03 : :
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