Why does a baby wheeze and grunt while sleeping on their back, and what should be done?

Generally, if an infant experiences labored breathing or makes snoring or grunting sounds while lying flat, it may be related to factors such as incomplete laryngeal cartilage development, improper sleeping posture, upper respiratory tract infection, adenoid hypertrophy, or bronchopneumonia. Timely general treatment or medication should be administered based on the underlying cause. If any discomfort occurs, prompt medical attention is recommended. A detailed analysis is as follows:

1. Incomplete Laryngeal Cartilage Development

Due to underdeveloped laryngeal cartilage in infancy, temporary airway narrowing may occur, leading to the aforementioned discomfort when lying flat. However, as the infant grows, symptoms typically improve with cartilage development, and usually no special treatment is required.

2. Improper Sleeping Posture

When infants lie flat, improper posture or incorrect neck flexion angle may compress the airway, causing labored breathing and even snoring sounds. The sleeping posture should be adjusted promptly, and a pillow of moderate height should be used to reduce airway compression.

3. Upper Respiratory Tract Infection

Upper respiratory tract infections are primarily caused by viral or bacterial infections. When the condition is severe, congestion and edema of mucous membranes in the nasal passages and pharynx may block the airway, causing the aforementioned symptoms. These may be accompanied by nasal congestion, runny nose, and other symptoms. It is recommended to follow medical advice and promptly administer medications such as ribavirin granules, ambroxol hydrochloride oral solution, and pediatric paracetamol-triprolidine granules.

4. Adenoid Hypertrophy

The adenoids are located at the top of the nasopharynx. When local inflammation causes adenoid enlargement, it may block the posterior nasal openings and the pharyngeal openings of the eustachian tubes, leading to breathing difficulties and labored breathing. Symptoms often include snoring and mouth breathing. Treatment may include nasal sprays such as mometasone furoate nasal spray, cefixime granules, and budesonide nasal spray, as directed by a physician.

5. Bronchopneumonia

Bronchopneumonia may be caused by bacterial or viral infections. When the lungs are repeatedly irritated by inflammation, increased secretions may block the airway when lying flat, causing breathing difficulties, coarse breathing sounds, and labored breathing. Symptoms may also include fever, coughing, and sputum production. It is recommended to follow medical guidance and use medications such as amoxicillin-clavulanate potassium granules, pediatric expectorant antitussive granules, and salbutamol aerosol for treatment.

It is advised to monitor the infant's condition regularly. If the symptoms do not affect mental status or sleep quality, specific treatment may not be necessary. However, if symptoms persist for a prolonged period, further attention and targeted treatment are required.