Newborn Nursery at LPCH

Grunting

photo and audio recording by Janelle Aby, MD                                 interactive image provided by http://expand2web.com

Grunting is a sign of respiratory distress in a newborn. Grunting frequently occurs in combination with nasal flaring and intercostal or subcostal retractions as all three are associated with increased work of breathing. The distinctive sound of grunting is produced when the glottis is closed during expiration. This increases end-expiratory pressure in the lungs (similiar to increasing the PEEP setting on a ventilator) and helps to improve oxygenation to the patient. Although occasional grunt can at times be heard in healthy infants during normal crying, grunting with each breath is never normal. The patient above is crying through part of the exam, but the grunting quality of the sound can still be easily appreciated, especially at the end of expiration.

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