Hello
I understand how scary it can be to see your baby grunt, cry, or have chest retractions at night. You have done the right thing by getting her examined immediately.
Her lungs, heart rate, oxygen saturation, and overall examination are normal.
She is active, feeding well, has no fever or cough, and her symptoms happen only at night — all of these point toward a benign, self-limiting cause, not a lung or heart disease.
At this age, babies have very narrow nasal passages.
During early morning hours (3–4 AM), due to temperature drop, the nose can get more congested. When the nose blocks:
Baby breathes through the mouth
Grunting/crying can occur
Mild, brief chest retractions may be seen
Reflux/spit-ups can worsen congestion too
This is common in infants and usually NOT dangerous when the baby is otherwise normal in the daytime.
Chest X-ray or Echocardiography is NOT required at this point. If there was any suspicion of heart/lung disease, the symptoms would be persistent day and night, and the doctor’s examination would not be normal.
Next Steps
Nasal saline drops (NasoClear) 2–3 drops in each nostril before sleep and again at 3–4 AM if needed.
Steam in the room: Not direct steam to baby — just keep a steamer/humidifier running to keep air moist.
Keep baby upright 20–30 mins after feeds- Helps reduce reflux-related congestion.
Frequent burping after feeds.
Keep the room comfortably warm; avoid cold air blowing directly.
Health Tips
Red flags:
Continuous retractions (not just brief episodes)
Poor feeding
Bluish lips
Lethargy or baby not waking for feeds
Fast breathing continuously
Fever or cough develops