Why Your Child Might Be Making Grunting Noises

If you notice your child is grunting, it may be a sign that they have asthma or are having trouble breathing. In this case, you may notice the child's nostrils flare when they breathe in, and a grunting sound when they breathe out.

In children with autism, repetitive behaviors like grunting, groaning, and throat-clearing may seem purposeless but are typically done as a means of self-soothing. And, in children with Tourette's syndrome, grunting is a common vocal tic.

This article takes a closer look at the possible causes of grunting in children, from breathing difficulties and asthma, to autism and Tourette's syndrome. It covers the signs of these conditions to look for, along with when to see a healthcare provider.

Breathing Difficulties

A child experiencing breathing difficulties may make a grunting sound each time they exhale. The grunting happens as their body tries to keep air in the lungs and force them to stay open.

Other signs or symptoms that a child may be having trouble breathing, also known as respiratory distress, include:

• Tachypnea: A fast breathing rate
• Cyanosis: Bluish discoloration around the mouth, inside the lips, or on the fingernails
• Nasal flaring: Nostrils that may seem wide open as the child has difficulty breathing
• Retractions: A child's chest sinking in just below their neck and/or beneath their ribs with each breath
• Wheezing: A tight musical or whistling sound that may be heard when a child breathes in or out
• Stridor: A harsh, high-pitched sound that is heard when a child, usually with croup, breathes in
• Relentless cough: A non-stop cough as the body tries to clear the airways of mucus or particles and keep them open

Asthma

An estimated six million children in the United States have asthma, accounting for at least 700,000 pediatric hospitalizations each year.

Children experiencing an asthma attack may make persistent, loud grunting noises as their body tries to force the airways open. In this way, grunting mimics the effect of blowing up a balloon.

In addition to grunting, a child experiencing asthma-related breathing distress may present with:

• A pale face
• Nostril flaring
• Head bobbing
• Wheezing
• Retractions, in which the mid-portion of the chest visibly sinks in as the child attempts to inhale

Autism

Children with autism spectrum disorder (ASD) often engage in what's known as stereotypy. Defined as any persistent, repetitive behavior that appears without clear purpose, stereotypy can manifest in two ways:

• Motor stereotypy, which includes movements that involve the whole body, like rocking back and forth, or parts of the body, like hand flapping.
• Vocal stereotypy, in which the child repeats words or sounds, usually without any clear purpose for communication.

Research shows that as many as 83% of people with ASD present with non-communicative vocal stereotypy, such as grunting, groaning, or throat clearing.

Stereotypy tends to occur when the child feels bored, anxious, excited, or fatigued, or when they are focused on an activity.

According to first-person accounts of people with ASD, stereotypy behaviors are described as being relaxing, and that they "help focus the mind and cope in overwhelming sensory environments."

Tourette's Syndrome

If your child's grunting persists, does not seem related to breathing, and comes with other tic-like symptoms and repetitive movements, it could be a sign of Tourette's syndrome.

Tourette's syndrome is a neurological condition that causes people to repeat movements, make noises, and perform other tic behaviors.

While some people can minimize or suppress their tics, tics are involuntary and largely out of control. In most cases, Tourette's syndrome is diagnosed in childhood and is more common among boys.

If a pediatrician suspects Tourette's syndrome, they might recommend a consult with a pediatric neurologist. Upon diagnosis, anti-tic medications and psychological therapies can help keep symptoms of Tourette's syndrome in check. 

When to See a Healthcare Provider

If you suspect your child is experiencing respiratory distress (trouble breathing), whether they have received a diagnosis or not, call 911 or take your child to the nearest emergency room immediately.

Signs of respiratory distress include:

• Fast breathing
• Fast heart rate
• Color changes, such as blue-tinged lips, skin, or fingernails
• Grunting
• Nose flaring
• Retractions, in which the chest sinks in as the child tries to breathe
• Cool, clammy skin or sweating
• Wheezing
• Stridor, a high-pitched heard in the upper airway when the child inhales
• Head bobbing
• Changes in alertness

If your child is grunting but does not appear to have difficulty breathing or other immediately concerning symptoms, call a healthcare provider or pediatrician for an evaluation.

Should the provider suspect that a developmental or neurological condition is at play, they will call for further testing. From there, your healthcare team will work with you to create an appropriate plan for medication, behavioral therapy, or another treatment.

Summary

A child who is grunting could be experiencing breathing difficulties or asthma, in which case grunting is the body's way of forcing the airways open. Grunting is also seen as a form of vocal stereotypy in children with autism, as well as a vocal tic in children with Tourette's syndrome. If you suspect your child is having trouble breathing, take them to the nearest emergency room right away. If the child does not appear to have any other concerning symptoms, call your healthcare provider for an evaluation.