A newborn becomes apneic and cyanotic during breastfeeding. What condition should be suspected?

When a newborn experiences apnea and cyanosis during breastfeeding, one condition that should be suspected is choanal atresia. This condition occurs when there is an obstruction at the back of the nasal passage, which can prevent the newborn from breathing effectively through the nose, particularly in situations where they are sucking or swallowing, such as during breastfeeding.

In the context of breastfeeding, a newborn may become apneic if the obstruction prevents adequate airflow while the baby is latched onto the breast. The presence of cyanosis—indicating a lack of oxygen—further underscores the urgency of the situation, as the infant may be unable to coordinate swallowing and breathing due to the obstruction.

Choanal atresia is often diagnosed in the newborn period and can lead to distressing symptoms shortly after birth, particularly noticeable during feeding or other activities that require coordination of breathing and oral intake.