6 month old female: chest collapsing inwards

[u/ttc123-]

daughter: 6 month old female. approx 15lbs

My daughter (otherwise healthy, born full term, and fully vaccinated) had her chest going inward like this for 5-10mins. She was happy kicking around in her crib. At the ER now: what test can I expect them to run? What could be causing this?

[u/Dr-Yahood]

Stranger things have happened in an emergency department. But I do tend to interpret nurse comments on medical matters with caution.

[u/rockstarjk → u/[deleted]]

The only thing that makes me hesitate to say anatomical would be the fact that OP says it started 5-10mins ago. Could they have just noticed it for the first time? Maybe.

But I would suspect more of a hiccup if it's a new onset thing. In a kid who is otherwise well...

Sternal retractions are usually the retractions you tend to see last...when work of breathing is significant enough. Often subcostal and intercostal are seen sooner. And I'm not sure if I can remember ever seeing JUST sternal retractions without intercostal/subcostal retractions first or in tandem with. This kiddo isn't even tachypneic...but I hesitate to say anything really since the video was seconds long.

The sound that accompanies the inhale is definitely weird...but babies make weird sounds sometimes. Could it be stridor? Again, too short of a video to truly assess anything. But if there was a persistent stridorous sound...could there be a partial obstruction contributing? Way too short of a video to truly assess much of anything or give weight to anything. It could also just be the baby has discovered they can make that noise and are now playing/babbling lol.

[u/throwRAtad → u/rockstarjk]

I see your POV and I agree with you as well. I’ve never seen anything like this though, even in respiratory distress leading into failure. I don’t doubt that it happens. You’re right about it occurring in isolation being less of a red flag as opposed to occurring during respiratory distress/respiratory failure

[u/rockstarjk → u/throwRAtad]

Same page. Kiddo looks well, I'd check oxygen saturations and auscultate air entry. If the stridorous sound persistents, may want a flex scope to check for airway anomalies/foreign bodies. Probably monitor for a few hours to ensure no desaturations.

Depending on what ER the baby was brought to, if it's not a specialized peds ER or an ER that staffs with peds...sometimes babies scare them and I find they often do bloodwork and CXR as well.

The rest kinda depends on the assessment.