As parents, we all want to do what’s best for our children—especially when it comes to protecting their health during those fragile first months of life. That’s why it’s important to understand how newborns are physically different, particularly when it comes to their airway—and how those differences can impact the way their bodies handle respiratory viruses like RSV, the flu, and whooping cough.
The more we know, the better we’re equipped to make informed decisions for our families.
What Makes a Baby’s Airway Different?
Newborns aren’t just smaller versions of adults. Their anatomy and immune systems are fundamentally different. During the first year of life:
- The upper airway is narrower, making it easier to become blocked by inflammation or mucus during illness.
- Infants breathe mostly through their noses, especially in the first few months, which makes any nasal congestion more dangerous.
- Their chest walls are more compliant (softer), and they have fewer respiratory muscle reserves, meaning they tire out more quickly during breathing distress.
- Their immune system is still developing, which limits their ability to fight off infections.
These differences are well-documented in pediatric and respiratory medicine. One review explains that “infants, especially in the first 12 months of life, are anatomically predisposed to more severe respiratory illnesses due to the small caliber of their airways.”
What Happens When Babies Get Respiratory Infections?
Viruses like RSV (respiratory syncytial virus), influenza, and pertussis (whooping cough) can be dangerous for anyone, but they’re especially serious for babies. Each year in the United States:
- RSV leads to 58,000–80,000 hospitalizations among children under 5, with infants under 12 months at highest risk.
- Influenza results in hundreds of pediatric deaths annually, most of them in children without underlying conditions.
- Pertussis can cause apnea, pneumonia, seizures, and even death in infants—especially before they’re old enough to be fully vaccinated.
Vaccination: One Tool in the Toolbox
Vaccination isn’t a silver bullet, and no one solution works for every family. But it is one tool that can help protect the youngest among us during a particularly vulnerable stage of life.
For example:
- The flu vaccine is recommended for all individuals over 6 months old, and maternal vaccination during pregnancy can offer passive protection to infants in their first few months.
- New treatments for RSV, such as nirsevimab, are now available to help protect infants during their first RSV season.
- Tdap vaccination during pregnancy passes protective antibodies to the baby, helping shield them from whooping cough before they can receive their own series of shots.
You’re in the Driver’s Seat
We know that parents are the first and most important decision-makers when it comes to their children’s health. And with so much information out there, it can be hard to know what to trust.
That’s why we’re committed to giving you the facts—no scare tactics, no spin.
No matter where you stand on individual vaccines, understanding the biology behind your baby’s vulnerability can help you ask smarter questions, have more productive conversations with your pediatrician, and make the decision that’s right for your family.
At the end of the day, it’s your child. It’s your choice. We’re just here to help you make it an educated one.
Want to learn more about each vaccine on the childhood schedule? Check out our Vaccine Comparison Table and Resources Page.