Inspiratory Phonation in Baby Voice

  • Kathleen Wermke
    Address correspondence and reprint requests to Kathleen Wermke, Center for Pre-Speech Development and Developmental Disorders, University Clinics, Julius Maximilian University of Würzburg, Würzburg 97070, Germany.
    Center for Pre-Speech Development and Developmental Disorders, Department of Orthodontics, University of Würzburg, Würzburg, Germany
    Search for articles by this author
  • Asin Ahmad Haschemi
    Center for Pre-Speech Development and Developmental Disorders, Department of Orthodontics, University of Würzburg, Würzburg, Germany
    Search for articles by this author
  • Volker Hesse
    German Center for Growth, Development and Health Encouragement during Childhood and Youth, Children's Hospital Lindenhof, Berlin-Lichtenberg, Germany

    Institute for Experimental Paediatric Endocrinology, Charité—University Medicine, Berlin, Germany
    Search for articles by this author
  • Michael P. Robb
    School of Health Sciences, University of Canterbury, Christchurch, New Zealand
    Search for articles by this author



      This study aimed to evaluate the developmental occurrence of inspiratory phonations (IPs) in the spontaneous cries of healthy infants across the first 10 weeks of life.

      Study Design

      This is a populational retrospective study.


      The spontaneous crying of 17 healthy infants (10 were male) was retrospectively investigated.

      Materials and Methods

      Sound files of spontaneously uttered cries that were repeatedly recorded once per week for across the first 10 weeks of life were retrospectively analyzed. Frequency spectra and waveforms were used to identify the occurrence of IPs and to measure the duration and fundamental frequency (fo) of each instance of IP.


      A consistent number of IPs were identified across the 10-week period. All infants were observed to produce IPs in their spontaneous cries, although the frequency of occurrence was not consistent across infants. A marked sex difference was observed with female infants producing a higher number of IPs compared to males. The duration and fo of IPs did not differ significantly across the 10 weeks or between sexes.


      The production of IPs is a regularly occurring phenomenon in healthy, normally developing infants' spontaneous crying. The proportional difference in the production of IPs between female and male infants, observed for the first time here, is postulated to be linked to sex-based differences (including steroidal hormones) in respiratory anatomy and physiology.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bosma J.F.
        • Truby H.M.
        • Lind J.
        Cry motions of the newborn infant.
        Acta Paediatr. 1965; 54: 60-92
        • Aronson A.E.
        • Bless D.M.
        Clinical Voice Disorders.
        4th ed. Thieme Publishers Series, 2009
        • Gavriely N.
        • Palti Y.
        • Alroy G.
        • et al.
        Measurement and theory of wheezing breath sounds.
        J Appl Physiol. 1984; 57: 481-492
        • Hogikyan N.D.
        • Wodchis W.P.
        • Spak C.
        • et al.
        Longitudinal effects of botulinum toxin injections on voice-related quality of life (V-RQOL) for patients with adductory spasmodic dysphonia.
        J Voice. 2001; 15: 576-586
        • Eklund R.
        Languages with pulmonic ingressive speech: updating and adding to the list.
        (Proceedings from Fonetik, Lund University Sweden; 31–34; Available at:) (Accessed July 2, 2017)
        • Finger L.S.
        • Cielo C.A.
        Reverse phonation—physiologic and clinical aspects of this speech voice therapy modality.
        Braz J Otorhinolaryngol. 2007; 73: 271-277
        • Colton R.H.
        • Casper J.K.
        • Leonhard R.
        Understanding Voice Problems: a Physiological Perspective for Diagnosis and Treatment.
        4th ed. Lippincott Williams & Wilkins, 2011
        • Vanhecke F.
        • Lebacq J.
        • Moerman M.
        • et al.
        Physiology and acoustics of inspiratory phonation.
        J Voice. 2016; 30: 769.e9-769.e18
        • Orlikoff R.F.
        • Baken R.J.
        • Kraus D.H.
        Acoustic and physiologic characteristics of inspiratory phonation.
        J Acoust Soc Am. 1997; 102: 1838-1845
        • Grau S.M.
        • Robb M.P.
        • Cacace A.T.
        Acoustic correlates of inspiratory phonation during infant cry.
        J Speech Hear Res. 1995; 38: 373-381
        • Newman J.D.
        Neural circuits underlying crying and cry responding in mammals.
        Behav Brain Res. 2007; 182: 155-165
        • Holmberg E.B.
        • Hillman R.E.
        • Perkell J.S.
        Glottal airflow and transglottal air pressure measurements for male and female speakers in soft, normal, and loud voice.
        J Acoust Soc Am. 1988; 84: 511-529
        • Merkus F.M.
        • de Jongste J.C.
        • Stocks J.
        Respiratory function measurements in infants and children.
        in: Gosselink R. Lung Function Testing, European Respiratory Society Monographs. 2005: 166-194
        • Stephens R.E.
        • Bancroft A.
        • Glaros A.G.
        • et al.
        Anatomic changes related to laryngeal descent from birth to 1 year of age: do they play a role in SIDS?.
        Ear Nose Throat J. 2010; 89: 313-317
        • Wermke K.
        • Teiser J.
        • Yovsi E.
        • et al.
        Fundamental frequency variation within neonatal crying: does ambient language matter?.
        Speech Lang Hear. 2016;
        • Wermke K.
        • Ruan Y.
        • Feng Y.
        • et al.
        Fundamental frequency variation in crying of Mandarin and German neonates.
        J Voice. 2016; 31 (pii: S0892-1997(16)30124-2; Epub ahead of print): 255.e25-255.e30
        • Lind K.
        • Wermke K.
        Development of the vocal fundamental frequency of spontaneous cries during the first 3 months.
        Int J Pediatr Otorhinolaryngol. 2002; 64: 97-104
        • Wermke K.
        Neonatal crying behaviors.
        in: Wright J.D. International Encyclopedia of the Social & Behavioral Sciences. 2nd ed. Elsevier, Oxford2015: 475-480
        • Wermke K.
        • Mende W.
        • Kempf A.
        • et al.
        Interaction patterns between melodies and resonance frequencies in infants' pre-speech utterances.
        (Proceedings of the Fourth International Workshop on Models and Analysis of Vocal Emissions for Biomedical Applications, University of Firenze, Italy)2005 (187–190)
        • MacLarnon A.M.
        • Hewitt G.P.
        The evolution of human speech: the role of enhanced breathing control.
        Am J Phys Anthropol. 1999; 109: 341-363
        • Borysiak A.
        • Hesse V.
        • Wermke P.
        • et al.
        Fundamental frequency of crying in two-month-old boys and girls: do sex hormones during mini-puberty mediate differences?.
        J Voice. 2017; 31 (Epub 2016 Jan 14): 128.e21-128.e28
        • Behan M.
        • Wenninger J.M.
        Sex steroidal hormones and respiratory control.
        Respir Physiol Neurobiol. 2008; 164: 213-221
        • Quast A.
        • Hesse V.
        • Hain J.
        • et al.
        Baby babbling at five months linked to sex hormone levels in early infancy.
        Infant Behav Dev. 2016; 44 (Epub 2016 May 18): 1-10
        • Becker M.
        • Oehler K.
        • Partsch C.
        • et al.
        Hormonal “minipuberty” influences the somatic development of boys but not of girls up to the age of 6 years.
        Clin Endocrinol (Oxf). 2015; 83 (Epub 2015 Jul 1): 694-701
        • Carey M.A.
        • Card J.W.
        • Voltz J.W.
        • et al.
        It's all about sex: gender, lung development and lung disease.
        Trends Endocrinol Metab. 2007; 18 (Epub 2007 Aug 30): 308-313
        • Torday J.S.
        • Nielsen H.C.
        • Fencl Mde M.
        • et al.
        Sex differences in fetal lung maturation.
        Am Rev Respir Dis. 1981; 123: 205-208
        • Langston C.
        • Kida K.
        • Reed M.
        • et al.
        Human lung growth in late gestation and in the neonate.
        Am Rev Respir Dis. 1984; 129: 607-613
        • Patel M.
        • Mohr M.
        • Lake D.
        • et al.
        Clinical associations with immature breathing in preterm infants: part 2-periodic breathing.
        Pediatr Res. 2016; 80 (Epub 2016 Mar 22): 28-34
        • Kelly D.H.
        • Stellwagen L.M.
        • Kaitz E.
        • et al.
        Apnea and periodic breathing in normal full-term infants during the first twelve months.
        Pediatr Pulmonol. 1985; 1: 215-219
        • Wilkinson M.H.
        • Skuza E.M.
        • Rennie G.C.
        • et al.
        Postnatal development of periodic breathing cycle duration in term and preterm infants.
        Pediatr Res. 2007; 62: 331-336
        • Edwards B.A.
        • Sands S.A.
        • Berger P.J.
        Postnatal maturation of breathing stability and loop gain: the role of carotid chemoreceptor development.
        Respir Physiol Neurobiol. 2013; 185 (Epub 2012 Jun 13): 144-155
        • Kinney H.C.
        • Filiano J.J.
        • Harper R.M.
        The neuropathology of the sudden infant death syndrome. A review.
        J Neuropathol Exp Neurol. 1992; 51: 115-126
        • Krous H.F.
        • Beckwith J.B.
        • Byard R.W.
        • et al.
        Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach.
        Pediatrics. 2004; 114: 234-238
        • Kinney H.C.
        • Richerson G.B.
        • Dymecki S.M.
        • et al.
        The brainstem and serotonin in the sudden infant death syndrome.
        Annu Rev Pathol. 2009; 4: 517-550
        • Emery M.J.
        • Krous H.F.
        • Nadeau-Manning J.M.
        • et al.
        Serum testosterone and estradiol in sudden infant death.
        J Pediatr. 2005; 147: 586-591
        • Marschik P.B.
        • Kaufmann W.E.
        • Sigafoos J.
        • et al.
        Changing the perspective on early development of Rett syndrome.
        Res Dev Disabil. 2013; 34 (Epub 2013 Feb 9): 1236-1239
        • de Bona C.
        • Zappella M.
        • Hayek G.
        • et al.
        Preserved speech variant is allelic of classic Rett syndrome.
        Eur J Hum Genet. 2000; 8: 325-330