What is apnea?

Apnea normally means that breathing has stopped. With apnea of prematurity, a baby’s breathing usually slows down gradually, stops briefly, then slowly returns to a normal rate. However, apnea can also happen suddenly. Babies who are born earlier than 35 weeks of pregnancy often have apnea. Babies outgrow apnea of prematurity (AOP), usually by 1 month after their due date.

AOP does not cause long-term brain damage, as long as your baby is able to start breathing again. Apnea that begins after the second week of life or lasts longer than 20 seconds is more serious. AOP does not cause SIDS (sudden infant death syndrome, or crib death).

What is the cause?

Before birth, a baby gets oxygen from the mother’s blood. Once born, the brain tells the body to breathe regularly to get oxygen. A premature baby’s brain may not yet fully developed. As the baby gets older, the brain matures and the breathing problem usually goes away. A premature baby’s airway muscles may also not be strong enough to keep the airway open and makes it harder for the baby to breathe.

Apnea in premature babies can also be made worse by an infection, lung or heart problems, feeding problems, or not enough red blood cells in the blood.

What are the symptoms?

Symptoms may include:

• Slowing in breathing or stopping breathing for 5 to 10 seconds
• Having a heartbeat below 80 beats a minute when the baby slows or stops breathing
• Getting a pale or bluish skin color during an apnea spell

It may be hard for a premature baby to suck, swallow, and breathe all at the same time.

Apnea may happen once a day or many times a day. The more premature the baby is, the more likely he will have apnea spells.

How is it diagnosed?

Your baby may have tests such as:

• Blood tests
• Monitoring the baby’s heart rate, brain waves, chest movement, and blood oxygen levels
• X-rays

How is it treated?

The treatment for apnea is to help the baby breathe until he outgrows the problem.

Monitoring

In the hospital, your baby will be attached to a monitor that constantly measures heart rate and breathing rate. If your baby stops breathing for too long or his heart rate drops too low, the monitor sounds an alarm. Many times your baby starts breathing again by himself and does not need any help.

If he is not breathing, a nurse will gently rub your baby’s back, arms, or legs. She may turn his head to a different side or turn him over. If your baby is still pale or bluish, he may be given oxygen.

Medicines

Medicine can help the part of the brain that controls breathing to be more active. This can reduce the number of apnea spells. Your baby keeps getting medicine until he has outgrown the apnea.

Breathing machines

If apnea spells happen a lot or last a long time and your baby needs help to start breathing again. He may need a machine that uses a soft plastic tube to blow air into his nose and help remind him to breathe. If this does not help, he may need a breathing machine for a few days or weeks.

Treating other problems

Infection, low red blood cell counts, low body temperature, low blood sugar, or bleeding in the brain can make apnea worse. If your baby has any of these problems, they will also be treated.

How can I take care of my child?

Usually, babies who have no apnea spells for 5 to 7 days can go home. Your baby may still need medicines or home monitoring. You will be taught what to do if your baby has apnea spells. Usually, all that is needed is gentle stimulation. But, it’s also a good idea for your family to learn infant cardiopulmonary resuscitation (CPR) before the baby goes home. Even if you never use CPR, it is best to be prepared.

Do not give your baby any medicines unless your healthcare provider tells you to do so. Follow the full course of treatment prescribed by your child’s healthcare provider.

Ask your provider:

• How and when you will hear your child’s test results
• How long it will take your child to recover
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.