Apnea

Apnea is a pause in breathing that has one or more of the following characteristics:

• lasts more than one to 20 seconds
• is associated with the baby's color changing to pale, purplish or blue
• is associated with bradycardia or a slowing of the heart rate

Premature babies have apnea because they have immature respitratory centers in the brain. Preemeies normally have burst of big breaths followed by periods of shallow breathing or pauses. Apnea is most common when the baby is sleeping. Apnea of prematurity is by far the most common cause of apnea in a premature infant, but apnea can be caused or increased by many problems including infection, low blood sugar, patent ductuse arteriosus, seizures, high or low body temperture, brain injury or insufficient oxygen.

Apnea of premaureity markedly improves or goes away by the time the baby nears her due date. There are several treatments possible. A baby may be treated with one or more of the following:

• Medications that stimulate breathing. Commonly used drugs include caffeine, theophylline, or aminophylline.
• CPAP
• Mechanical ventilation (breathing machine) If the apnea is sever, the baby may need a few breaths from the ventilator every minute. These might be given at regular intervals or only if apnea occurs.

A baby's respirations are monitored continuously if she is at risk for apnea. An alarm will sound if there is no breath for a set number of seconds. If the alarm goes off the nurse will check to see if she is breathing, if there is a change in color of if the heart rate is falling. False alarms occur often. The nurse may stimulate the baby if the baby needs a reminder to breath, or she bay give the baby an few breaths with a bag and mask, or extra breaths on the mechanical ventilator.

Most infants are over their apnea completely when they go home; however, some babies reach all other criteria for discharge before their apnea is completely gone. Some babies are candidates for home apnea monitoring. A baby would be a canadiate for home apnea monitoring if:

• she has apnea that is heart and she recovers without any stimulation;
• She has no color change or brady cardia with the apnea
• the apnea is not expected to go away in the next several days or
• parent has completed home apnea training and a course in CPR