Children - Apnea of Prematurity

Many preemies have apnea (breathing that stops for more than 15 to 20 seconds). Action may be needed to restart the baby’s breathing. In some babies, apnea occurs only during sleep. In most cases, the problem resolves over time.

Causes of apnea in premature infants

  • Immature nervous system: A premature baby’s brain and reflexes aren’t fully developed. So the baby may not have the reflex to breathe when the blood oxygen level is too low.

  • Fatigue: Breathing is hard work, and preemies’ muscles are not yet fully developed. The baby may also find feeding to be tiring.

  • Feeding problems: A baby may stop breathing because it hasn’t yet learned to coordinate suckling, swallowing, and breathing.


How is apnea treated?

  • Mild stimulation. Rubbing the baby’s back or feet or patting the skin stimulates the baby’s nervous system, which can restart breathing.

  • Shorter, more frequent feedings. This can prevent the baby from getting tired. A nurse can show you techniques for feeding a preemie.

  • Medications. Caffeine and similar medications may be given in the hospital to help stimulate breathing.

  • CPAP (continuous positive airway pressure). This machine sends a gentle, continuous stream of air into the baby’s lungs, helping to ease breathing. It can also be used to give the baby extra oxygen if needed.

  • Ventilation. A machine called a ventilator that assists breathing by giving the baby air, oxygen, or a mixture through a tube that goes directly into the windpipe.

What happens if my baby stops breathing?

While in the NICU (neonatal intensive care unit), your baby is closely monitored. If the baby doesn’t breathe for a certain number of seconds, an alarm goes off. NICU staff will then check the baby. If the baby is not breathing, stimulation, oxygen, or ventilation is used to restart breathing. This is done very quickly, to help prevent any harm to your baby.

What are the long-term effects?

Apnea of prematurity goes away as a baby matures. Once it goes away, there are no long-term effects. Most infants are over apnea by the time they’re ready to leave the NICU. Babies who have had apnea of prematurity are not more prone to SIDS (sudden infant death syndrome) later on.

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