Apnea Of Prematurity

WHAT YOU SHOULD KNOW:

  • Apnea (AP-nee-ah) of prematurity, also called AOP, is a breathing problem in a premature baby. A baby is premature if he is born earlier than 37 weeks gestation (time spent in womb). A baby normally breathes in air almost every two seconds. With AOP, there is a pause in breathing of a premature baby for at least 15 to 20 seconds. It may also be a pause in breathing of any duration combined with other conditions. These conditions may include a slow heartbeat and bluish or pale color of the skin or fingernails.

  • AOP may show as early as the first or second day of life. The less the baby weighs and the more premature he is, the more likely he will have AOP. AOP can only be diagnosed once other possible causes of apnea have been ruled out. This may be done with blood and urine tests, x-rays, computerized tomography (CT) scan, echocardiogram, or lumbar puncture.

  • Treatment will depend on how bad and how long your baby is having apnea. Most of the times watchful waiting may be all that is needed for mild apnea. Your baby may need medicine or treatment to help him breathe if the apnea is severe. Most premature babies with AOP get better after a few weeks. With proper treatment and care, your baby is more likely to outgrow AOP without having further problems. Ask your caregiver for more information about these tests and treatments.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.

  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Apnea monitor:

  • Your baby may have to go home with an apnea monitor. Monitoring could go on until your baby's caregiver feels that your baby's lungs are working well enough. Ask your caregiver for more information on apnea monitors.



Baby care:

The following may help your baby get better and feel more comfortable:

  • Keep your baby in a room with a constant temperature. Keep the room warm and quiet.

  • Let your baby get plenty of sleep. It is best to have him sleep for at least 4 hours straight.

  • Look at your baby's belly to see if it is bloated. Your baby's belly should stick out a bit, especially after he has just been fed. Between feedings, his belly should feel soft. If it feels swollen and hard, call your baby's caregiver.

  • Watch your baby for signs of apnea. Record them and tell your baby's caregiver.

  • Watch your baby's abdomen (belly). It should move up and down with his breathing.

Breathing:

The following may help your baby breathe easier:

  • Do not let anyone smoke around your child. Breathing in cigarette smoke can harm your child's body in many ways. Your child is more likely to get certain types of infections if he breathes in cigarette smoke. Being around cigarette smoke can also affect your child’s lungs and cause breathing problems. Do not let anyone smoke inside your home. If you smoke, you should quit. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.

  • Help remove the mucus from your baby's nose using a bulb syringe.

    • A bulb syringe is used to keep your baby's nose mucus-free. This works well for bottle and breastfed babies. You can find bulb syringes at a local pharmacy or grocery store. The bulb syringe should be boiled in water for 10 minutes after each use. This will kill most of the bacteria in the bulb syringe.

    • Squeeze the bulb and gently put the tip into one of your baby's nostrils (nose opening). Close the other nostril with your fingers. Release the bulb so that it sucks up the mucus. Empty the bulb syringe into a tissue and do it again if needed. Do this again in the other nostril.

  • Let your baby lie with his head in midline. Your baby may be able to breathe better when his head and neck are not turned to one side or the other. Make sure your baby's head does not flop forward or his neck does not bend too much. When your baby is sleeping, make sure to lay him on his back. Avoid placing your baby to sleep on his stomach.

  • Run a cool mist humidifier. This will help increase air moisture in your child's room. Follow the humidifier instructions carefully for running and cleaning it. Direct the mist stream towards your child's face, but keep the humidifier out of your child's reach.

  • Take extra care when feeding your baby. During feeding, hold your baby so his head is higher than his stomach. Feed your baby in a place with enough light which will let you see any skin color changes. Stop from time to time to allow him to take enough breaths between sucks on the bottle or breast. Your baby may become tired easily when feeding, always check for signs of fatigue (tiredness). Stop the feeding if he looks tired.

Cardiopulmonary resuscitation (CPR):

If your baby appears to have stopped breathing, try to stimulate him by rubbing him with your hand. You may also try rubbing your baby's back or striking the soles of his feet. Never pick up and shake your baby. If your baby still does not cry or move, begin CPR and send someone to call 911 for help. If you are alone, begin the steps of CPR and do them for 1 minute. After 1 minute, call 911 yourself. Remember that CPR on a baby is different from an adult. Ask your caregiver for more information on baby CPR.

CONTACT A CAREGIVER IF:

  • Your child has a fever.

  • Your baby has chills or a cough.

  • Your baby's skin is swollen or has a rash.

  • You have any questions or concerns about your baby's condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

  • Your baby has trouble breathing.

  • Your child has a fever.

  • Your baby is unable to eat or drink anything for 24 hours.

  • Your baby's skin, lips, or fingernails are pale or bluish in color.

  • Your baby is unable to wake up after having an apnea event.

    • Call 911 immediately or have someone else do it. Begin the steps of CPR. Take your baby to the hospital even if CPR seems to have made your baby start breathing again.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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