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Apnea Of Prematurity

What is apnea of prematurity?

Apnea of prematurity (AOP) is a breathing problem in a premature baby. A baby is premature if he is born earlier than 37 weeks gestation. A baby normally breathes in almost every 2 seconds. With AOP, there is a pause in breathing for at least 15 to 20 seconds. AOP may also be a pause in breathing of any length when it is combined with a slow heartbeat and bluish or pale skin or fingernails.

What causes apnea of prematurity?

The main cause of AOP is the baby being born prematurely. Most premature babies are born before vital parts of the body have fully formed. AOP may happen when the part of the brain that controls breathing is affected. AOP may also be due to weak airway and breathing muscles. The less the baby weighs and the earlier he is born, the more likely he will have AOP.

What are the signs and symptoms of apnea of prematurity?

Your baby may have any of the following:

  • Decreased or slowed heartbeat

  • Limp muscles

  • No movement of the abdomen or chest for at least 15 to 20 seconds

  • Pale or blue skin or nails

How is apnea of prematurity diagnosed?

Apnea in babies may be caused by problems other than prematurity. AOP can only be diagnosed once other possible causes of apnea have been ruled out. Your baby may have any of the following tests:

  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your child's body. Your child may be given dye, also called contrast, before the test. Tell the caregiver if your child is allergic to dye, iodine, or seafood.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your child's heart.

  • EEG: This test is also called an electroencephalogram. Many small pads or flat, metal buttons are put on your child's head. Each pad has a wire that is hooked to a machine. This machine records a tracing of brain wave activity from different parts of your child's brain. Caregivers look at the tracing to see how your child's brain is working.

  • Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.

  • X-rays: X-rays of different parts of your baby's body may be taken. These may include your baby's chest or abdomen. X-rays help caregivers look for signs of infection or other problems.

How is apnea of prematurity treated?

Treatment of AOP depends on how severe the apnea is. Most premature babies outgrow AOP and get better after a few weeks. Gentle stimulation, such as rubbing the baby's skin, may be used if the apnea is mild. Your baby may be given medicine if he has apnea more often or if his skin turns blue. This medicine stimulates the part of his brain that controls breathing. Oxygen, continuous positive airway pressure (CPAP), or a ventilator may also be needed to help your baby breathe better.

What are the risks of apnea of prematurity?

Medicines for treating AOP may cause decreased bone density, anemia (low blood count), or poor weight gain. Being hooked to a monitor or ventilator may make your baby uncomfortable. If left untreated, the apnea may cause low oxygen levels and affect your baby's heart and brain. Your baby may also have problems with his development, such as blindness, deafness, or learning problems. AOP can be life-threatening if it is not controlled with medicine or treatment.

Where can I find support and more information?

  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your baby has a fever.

  • Your baby has chills or a cough.

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

  • You have questions about your baby's condition or care.

When should I seek immediate help?

Seek help immediately or call 911 if:

  • Your baby has trouble breathing.

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

  • Your baby's skin, lips, or fingernails are pale or blue.

  • Your baby is not able to wake up after he has an apnea event.

    • Call 911 immediately. Begin CPR. Take your baby to the hospital even if CPR makes your baby start breathing again.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby. 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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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