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Brue (brief Resolved Unexplained Event)

WHAT YOU NEED TO KNOW:

What is a BRUE?

A BRUE is when your baby suddenly stops breathing and will not respond. The event can be very frightening to the person who sees it. A BRUE may end quickly and not cause serious problems. It may be a sign of a medical problem that needs to be treated. His healthcare providers may want to observe him in the hospital to see if he has another BRUE. You will need to continue to watch for any breathing problems after you take your baby home.

What are the signs and symptoms of a BRUE?

  • Blue or pale skin
  • Apnea (periods of not breathing), trouble breathing, or fast breathing
  • Limp or stiff muscles
  • Being irritable or jittery, or not responding to someone who touches or talks to him
  • Shaking or tremors in his arms or legs
  • Feeding problems, vomiting, or having milk in his nose or mouth
  • Choking or gagging
  • Eyes that roll or stare without seeming to see anything

What causes or increases my baby's risk for a BRUE?

The cause of your baby's BRUE may not be known. The following may lead to a BRUE or increase your baby's risk:

  • Reflux (stomach acid backs up), a seizure disorder, or a heart condition
  • A lung or airway infection such as bronchiolitis, respiratory syncytial virus (RSV), or pertussis
  • Choking on food or liquid
  • Too much medicine or other substance given to your baby or accidentally swallowed
  • Age younger than 1 year, especially under 10 weeks
  • Being male or born prematurely
  • Exposure to secondhand cigarette smoke
  • General anesthesia for a surgery he had recently

What should I tell my baby's healthcare provider about the BRUE?

Tell him as many details about the BRUE as possible:

  • When and where did the BRUE happen?
  • How long did the BRUE last? Panic can make it difficult to know how long the BRUE lasted. Even a few seconds can seem like a long time. Tell the healthcare provider anything you remember about how long the BRUE lasted.
  • What happened just before the BRUE? Was your baby awake or asleep? If he was awake, were his eyes open or closed?
  • What position was your baby in when the BRUE happened? Did he become limp? Did his arms and legs shake? Were his eyes rolling?
  • What color changes did you notice? For example, did your baby become pale or blue? Did his face turn red?
  • Did your baby start breathing on his own, or did he need help? Describe what was done to make the baby breathe.
  • Did your baby make any noises? For example, did he grunt or wheeze? Did he cry or whimper?
  • When did your baby last breastfeed, eat, or drink formula? Did he choke or gag during the feeding? Did you see any milk or blood in his mouth or nose?
  • Has your baby received any medicine? Is it possible he accidently swallowed medicine or other substance?

How is the cause of a BRUE diagnosed and treated?

A BRUE may last a short time. This can make the cause difficult to identify. Your baby's healthcare provider will check his color and breathing. Tell him if your baby was born prematurely or had a BRUE before. Tell him about all of your baby's medicines. He may ask if your baby sleeps in a crib with a firm mattress. He may also ask if anyone who cares for the baby smokes cigarettes around him. Your baby may also need any of the following:

  • Blood or urine tests may be used to find signs of an infection. The tests may also show if your baby swallowed any medicines or poisons that could cause a BRUE. Some medicines can be passed from the mother to her baby through breast milk.
  • X-ray pictures may show signs of a lung infection.
  • CT or MRI pictures of your baby's head may show bleeding and swelling. Your baby may be given contrast liquid to help healthcare providers see the bleeding and swelling better. Tell the healthcare provider if your baby has ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.
  • Tests may be done to check for GERD or heart problems.
  • A monitor may be used at home to check for breathing problems.
  • Treatment may include medicines to fight a bacterial infection or to control seizures. The cause of your baby's BRUE may need to be treated in the hospital.

What can I do to manage a BRUE?

  • Do not shake your baby during or after a BRUE. It is important to stay calm and not panic. Panic could lead to shaking the baby to make him breathe. This can cause shaken baby syndrome (also called abusive head trauma). The shaking can cause permanent brain damage or blindness.
  • Try to get him to respond. Your baby may respond to someone rubbing his back or feet. He may respond to his name spoken loudly. If he still does not start breathing after these methods, call 911 .
  • Learn infant CPR. All of your baby's caregivers may want to learn infant CPR. Your healthcare provider can give you information on classes you can take. Infant CPR is different from adult CPR. You will need to take an infant CPR course even if you already know adult CPR. Ask for more information on infant and child CPR.

What can I do to prevent a BRUE?

A BRUE happens suddenly. This makes prevention difficult, but the following can help reduce your baby's risk:

  • Prevent feeding problems. Feed your baby small amounts at a time. Burp him often during a feeding. Keep him upright for a time after he finishes. Do not lay him down right after a feeding.
  • Make sleep time safe. Always lay him on his back to sleep. Make sure his crib has a firm mattress.
  • Do not smoke around your baby. Do not let anyone else smoke around him.

Call 911 for any of the following:

  • Your baby stops breathing and you cannot get him to breathe.

When should I seek immediate care?

  • Your baby has another BRUE.
  • Your baby's skin or fingernails turn blue.
  • Your baby has trouble breathing.

When should I contact my baby's healthcare provider?

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

Care Agreement

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

© 2016 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.

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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