What is apnea of prematurity?

Apnea of prematurity occurs when newborns, especially those born prematurely, stop breathing for short periods of time. Apnea can be caused by immaturity of the brain and weakness of the muscles that keep the airway open. At times, additional stresses in a premature baby — including infection, heart or lung problems, low blood count, low oxygen levels, temperature problems, feeding problems and overstimulation — may worsen apnea.

Symptoms

Very shallow breathing. The baby may also experience a drop in the heart rate, known as bradycardia. The baby may or may not have associated poor color and an appearance of not looking well.

Diagnosis

Because most preterm babies have some degree of apnea, they are usually kept on monitors that measure heart rate and breathing rate. Alarms are set to notify the staff when lower heart rate or breathing rate limits are met.

Treatment

Treatment of apnea depends on the most likely causes, the frequency of apnea spells and the severity of spells. Babies who appear to be otherwise healthy with few spells per day are simply watched and can be gently stimulated during their occasional episodes. Babies who appear well but with multiple spells may be placed on a caffeine preparation to help stimulate their breathing. Proper positioning, slower feeding time, oxygen and in some cases ventilator support may be needed to assist in breathing.

Prognosis

Because apnea is common in premature newborns and because most of these babies have normal outcomes, it is felt that mild apnea does not have long-term effects. However, most doctors feel that prevention of multiple or severe episodes is better for the baby in the long run.