Apnea in Prematurity

Terri Forehand is back to discuss a common malady for premature infants. Good information for an author writing about this age group.

Welcome back, Terri!

Apnea is one of the most frightening symptoms for parents of premature infants. Apnea is a pause in breathing for 15-20 seconds.  It is associated with the infant’s color changing to a pale or bluish tint and with the heart rate slowing for a period of time. It can be alarming for those witnessing an episode of apnea for the first time and requires reassurance and education from the staff for those frightened parents.

The major reason premature infants experience apnea is their immature respiratory center of the brain. Preemies have bursts of big breaths followed by periods of short or shallow breaths or breathing pauses. It is most common in sleeping infants which is also reason for concern for new parents.

Bradycardia or the slowing of the infant’s heart rate is also a common symptom of prematurity and often goes along with the episode of apnea. Other causes for the premature infant to drop their heart rate include during or after a feeding and during a bowel movement.

Treatment for apnea may include medications such as caffeine or aminophylline to stimulate breathing and CPAP (continuous positive airway pressure) or oxygen by nasal cannula. Nasal cannula is the preferred way to administer this treatment and is done with little tubes into the baby’s nose. Mechanical ventilation may be used for very premature infants until they can manage breathing on their own with the assistance of CPAP only.

Most infants grow out of these symptoms close to their original due date as their brain centers mature. If premature infants still are having apnea spells but otherwise could go home, they can go home on an apnea monitor. Parents are trained to apply the monitor and to know how to use it as well as what to look for in their baby if the alarms go off.

Once the premature infant matures and the apnea resolves, it will not come back. Education and reassurance will help new parents of the premature infant to feel confident in caring for their infant during the last few days before discharge and when finally at home with their new baby.

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Terri Forehand is a pediatric/neonatal critical nurse and freelance writer. She writes both fiction and nonfiction, is the author of The Cancer Prayer Book released in 2011. Her picture book titled The ABC’s of Cancer According to Lilly Isabella Lane is due out in 2012. She writes from her rural home in Indiana which she shares with her husband of almost 30 years and an array of rescue animals.