If you have a baby brother or sister who was born earlier than they should have been, chances are they might have had to stay in the hospital for a while before going home.  One of these reasons is that they tend to have breathing problems, one of which is called apnea of prematurity.  If you are curious about what this condition is, read on to get the low down on the common problem in premature babies.

What is Apnea of Prematurity?

This term refers to a breathing problem that often happens to babies who have been born before the full 40 weeks of pregnancy: as a matter of fact, the baby’s breathing slows down and can even stop for short periods of time.  This problem is usually diagnosed before mom and baby even leave the hospital and can last for 2-3 months afterwards.   It is not the same thing as another respiratory disorder called periodic breathing, where the breathing also stops for a short period of time but the heart rate is not affected and the baby does not change color.

What Causes Apnea of Prematurity?

Premature babies – also called “preemies” – tend to have breathing problems for two very important reasons. Firstly, the central nervous system which regulates breathing in the first place is not always well-developed if a baby is born early. This means that the lungs don’t always get the message from the brain that they need to keep on breathing!  Also, the muscles that help the lungs expand and contract during breathing aren’t always very strong in premature babies and need time to develop further.

If the baby is under some sort of stress – for example, if it has an infection or is feeding poorly or is even getting overstimulated, these stressors can all make the breathing problems worse.

What are the Symptoms of this Condition?

Apnea of prematurity is a condition with some pretty definite symptoms that doctors usually pick up on right away. These include:

  • Short intervals (5-10 seconds) where breathing becomes very slow or even stops
  • These intervals are followed by a return to normal breathing
  • Decrease in the number of heartbeats per minute (the medical term for this is bradycardia)
  • Pale or bluish color of the skin
  • Baby can look ill or sickly
  • Limpness
  • Noisy breathing

If a baby has apnea of prematurity, these episodes can happen anywhere from once to several times a day.

What is the Treatment?

The kind of treatment that babies receive for this problem depends on how severe it is and how often it happens.

Babies born with severe apnea of prematurity are often whisked away to neonatal intensive care unit (NICU) where they will be hooked up to monitors which keep track of things like heart rate, rate of breathing, oxygen level and other important markers. If a baby slips below levels that are considered normal, an alarm will go off to alert the hospital staff.  Sometimes, babies will have to be on a solution of caffeine to help stimulate their breathing.  Suctioning and the use of an oxygen bag and mask to help the baby’s breathing is also common in the hospital setting.  If the problem is very severe, it may be that an actual breathing machine is needed.

For a baby who has the problem mildly or not very often, usually it is enough to monitor the baby while sleeping and, if breathing appear slow or has stopped, to gently rub the baby’s back and limbs to help stimulate the breathing once more.

Sometimes, babies will be sent home from the hospital with instructions to continue the caffeine solution to make sure the breathing stays normal.  Babies may also be sent home with an at-home monitor, which is made up of a series of sensors that fit onto the baby’s chest as well as an alarm which will go off and alert the parents if a baby’s breathing, heart rate or oxygen level drops too low.  Parents will be taught how to stimulate the baby’s breathing if this happens  — and also be instructed to perform CPR or call 911 if the baby needs more advanced medical care.

All this might sound a little scary – and can definitely upset parents who are already concerned about their baby’s well-being. It important to remember, though, that this condition is very common in preemies and often will go away on its own. In the meantime, it might make parents – and siblings –feel better to know that the outlook for babies with apnea of prematurity is very good indeed.