Definition

Apnea of prematurity is a brief stop in breathing in babies born before 35 weeks of pregnancy. It lasts 15-20 seconds. The brief stop may be less than 15 seconds if the baby has a slow heart rate or turns blue or pale.

Causes

An immature nervous system, weak breathing muscles, or a mix of both may cause apnea.

The brain controls breathing. It should sense the need to breathe and tell the body to do it. Young nervous systems may not be able to do this. This is called central apnea.

Premature babies may also have weak breathing muscles. They can’t support the airway and keep it open. This makes it hard to breathe. This is called obstructive apnea.

Normal Upper Airway During Sleep
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Risk Factors

This is more common in babies born before 35 weeks of pregnancy. The risk is greater the earlier your baby is born.

Other things that may raise the risk are:

  • Genetics
  • Cesarean delivery
  • Conception through fertility treatments
  • Lack of red blood cells (anemia)
  • Gastroesophageal reflux

Symptoms

Symptoms happen in the first week of life. They may be:

  • Long pauses between breaths
  • Bluish skin color
  • Slow heart rate

Diagnosis

The doctor will watch your baby’s breathing and heart rate.

Blood tests will be done.

Pictures will be taken of your baby's chest, belly, and head. This can be done with:

The doctor will measure chest movements and air flow at the same time. This can help find out the type of apnea your baby has.

Treatment

Apnea will go away on its own as your baby reaches what would have been the 36th week of pregnancy.

Treatment may be needed until it goes away. It depends on how often apnea happens and how severe it is. It also depends on your baby’s health. Most babies will be in the hospital during this time. Your baby’s heart rate and breathing will be watched. An alarm will sound when breathing stops.

Rubbing or patting your baby can get breathing to start again. Babies with mild and infrequent episodes can be observed and stimulated when needed. More frequent episodes may mean:

Medications

Caffeine may be given as a medicine to help with breathing.

Supportive Care

A continuous positive airway pressure (CPAP) machine can help take over breathing if there is a long pause. This machine gives gentle pressure in the airways. It helps keep them open and provides oxygen.

Here are other steps you can take:

  • Maintain a comfortable and quiet climate.
  • Remove nasal secretions.
  • Position your baby carefully.

Learn how to give CPR in an emergency should happen.

Prevention

There is no known way to prevent apnea of prematurity.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kathleen A. Barry, MD
  • Review Date: 06/2018 -
  • Update Date: 07/26/2018 -