What is Apnea of Prematurity?

Apnea of prematurity is a breathing disorder seen in preterm babies where they experience episodes of shallow or nonexistent breathing. The areas of the brain responsible for regulating respiration may not be fully formed, and the baby could also have underdeveloped lungs, leading to problems with breathing independently. Commonly, the baby also experiences bradycardia, where the heart rate slows down. Apnea of prematurity generally is a temporary condition that most babies recover from, but they need careful monitoring until they are out of the danger zone.

Extremely premature babies often wind up in a neonatal intensive care unit or special care baby unit for monitoring because they have trouble surviving on their own. Monitors are available and will issue an alarm when a baby stops breathing or has a slow heart rate. Depending on the case, doctors may deal with apnea of prematurity by providing artificial ventilation for babies who cannot breathe reliably on their own. For babies not on ventilators, often gentle touch will stimulate the baby, increasing awareness levels and causing the baby to start breathing again.

There are serious risks with apnea of prematurity. Periodic episodes of low oxygen can damage the brain, as well as muscles and vital organs. If a baby stops breathing long enough, he could die. Treatments to regulate respiration and intervene promptly when the baby stops breathing are critical for the management of this condition. When babies are in the hospital, nurses will carefully chart their breathing and heart rate so a doctor can see if they are improving.

Approaches to management of this condition vary, depending on the policies at a given facility and the baby's gestational age at birth. Researchers study fetal development to learn more about how and when breathing reflexes develop, with the goal of creating more detailed plans for managing infants with this condition. Parents with high risk pregnancies and concerns about an early delivery may want to discuss the possibility of temporarily relocating to an area with a very high quality neonatal intensive care program so their babies can get the best care.

When a baby is more stable, the doctor can send her home. If she is still experiencing apnea of prematurity, the doctor will recommend an apnea monitor. This device will sound an alarm if the baby stops breathing so parents can quickly respond to get the baby breathing again. Parents caring for a premature baby at home should advise their local emergency services so that if they call for help in the middle of the night, the dispatcher will be aware of the situation and can provide some advance warning to paramedics and other first responders.