Apnea of Prematurity

GENERAL INFORMATION:

What is apnea of prematurity? Apnea (AP-nee-ah) of prematurity (AOP), is a breathing problem in a premature baby. A baby is premature if he is born earlier than 37 weeks gestation (time spent in womb). A baby normally breathes in air almost every two seconds. With AOP, there is a pause in breathing of a premature baby for at least 15 to 20 seconds. It may also be a pause in breathing of any duration combined with other conditions. These conditions may include a slow heartbeat and bluish or pale color of the skin or fingernails. AOP may show as early as the first or second day of life. The less the baby weighs and the more premature he is, the more likely he will have AOP.

What causes apnea of prematurity? The main cause of AOP is the baby being born prematurely. Most premature babies are born before vital parts of the body have fully formed. AOP may happen when the part of the brain that controls breathing is affected. AOP may also be due to weak muscles that keep the airway (windpipe) open or are used for breathing.

What are the signs and symptoms of apnea of prematurity? Your baby may have any of the following:

• Decreased or slowed heartbeat.
  
  
• Limp or floppy muscles.
  
  
• No movement of the abdomen (belly) or chest for at least 15 to 20 seconds.
  
  
• Pale or blue color of skin or nails.

• Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Blood tests can give caregivers more information about your child's health condition. Your child may need to have blood drawn more than once.
  
  
• CT scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your child's body. It may be used to look at your child's bones, muscles, brain, body organs, and blood vessels. Your child may be given dye by mouth or in an IV before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.
  
  
• Echocardiogram: This test is also called an echo. Sound waves are used to show pictures of the size and shape of your child's heart. The echo can also show how well the heart is pumping and how well blood flows through it. Your child will lie down during the test. Caregivers will squirt clear gel onto your child's chest to help the echo probe move easily. The echo pictures are shown on a TV-like screen. The barking or whooshing noise that you may hear is the sound of blood flowing through the heart. Caregivers may ask you to stay in the room with your child during this test.
  
  
• EEG: This test is also called an electroencephalogram. Many small pads or flat, metal buttons are put on your child's head. Each pad has a wire that is hooked to a machine. This machine records a tracing of brain wave activity from different parts of your child's brain. Caregivers look at the tracing to see how your child's brain is working.
  
  
• Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.
  
  
• X-rays: X-rays of different parts of your baby's body may be taken. These may include your baby's chest (lungs and heart) or abdomen. X-rays may help caregivers look for signs of infection or other problems.

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org