Apnea of Prematurity

When a baby is born prematurely, the part of the brain that controls breathing and heart rate may not be fully developed. This may lead to spells where breathing stops for up to 15 to 20 seconds, then starts again. This is called apnea of prematurity (AOP). AOP is common among premature babies. The earlier the preemie and the lower the birth weight, the more likely it is that AOP will happen.

During an apnea spell, the infant may become limp, pale, or bluish. Most of the time, the baby begins breathing on his or her own again within 20 seconds. It is sometimes necessary to help the baby to start breathing again. Apnea spells may happen once a day or many times a day until the brain becomes more mature.

AOP goes away as a baby matures and usually goes away within a month or so. Once your infant stops having apnea spells for at least a full week, they probably will not happen again. Once AOP goes away, there are no long-term effects. Babies who have had AOP are not more prone to SIDS (sudden infant death syndrome) later on.

Home care

  • During an episode, you can rub the baby's back or feet or pat the skin. This stimulates the baby's nervous system, which can help restart breathing.

  • Never shake your baby in an attempt to restart breathing. This can cause a severe brain injury.

  • Feed your baby for a shorter time more often. This can help prevent the baby from getting tired. Ask for more advice about feeding a premature infant.

  • Always place your infant on his or her back to sleep and never on his or her stomach. This is true for naps as well as nighttime sleep.

  • Don't place your infant face down on soft surfaces, such as a waterbed, sheepskin, soft pillow, bean bag, soft mattress, or fluffy comforter.

  • Don't expose your infant to cigarette smoke. Never smoke in the home or around the baby. If you smoke, change your clothes before touching your infant. Insist that other smokers follow your example. Make your home and car smoke-free at all times.

  • In some cases, infants with AOP are sent home with an apnea monitor. If this is true for your baby, you will be instructed how to use it.

  • Parents and caregivers of infants with AOP should be trained in infant CPR. It is unlikely, however, that CPR will ever be needed.

Follow-up care

Follow up with your baby's healthcare provider. Contact the provider if you have any questions or if you feel the stress of caring for your infant is too much.

When to seek medical advice

Call your child's healthcare provider if any of the following happen:

  • Episode of apnea does not respond to simple stimulation

  • Fever of 100.4°F (38.0°C) or higher, or as directed by your child's healthcare provider

  • Baby vomits repeatedly or is not eating well

  • Baby is not responding normally

  • Baby's skin is a bluish color during periods of normal breathing

  • Baby breathes very fast (birth to 6 weeks: over 60 breaths/minute; 6 weeks to 2 years: over 45 breaths/minute)

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