Apnea and Bradycardia in Preemies

Bringing home a preemie is scary. He or she is so tiny that a teacup seems like a good crib for the first month or so. What’s even scarier is the host of health issues that comes home with Baby. Apnea and bradycardia are probably the most likely ones the doctors and nurses talked about. Just what are these conditions and how does a new parent cope with a minimum of panic, hysteria, and chocolate-fueled feeding frenzies?

Preemies haven’t quite gotten a handle on this whole breathing-on-your-own thing. Plus, babies are natural drama queens at the best of times. Nothing brings Mom and Dad running as fast as forgetting to breathe.

• Preemies who forget to breathe for 20 seconds or longer are said to have apnea.

• Apnea causes bradycardia, a drop in the oxygen level in the baby’s blood which in turn slows down the heart rate below 80 beats per minute.

Medical professionals often call this combination “A’s and b’s.” Parents call it “get out the smelling salts because I’m going to faint.”

Babies really don’t do this on purpose just for the attention. There are a few problems their little bodies are battling that can often cause apnea and bradycardia. Their brains and muscles haven’t figured out how to work as a team yet.

What can parents do to reduce or eliminate apnea and resulting bradycardia?

• Apnea seems to happen when the baby is coming out of a deep sleep into a period of lighter sleep. Making sure the preemie gets lots of deep and undisturbed sleep is the first step in avoiding problems while in neonatal intensive care.

• Try to visit during feeding time or when the nursery denizens are being assessed.

• Remain as quiet as possible and speak in low voices if the baby is sleeping during a visit.

• Keeping the temperature in the incubator at a constant level seems to help.

• Try to pace the baby’s rate of nursing whether on the breast or bottle. Constant feeding without stopping to breathe can touch off apnea. Constant eating will once again become an issue in the teenage years. However, teenagers come up for air once in a while to talk on the phone.

How long does this phase last and can it continue once the baby comes home?

• Most babies grow out of apnea and bradycardia around the time they would have been delivered full-term. Usually, they won’t have spells once their nervous systems and muscles have matured.

• Babies are usually sent home once they have a certain period of apnea-free days in a row.

• Sometimes apnea and bradycardia still happen when the baby comes home. In this case, an apnea monitor will be provided until the spells stop. Parents received training in its use.

Remember the words printed on the cover of The Hitch Hiker’s Guide to the Galaxy: Don’t Panic. The medical folks are trained to treat preemies and make them well before they venture farther out into the world.

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