APNEA & BRADYCARDIA

(As & Bs, “Spells”)

CONTENTS

What is apnea & brady

What causes it

How do you know the baby is having As & Bs

How is it treated

Will my baby outgrow Apnea & Brady

Are there any long term effects of Apnea & Brady

What can I do as a parent

WHAT IS APNEA & BRADY

  1. Apnea means the baby stops breathing for more than 20 seconds.
  2. Brady or bradycardia is when the baby’s heart rate slows or drops down below 80 beats per minute.
  3. When a baby stops breathing it causes his/her heart rate to slow down.
  4. We sometimes call it apnea and brady/bradycardia, As & Bs “spells.”

WHAT CAUSES IT

  1. The most common cause of apnea & bradycardia in premature babies is immaturity of their brain and lungs. The baby just “forgets” to breathe.
  1. When babies are born prematurely they may not remember to breathe all the time—they forget. When the baby “forgets,” apnea and bradycardia happens.
  1. Other causes of As & Bs may be
  1. Infection
  2. Lack of enough oxygen
  3. Low blood sugar
  4. Over-stimulation
  5. High or low body temperature
  6. Reflux of milk from the stomach back into the esophagus
  7. Seizures.

HOW DO YOU KNOW THE BABY IS HAVING As & Bs

  1. All babies in the NICU and the Intermediate Nursery are on monitors.
  1. These monitors count the baby’s breathing and heart rates.
  1. If your baby stops breathing or the heart rate slows down, an alarm will sound to tell the nurse.
  1. Also, some babies will look a bit blue or “dusky” when they have apnea and bradycardia.

HOW IS IT TREATED

  1. Some babies are able to restart their breathing without help; others will need some help to remind them.
  1. Some babies may need a light touch or a gently rubbing of their back.
  1. Some babies may be started on a medication.

a.The most common medication we use is Caffeine.

b.Caffeine stimulates the baby’s breathing (helps him to remember.)

  1. Some babies may need a change in the breathing assistance they’re receiving.

a.If the apnea is frequent or severe the baby may need assistance with their breathing

b.They may have to go back toCPAP (prongs in their nose or a mask over their nose) or they may need to be intubated and placed on a mechanical ventilator.

WILL MY BABY OUTGROW APNEA & BRADY

  1. Babies are different and grow at their own pace.
  1. As your baby comes close to his “due date,” apnea & bradycardia should begin to decrease.

ARE THERE ANY LONG TERM EFFECTS OF APNEA & BRADY

1.As your baby grows and gets older the As & Bs will stop.

2.Once they stop, they do not restart.

3.Some babies may need to go home on a monitor if they do not outgrow their As & Bs before discharge.

4.If your baby is going home on a monitor, we will talk with you about his/her care.

5.You will have a class to teach you:

a.How to use the monitor your baby will be using at home

b.What to do if the alarm goes off.

6.You will practice putting on and taking off your baby’s monitor before discharge so you can be comfortable with it.

WHAT CAN I DO AS A PARENT

  1. Parents can helptheir baby by:
  1. Talking quietly with your baby
  2. Holding and touching him
  3. Rocking them.
  1. Please talk with your baby’s nurse each time you visit and before starting any of these activities.
  1. These activities are also ways to help your baby’s overall growth and development.

a.Sometimes, however, too much stimulation may increase the baby’s apnea and bradycardia.

  1. No one can predict when your baby will grow and develop and be able to regulate his breathing (“remember to breathe.”)
  1. This is one reason why parents can become discouraged.

a.It is very frustrating and discouraging to visit or call every day and find that your baby is still having As & Bs.

  1. You may find yourself becoming angry with yourself, the NICU staff or even with the baby for not being able to change the situation.
  1. Try not to expect your baby to keep up a normal breathing or heart rate before he or she is ready.
  1. Babies need time to grow and develop. Your visits, love and patience go a long way to helping.

Reviewed/Revised: 05/01…..06/13

Apnea & Brady 1