If a premature baby has breathing intervals between breaths that extend for longer than 20 seconds, the baby is having apnea. Diagnosis of apnea involves ruling out other possible conditions.
It is common for premature babies to have periodic breathing, that is, moments when the time between breaths is longer than what would normally be expected. If these intervals between breaths extend for longer than 20 seconds, the baby is considered to be having apnea. At times, these pauses are accompanied by a slowing of the heart rate, which is called bradycardia. Parents unused to these events can find them quite alarming. However, in most cases, apnea resolves itself with no harm done.
Apnea can be a condition unto itself or it may be a symptom of other conditions. A baby with apnea will often have other complications, such as low blood sugar or infection. As these other conditions are treated, the apnea will disappear.
Apnea is categorized in several ways:
- Central apnea has a primarily neurological cause: the part of the brain that controls the breathing mechanism is immature and not functioning properly. Usually, it is just a matter of time until the brain catches up and begins to regulate breathing properly.
- Obstructive apnea is caused by some blockage of the airway. Elimination of the blockage will reduce symptoms.
- Mixed apnea is a combination of both central and obstructive apnea.
How apnea of prematurity is diagnosed
Because apnea can be a symptom of other conditions, a diagnosis will attempt to rule out these other possible conditions. Blood work will rule out infection, hypoglycemia, and metabolic disorders. A lumbar puncture, also called a spinal tap, may be done to investigate the possibility of meningitis. A head ultrasound may be done to look for signs of intraventricular hemorrhage, which is bleeding into the ventricles of the brain.