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Apnea in a Premature Baby: Care Instructions

Your Care Instructions

When a baby is born early, some body systems may need extra help for a while. A premature baby's nervous system may not be mature enough to send all the right signals at the right time. These babies often have a breathing problem called apnea. Apnea is a pause in breathing for 20 seconds or more. During the pause, there is a drop in oxygen in the blood. When this happens, your baby's heart rate might also slow down (bradycardia).

Babies with apnea may release a big breath and then have a period of no breathing or small breaths. Some babies turn pale and blue during an apnea spell. Your baby may only have one spell a day or could have a few spells an hour. Many babies stop having apnea spells when they reach their original due date. But if your baby was born very early, apnea spells may continue for a while, even months. One of the ways to treat this is to give caffeine to your baby.

If your baby still has apnea spells when it is time to come home, you may get a prescription for caffeine medicine for your baby. A nurse also may show you special ways to feed and hold your baby to help them breathe.

Worrying about your baby's breathing is very stressful. It may help you to learn as much as you can about your baby's condition and treatment.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

  • Your baby's doctor and nurse will help you prepare your home and teach you what to do if your baby has a breathing pause. If your baby still is not breathing after a few seconds, gently rub their legs, arms, and back. Try changing your baby's position a little. This usually starts the breathing.
  • If your baby's doctor prescribed medicines for your baby, give them as directed. Call your doctor or nurse advice line if your baby has any problems with any medicines.
  • Wash your hands before holding your baby. Keep your baby away from crowds and people who are sick.
  • Do not smoke or expose your baby to smoke. Smoking increases the chance of sudden infant death syndrome (SIDS), ear infections, asthma, colds, and pneumonia.
  • Put your baby to sleep on their back, not on the side or tummy. This reduces the risk of SIDS. Use a firm, flat mattress. Do not put pillows in the crib. Do not use sleep positioners, head-shaping pillows, or crib bumpers.
  • Too much light, touch, sound, or movement may upset your baby. Make your home calm and restful.
  • Swaddle your baby in a blanket. Keep the blanket loose around the hips and legs. If the legs are wrapped tightly or straight, hip problems may develop. Hold your baby as much as possible.
  • Take your time during feedings, because your baby may need to pause now and then to breathe a few times.
  • Learn how to do CPR and rescue breathing. It is important to know this in case your baby stops breathing. Talk to your doctor or take a class to learn how to do rescue breathing and CPR.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child stops breathing, turns blue, or becomes unconscious. Start rescue breathing or follow instructions given by emergency services while you wait for help.
  • Your child has severe trouble breathing. Signs may include the chest sinking in, using belly muscles to breathe, or nostrils flaring while your child is struggling to breathe.

Call your doctor or nurse advice line now or seek immediate medical care if:

  • Your child's apnea spells get worse, or they happen more often.
  • Your child is rarely awake and does not wake up for feedings, is very fussy, seems too tired to eat, or is not interested in eating.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if:

  • Your child does not get better as expected.

Where can you learn more?

Go to

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