Diagnosing apnea of prematurity typically involves monitoring the baby’s breathing, heart rate, and oxygen levels. Here’s how the diagnosis process works:

• Monitoring and Evaluation: 
  • Babies with apnea of prematurity are closely monitored using cardiorespiratory monitors that track their breathing, heart rate, and oxygen levels. 
  • Diagnosis often involves observing these readings.
• Ruling Out Other Causes: 
  • While apnea is often due to the baby’s immature breathing control, it can also be a sign of other issues like infections, low blood sugar, bleeding in the brain, or problems with the heart or nervous system. 
  • Doctors will thoroughly check for these other causes with a detailed history, physical examination, and necessary tests before concluding that the apnea is due to prematurity.

Treatment for apnea of prematurity focuses on supporting the baby’s breathing and helping them grow out of the condition. Gertrude’s Children’s Hospital offers a range of treatment options, including:

• Monitoring and Stimulation: 
  • Babies with apnea of prematurity are admitted to a monitored setting. 
  • If an apnea episode occurs, either noticed by caregivers or triggered by an alarm, gentle stimulation (like rubbing the baby’s back or feet) is often enough to restart breathing. 
  • If the baby doesn’t start breathing again, a bag-valve-mask is used to help them breathe.

• Evaluating and Treating Underlying Causes: 
  • If the apnea episodes are frequent or severe, doctors will quickly check for any underlying issues, like infections, that can be treated. 
  • If no other cause is found, treatment focuses on supporting the baby’s breathing.

• Respiratory Stimulants: 
  • For frequent or severe apnea, doctors may use medication which helps stimulate the baby’s breathing. 

• Continuous Positive Airway Pressure (CPAP): 
  • If apnea persists despite using medication, the baby might be placed on CPAP, which provides gentle air pressure to keep the airways open and support breathing.

• Ventilator Support: 
  • In rare cases where apnea is severe and doesn’t respond to other treatments, the baby may need a ventilator to assist with breathing.

• Discharge and Monitoring: 
  • Before going home, doctors will monitor the baby to ensure they’ve gone 5 to 10 days without needing intervention for apnea. 
  • Some doctors might discharge the baby while still on medication if it’s working well, while others prefer to observe the baby in the hospital for a few more days after stopping treatment to make sure the apnea doesn’t come back.

Home Monitoring:

• When Can Your Baby Go Home Without a Monitor? 
  • If your baby has been in the hospital and hasn’t had any significant breathing or heart problems for 3 to 10 days, they can usually go home safely without a monitor.

• When Might a Monitor Be Used at Home? 
  • Sometimes, if your baby is almost ready to go home but still has occasional breathing or heart issues that resolve on their own, a doctor might prescribe a home monitor or medication to help shorten their hospital stay. 
  • However, only a few babies are sent home with a monitor, and only if their episodes stop on their own without needing any intervention.

• Parental Training: 
  • If your baby goes home with a monitor, you’ll be taught how to use the equipment, what to do if an alarm goes off, and how to perform CPR if necessary.
  • You’ll also be given 24/7 phone support and regular check-ins to help decide when to stop using the monitor. 
  • Monitors that can store event data are preferred.

Safe Sleep Positioning:

• Back Sleeping Is Best: 
  • Always place your baby on their back to sleep on a firm, flat, and non-inclined surface, unless your doctor advises otherwise due to specific medical conditions. 
  • Avoid side sleeping or propping up the baby, as these positions are unstable.

• Proper Head and Neck Position: 
  • Keep your baby’s head in the middle and their neck in a neutral or slightly extended position to prevent airway blockage.

Car Seat Safety:

• Car Seat Challenge Test: 
  • All preterm infants, especially those with apnea of prematurity, should undergo a car seat challenge test before going home. 
  • This test ensures that your baby can maintain normal breathing, heart rate, and oxygen levels while in a car seat, reducing the risk of apnea, bradycardia, or low oxygen levels during car rides.

At Gertrude’s Children’s Hospital, we are committed to providing the best possible care for children with Apnea of Prematurity. Here’s why families trust us:

If your baby has been diagnosed with apnea of prematurity or if you have concerns about your baby’s breathing, we encourage you to schedule an appointment with our neonatal specialists. Our team is here to provide the support and care your baby needs to thrive.