The A’s and B’s of the NICU

help-breathingApnea (A) and bradycardia (B) are two conditions that are monitored in the NICU. Apnea refers to an interruption in your baby’s breathing, while bradycardia is the slowing of your baby’s heart rate.

Babies in the NICU are constantly monitored for these “A’s and B’s.”

Premature babies often have breathing problems because they were born before their lungs were fully developed. As many as 80 percent of babies born before 30 weeks of pregnancy have apnea. Full-term babies may have breathing problems due to birth defects, infections or complications from labor and delivery.

When is irregular breathing considered apnea?

Often, preemies do not breathe regularly. Your baby may take a long breath, a short one, and then pause for 5-10 seconds before breathing regularly. This is not considered harmful and your baby should outgrow it. But, if a preemie or sick baby stops breathing for 15 – 20 seconds or longer, or if the pause in breathing happens along with a slower heart rate (bradycardia) or a change in your baby’s color, then it is called apnea.

A premature baby’s heart beats much than faster yours. Bradycardia is defined as “the slowing of a baby’s heart rate from its usual range of 120 to 160 beats per minute to a rate of fewer than 100 beats per minute” according to the authors of the Preemies book.

The sensors on your baby’s chest are connected to a machine which will start beeping if your baby stops breathing. The nurse will check your baby and determine if she needs to be stimulated to help her start breathing again. To resume breathing, the nurse may gently touch your baby.

If necessary, your baby’s neonatologist may give your baby medication or place her on a C-PAP machine to help deliver air to your baby’s lungs. In C-PAP (continuous positive airway pressure), air is delivered to your baby’s lungs either through small tubes in her nose or through a tube that has been inserted into her windpipe. The tubes are attached to a machine, which helps your baby breathe. With C-PAP, your baby breathes on her own, but the steady flow of air coming in through the tubes keeps enough pressure in her lungs to prevent the air sacs from collapsing after each breath. It’s a little extra support to help her lungs work better.

Machines can be scary

Seeing your baby hooked up to machines can be scary, and when those machines start to beep, it can be nerve wracking. But, the way your baby looks is a very important indicator of how she is doing. For example, some experts recommend that when machines start beeping, take a look at your baby, not at the machine. Is your baby pink? Is her chest moving in and out? Are her nostrils slightly widening with each breath? If so, she is breathing and getting oxygen.

In addition, the machines are set up to start beeping with plenty of time for the nurse to attend to your baby, before your baby is in distress.

If your baby’s apnea is not resolving, the medical team will consider whether there is something else going on, such as an infection or other problem. As difficult as it is to see your baby struggle with breathing, it may be very comforting to know that apnea usually resolves without any problems.

Have questions? Send them to AskUs@marchofdimes.org. We are here to help.

Did your baby experience apnea? Did it resolve on its own?

 

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