Posts Tagged ‘C-PAP’

The A’s and B’s of the NICU

Wednesday, March 9th, 2016

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.


RDS and BPD – breathing problems in preemies

Wednesday, October 28th, 2015

NICU sign 1If your baby was born prematurely, you are probably concerned about his lungs. A baby’s lungs are not considered to be fully functional until around 35 weeks of pregnancy. If your baby was born before that, it is possible that he may struggle with breathing.



A serious breathing problem called respiratory distress syndrome (RDS) is the most common illness in the NICU. But, the good news is that due to medical advances, babies with RDS have a 99% survival rate.

Babies with RDS struggle to breathe because their immature lungs do not produce enough surfactant, a protein that keeps small air sacs in the lungs from collapsing. March of Dimes grantees helped develop surfactant therapy, which was introduced in 1990. Since then, deaths from RDS have been reduced by half.

Babies with RDS also may receive a treatment called C-PAP (continuous positive airway pressure). The air may be delivered through small tubes in the baby’s nose, or through a tube that has been inserted into his windpipe. As with surfactant treatment, C-PAP helps keep small air sacs from collapsing. C-PAP helps your baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a mechanical ventilator to breathe for them while their lungs recover. Learn more about the differences between C-PAP and a ventilator, as well as causes, symptoms and treatment of RDS.


BPD (bronchopulmonary dysplasia) is a chronic lung disease common in preemies who have been treated for RDS. These babies may develop fluid in the lungs, scarring and lung damage. Medications can help make breathing easier for them. Usually babies with BPD improve by age 2 but others may develop a chronic lung condition similar to asthma. Learn about asthma, including questions to ask your child’s health care provider and how to help your child understand his breathing problems.

Even though the outlook for babies born prematurely has improved greatly, many babies still face serious complications and lasting disabilities. Many March of Dimes grantees seek new ways to improve the care of these tiny babies, while others strive to prevent premature delivery.

Have questions?  Email or text We are here to help.


Charlie’s very early arrival

Friday, November 12th, 2010

Our guest post today is from one of our wonderful volunteers.

At my 20 week ultrasound, I was measuring and feeling great, and the baby was growing well. I was so excited to be pregnant. We had signed up for birthing and breast-feeding classes.  We bought our first house and a new car, and negotiated baby names. We thought we were prepared.  Just 5 short weeks later, though, we realized we were wrong.

I walked from work to the nearest hospital one morning with concerns about some cramping and light bleeding. The contraction monitor did not registering any activity, though, and a fetal heart-rate monitor showed no distress. I was suspicious about the fact that the cramps were occurring at regular intervals like contractions, but the machines kept everyone calm until the doctor examined me. Everything changed with his words: “You’re 6 cm dilated. Your baby is coming today.”

While I cried, the nurses sprang into action, administering steroids for the baby’s lungs and magnesium sulfate to delay labor. But my body would not cooperate. After a mercifully short labor, Charlie marked his entrance into the world with a tiny mewl of a cry that took my breath away.

Our sweet baby was immediately in danger. At just 1 pound, 15 ounces, his body was shocking in its minute perfection. We had only a minute or so with him before they whisked him away, but I was instantly in love. 

Within the week, we got an education in micro-prematurity: ventilators and C-PAPs, central lines, intraventricular hemorrhages, pulmonary embolism, patent ductus arteriosis, and bilirubin counts.  In layman’s terms, our baby boy was on a breathing machine, being fed through a tube in his belly, had a lung bleed and brain bleeds, and a congenital heart defect that might require surgery. He was jaundiced, his eyes were fused, and his face and body were bruised from my contractions. Some days it felt like too much to handle. But the doctors and nurses told us to believe in our son. “Your son’s a fighter”, they would remind us.  And they were right; after 85 long days in the NICU, we brought Charlie home.

The tough times were not over once we brought him home. We fortified his bottles and fretted over his weight gain – and now he’s tall for his age. We wondered why he didn’t babble like other kids, and now we can’t get him to be quiet. We thought he’d never start to crawl; today he races across the playground equipment and down the slide. Charlie is now 2 ½ years old and in preschool. He is strong, healthy, funny, brave and tests us constantly. He still exhibits every bit of the fighting spirit that helped him pull through in the NICU. We are so proud.

Our experience taught me so much that I wish all moms knew:
• Listen to your body. Machines may say everything is fine, but you know when you don’t feel right. Tell someone!
• Trust in the miracle of modern medicine, and the strides that the March of Dimes and others have made to dramatically improve the survival rate of preemies. 
• Understand that your baby is STRONG, and your love and support make a difference.

In the NICU – How does C-PAP differ from a ventilator?

Thursday, August 5th, 2010

help-breathing2Some premature babies are put on C-PAP to help them breathe. Others are on a ventilator.  What’s the difference?

In C-PAP (continuous positive airway pressure), air is delivered to a baby’s lungs either through small tubes in the baby’s nose or through a tube that has been inserted into her windpipe. The tubes are attached to a machine, which helps the baby breathe but does not breathe for her.  With C-PAP, the 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 the lungs do their job.

A mechanical ventilator is a breathing machine that delivers warmed and humidified air to a baby’s lungs. The sickest babies receive mechanical ventilation, meaning that the mechanical ventilator temporarily breathes for them while their lungs recover. The air is delivered to the baby’s lungs through an endotracheal tube (a small plastic tube that is inserted through a baby’s nose or mouth down into the windpipe). The amount of oxygen, air pressure and number of breaths per minute can be regulated to meet each baby’s needs.

For those of you who had a premature baby, was she on C-PAP or a ventilator?  How did you feel when you saw the equipment?


Updated October 2015.