The premature infant

 

We are going to talk about the premature infant and interventions to help the drug exposed infant .  Frequently, infants in your care that are premature have been drug exposed with little or no prenatal care.  These infants can be very challenging, but will improve with calm, loving care. 

 

Infantile apnea

 

Infantile apnea is when a baby stops breathing for more than 20 seconds or when a baby stops breathing for less than 20 seconds but has other symptoms at the same time, such as: fainting, pale or blue color skin, or a drop in heart rate below 80.

 

Some causes of apnea include:

• ¨      Infection                                           
• ¨      Blocked air passages                             
• ¨      Exposure to drugs in utero                     
• ¨      Congenital heart defects                              
• ¨      Reflux of stomach contents up the esophagus
• ¨      Unbalance of body salts
• ¨      Convulsions or seizures
• ¨      Low blood sugar
• ¨      Anemia                 

 

Apnea of the premature infant

          Apnea of the premature infant is the most common type of apnea in the newborn.  This occurs because the premature infant’s brain is still developing and is not completely ready to control the baby’s breathing.  The apnea stops once the premature baby grows and develops.  While the baby is still immature, repeated prolonged apnea may cause low heart rate, fainting, and blueness.  These symptoms can lead to low oxygen levels in the blood, possibly causing damage to the baby’s vital organs, including the brain.  This is why premature babies in the nursery are monitored and treated for apnea with stimulation, medication or even sometimes with respirator support.  The apnea monitor alerts us to apnea before it becomes prolonged, so that we may help the baby begin breathing again and avoid symptoms that are more serious.

 

Apnea monitor use

          The reason the baby needs to be on an apnea monitor and the length of the time the monitor is needed depends on the cause of the apnea, and how long it has been since any apnea has occurred.  The decision to stop using the apnea monitor is a serious one and needs to be made by the baby’s physician.  Generally, the monitor is continued until the baby has been apnea free for two months.  Siblings of SIDS victims are often monitored until 6 months of age, or two months past the age at which the sibling died.  Most premature infants will outgrow the need for a monitor by the time they are 3 to 4 months of age.