What is apnoea?
Apnoea means that air flow into the lungs has stopped. This can be because the baby stops breathing, or because the windpipe or airways have become blocked. In some instances, it may be due to a combination of both factors.Causes and risk factors
Irregular breathing and short apnoeic pauses are normal in young babies and have no adverse effects.According to the Foundation for the Study of Sudden Infant Deaths (FSSID), sometimes babies stop breathing for a longer period and have a sudden drop in blood oxygen which is accompanied by a colour change in the skin which turns blue or white. They may also become floppy and may choke or gag. This is now called an Apparent Life Threatening Event (ALTE) and used to be known as a ‘near miss cot death’. Other infants may become stiff or have a staring spell.
Symptoms
ALTEs may be associated with an identifiable disease or condition such as an infection. They may also be linked to the inhalation of vomit. However, in about half of the cases a cause is not found. In some instances it appears that a baby somehow forgets how to breathe. Some babies with unexplained ALTEs may have repeat attacks.Treatment and prevention
The baby may need vigorous stimulation and resuscitation to start normal breathing. Learning how to do this is complicated, and the FSSID recommends that all parents take a course in stimulation and resuscitation prior to the birth of their child.Cot death is the sudden and unexpected death of a baby for no obvious reason. The actual causes of cot death, or Sudden Infant Death Syndrome (SIDS) have not yet been established. It is not known whether a baby dies because breathing has stopped, or whether breathing has ceased because the baby is dead. . Putting the baby to sleep on its back, and not its front or side, seems to significantly reduce the risks of a cot death and also not using a pillow or duvet until the baby is a year old. Avoiding smoking, either during the pregnancy or afterwards, is a major improvement to a baby’s health and bed sharing is not a good idea.
There are some similarities between babies who have prolonged apnoeic attacks and cot death babies. For example, they occur in the same age range, are more frequent in boys than girls, and are more common in premature babies. Some babies with ALTEs have been shown to be at greater risk of sudden death. However, a recent UK study found that less than 4% of cot death babies had a history of apnoea.
Children who survive IVH, particularly severe cases or those which go on develop hydrocephalus, may suffer neurodevelopmental disability, such as cerebral palsy, as a result. Those who suffer the mildest form of the condition have been found to suffer no significant neurodevelopment disabilities - but those with the most severe grades are far more likely to be affected.
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