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Apnea Management Program 

A special program designed to identify and treat the child with apneic episodes and apnea of the premature.

Apnea – What is it?
Apnea simply means "without breath." Apnea is not always abnormal. For instance, between every breath we take is a period of apnea. Some periods are longer than others.

Bradycardia – What is it?
Bradycardia is a slowing of the heart rate, usually less than 80 beats per minutes for a premature infant. Bradycardia often follows an apnea or periods of shallow breathing. Sometimes it can be caused by a reflex such as when the baby is sucking or having a stool.

Do all babies have periods of apnea?
Yes, it can be normal for a newborn baby to have periods of apnea from 10-15 seconds. Newborn breathing can be very irregular and is considered normal.
The American Academy of pediatrics defines prolonged apnea as "cessation of breathing for 20 seconds or longer, or a briefer episode associated with bradycardia, cyanosis, or pallor." In layman's terms it means that breathing has stopped for more than 20 seconds or any time a period of apnea is accompanied by a change in skin color, a slowing of the heart rate or unresponsiveness.  

Why do premature infants have apnea?
Premature infants have immature respiratory centers in the brain. Preemies normally have burst of big breaths followed by periods of shallow breathing or pauses. Apnea is most common when the baby is sleeping.

What does a home monitor do?
A home monitor is a warning device that will send off an alarm sound if it detects an apneic episode or a change in heart rate. It is not a life saving device. It mearly acts to summon caregivers to the baby's bedside to observe the infant and act accordingly.

Which infants are candidates for a home monitor?
After a thorough evaluation and observation in the hospital, your doctor will decide if an infants needs to be monitored at home. Typically monitored are those infants with:
          • Apneic episodes requiring stimulation or resuscitation.
          • Conditions such as prematurity, structural abnormalities of the airway or tracheotomies.
          • Some types of chronic lung or heart disease.

Once apnea goes away, will it come back?
Apnea of prematurity is a result of immaturity. Once a baby matures and the apnea resolves, it will not return. If a baby should have breathing pauses after apnea goes away, it is not apnea of prematurity. It is due to some other problem and needs to be discussed with your baby's physician. This is not common.

How are the home apnea monitors set up? 
Apnea monitors are set up at St Mary's Hospital before a baby goes home. Parents and caregivers are educated in all aspects of monitor function, including proper response to alarm events and cardiopulmonary resuscitation. Once a physician has decided a baby needs a home monitor, parents and caregivers can sign up for an apnea monitor training class. These classes are held four times a week and various times.

Who do parents and caregivers call if they have questions after an infant goes home with the apnea monitor?
If parents and caregiver have questions regarding their apnea monitor, they can either call the apnea management program or the homecare company who is providing the monitor.
The Apnea Management Program is available Monday thru Thursday 7:00-3:30pm. Parents and caregivers are contacted every week to see how the baby is doing, but parents and caregivers can call anytime. 

Apnea Management Program can be contacted at:
608-258-5201 or 1-800-362-3382 ext 5201.

After a baby is discharged from the hospital, the home care company will contact the parents or caregivers and set up a time to come out to the home and do an initial visit. The home care company will also provide you with supplies during your time on the apnea monitor. The home care company has a respiratory therapist on-call 24 hours a day/7 days a week. Their phone number is provided at the time of the monitor training class.

How long are infants on apnea monitors? 
Length of time on an apnea monitor is determined on an individual basis. Generally speaking, if a baby goes home with caffeine (medication used with some babies to help stimulate breathing), it will be discontinued on the baby's original due date. The caffeine can remain in baby's system for up to 10 days, so baby will remain on the apnea monitor for 2-3 weeks after the caffeine has been discontinued.  If a baby does not go home on caffeine, the baby will stay on the monitor until approximately 2 weeks after the original due date. These are general guidelines and may change from baby to baby. 

Who will discontinue the caffeine and apnea monitor?
In most cases it will be the staff from the Apnea Management program. There are some situations where the baby's physician will discontinue the caffeine and apnea monitor. 


   
St. Mary's Hospital     700 South Park Street     Madison, WI 53715-0450     (608) 251-6100
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