A & B spells (Apnea and Bradycardia spells)
Episodes when the baby stops breathing for at least 15 seconds and the baby’s heart rate slows down to less than 100 beats per minute (normal is around 120-160 beats per minute). Premature babies have apnea and bradycardia spells more often than full-term babies, but babies born full-term can also have them. The cause of these spells is not clearly understood. Some researchers think the spells are related to centers inside the brain that regulate breathing and that may not be fully developed. Touching your baby gently or rocking the incubator slightly will almost always get the baby to start breathing again, which increases the heart rate. Medications (theophylline or caffeine) are often used to treat these spells in newborn babies.
There are two types of apnea (baby stops breathing): central and obstructive.
- Central apnea occurs when the child seems to “forget” to breathe.
- Obstructive apnea occurs when the child makes some effort to breathe, but the voice box or upper airway is closed. The voice box can close in response to food refluxing up from the stomach or just because the infant is small and cannot keep the airway open.
Prematurely born babies often have a combination of these two types of apnea.
Apnea does not cause sudden infant death syndrome (SIDS). However, prematurely born babies are more likely to get SIDS because they are prematurely born. No one knows exactly why this is the case.