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Re: Infant Apnea

Posted By HFHS.RN-AM on July 10, 1998 at 09:39:39:

In Reply to: Infant Apnea posted by Kelly on July 07, 1998 at 21:09:43:

My 2 month old daughter full term has had apnea since birth. The doctors keep telling us that her lungs are immature and she will grow out of it. Her condition does not seem to be improving. Now her pediatrician says it could be reflux. I have looked for information but everything seems to be geared to adults. Where can I find detailed information on the internet or in print on infant apnea? Even though the doctors have run a battery of tests could it be a problem that has been misdiagnosed?

I assume your daughter is on a home apnea monitor and you and all her caregivers are well-trained in infant CPR. The apnea may be developmental, which means she will soon outgrow it. The monitor will go off less and less often intil it doesn't alarm any more. Only then should you consider discontinuing the use of the monitor - and ONLY with the physicians agreement.
Apnea can be caused by reflux. We use the term Gastro-esophogeal Reflux to describe the condition where food/formula comes back up through the esophagus due to immaturity of the Cardiac Shincter ( opening to the stomach). GER can cause apnea, choking, broncospasm (kind of like asthma). We try to treat it conservatively at first with GE Reflux Precautions:
1. Keep head elevated at least 1/2 hour after feed.
2. Provide smaller, but more frequent feedings.
3. Burp you baby afetr every ounce of feeding
4. No bouncing, rocking, swinging for 1 hour after feeds.
5. If your doctor/nuse practitioner orders: thicken feedings with a small amont of rice cereal.
There are two common tests that the doctors can run to determine reflux; these are a 24 hour pH probe to detect the reflux of acid in the esophagus, a barium swallow and upper GI series. I recommend that you discuss these options with your pediatrician/nurse practitioner and possibly obtain a referral to a pediatric gastroenterologist.
*KEYWORD: Apnea of prematurity, Gastro-Esophageal Reflux

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