Apnea in newborns

Apnea in newborns: When a breathing pause is dangerous

Short breathing pauses are part of the normal, periodic breathing of a newborn. However, when these pauses become too long, it is called apnea and may be a sign of serious problems. Understanding the differences between normal and pathology is critically important.

Periodic breathing vs. Apnea

• Periodic breathing (normal): The baby takes several rapid breaths, then pauses breathing for 5-10 seconds, and then resumes normal breathing. During this pause the baby does not change color, and the heart rate remains normal. This is due to the immaturity of the respiratory center and is often observed during sleep.
• Apnea (pathology): This is a breathing stop lasting 20 seconds or longer, OR a shorter pause accompanied by cyanosis or a significant slowing of the heart rate (bradycardia).

Causes of apnea in newborns

Apnea is especially common in preterm infants (preterm apnea) due to the profound immaturity of their nervous system. In term infants, apnea can be a symptom of various conditions:

• Serious infections (sepsis, meningitis).
• Neurological problems (intracranial hemorrhages, seizures).
• Respiratory diseases, such as severe bronchiolitis.
• Gastroesophageal reflux, when gastric contents spill causing laryngeal spasm.
• Heart problems.

What should parents do?

If you notice an apnea episode, you should immediately and gently stimulate the baby — touch them, pat the back. This usually restores breathing. Any episode of true apnea, even if breathing resumes on its own, is a reason to call emergency services and hospitalize the infant immediately. The baby requires thorough examination to determine the cause.

Knowing the rules of safe sleep, especially sleeping on the back, is important for preventing breathing-related complications. Read about other breathing problems in our dedicated section.