Periodic breathing in an infant

• periodic breathing occurs when the breath pauses for up to 10 seconds at a time
  • may be several such pauses close together, followed by a series of rapid, shallow breaths
    • then the breathing returns to normal
  • a common condition in premature babies in the first few weeks of life. Even healthy full-term babies sometimes have spells of periodic breathing. It usually occurs when the infant is sleeping deeply, but may occur with light sleep or even when awake
  • a review noted that this condition is very common in preterm babies, especially during sleep, and associated with a decreased response from the respiratory centre (2)
    • managed by slightly raising the O2 levels whilst avoiding oxygen toxicity, using saturation monitoring
      
      
• periodic breathing is not the same as 'apnoea'
  • apnoea occurs when breathing stops for at least 20 seconds
    • infant may become limp. There may be a change in skin color (such as blue or pale color around the mouth) and a drop in heart rate before the baby starts breathing normally again
    • sometimes the baby must be stimulated to restart breathing
      
      
• a baby with periodic breathing will always restart normal breathing on its own
  • no stimulation is required
  • although this can be alarming to the parents, it is a harmless condition and it will go away as the baby gets older

Reference:

• University of Minnesota Medical Center. Periodic Breathing (Infant) (Accessed 20/8/2014)
• Tin W; Oxygen therapy: 50 years of uncertainty. Pediatrics. 2002 Sep;110(3):615-6.