Newborn breathing is a common concern for new parents. This article provides information on normal breathing patterns, reasons a newborn might stop breathing, the consequences of oxygen deprivation, and immediate and long-term actions. Any instance of a newborn not breathing is a medical emergency requiring immediate professional help.
Normal Newborn Breathing: What to Expect
Newborns exhibit breathing patterns that differ significantly from older children and adults. A typical newborn breathes between 40 and 60 times per minute when awake, slowing to 30 to 40 breaths per minute during sleep.
A common variation is periodic breathing, involving brief pauses, usually 5 to 10 seconds, followed by several quick breaths. This pattern often occurs during sleep and typically resolves by six months of age. However, if pauses extend beyond 10 seconds, or are accompanied by a change in skin color or unresponsiveness, it warrants immediate medical attention.
Why Newborns May Stop Breathing
When a newborn stops breathing, it is medically termed apnea. Unlike periodic breathing, apnea involves a cessation of breathing for 10 to 15 seconds or longer, often with a rapid heart rate or bluish skin. Several medical conditions can lead to apnea.
One frequent cause is apnea of prematurity, due to the underdeveloped respiratory control center in premature infants’ brains. Other medical issues that can trigger breathing cessation include infections like pneumonia or respiratory syncytial virus (RSV).
Neurological problems, such as an immature nervous system, can disrupt brain signals controlling breathing. Heart or blood vessel problems may also contribute by affecting blood flow to the brain. Additionally, issues like aspiration of milk, gastroesophageal reflux, certain birth complications, and maternal drug exposure can lead to apnea.
The Impact of Oxygen Deprivation on Newborns
Oxygen deprivation, or hypoxia, can have severe effects on a newborn’s body, especially the brain. The newborn brain has a high oxygen demand and is vulnerable to damage when oxygen supply is insufficient. The consequences depend on its severity and duration.
Brain cells can begin to die within five minutes of complete oxygen deprivation, and significant brain injury is likely within five to ten minutes. After ten minutes, the likelihood of severe and permanent neurological damage increases dramatically, with little possibility for survival or recovery after fifteen minutes. This rapid timeline underscores the urgent need for immediate intervention.
Hypoxic-ischemic encephalopathy (HIE) is a type of brain injury caused by a lack of oxygen to the brain. The severity and duration of oxygen deprivation correlate with the extent of potential permanent health complications.
Immediate Action and Medical Intervention
If a newborn stops breathing, immediate action is paramount. The first step is to call emergency services. While waiting for professional help, caregivers can initiate basic life support measures.
Gentle stimulation, such as rubbing the baby’s back or tapping their foot, can sometimes prompt a newborn to resume breathing. If the baby remains unresponsive, ensuring a clear airway is important. This involves gently tilting the head back slightly and lifting the chin to open the airway.
For trained individuals, infant cardiopulmonary resuscitation (CPR) may be necessary. Infant CPR involves cycles of chest compressions and rescue breaths. Chest compressions are performed by placing two fingers on the center of the baby’s chest, just below the nipples, and pushing down about 1.5 inches at a rate of 100 to 120 compressions per minute. After 30 compressions, two rescue breaths are given by placing the mouth over the baby’s mouth and nose, breathing just enough to make the chest rise. CPR should be administered until emergency medical services arrive.
Upon arrival, medical professionals will continue resuscitation efforts and may provide oxygen, assisted ventilation, or medications to stimulate breathing. Diagnostic tests, such as blood tests or an apnea study, will be conducted to identify the underlying cause.
Long-Term Considerations After Breathing Cessation
The long-term outcomes for newborns who experience breathing cessation vary widely, depending on the duration and severity of oxygen deprivation and the effectiveness of immediate medical intervention. Some infants may recover fully, while others may face a range of challenges.
Potential long-term consequences include developmental delays, cognitive impairment, and neurological damage. Other issues can include learning disabilities, epilepsy, and vision or hearing impairments. Behavioral and emotional challenges may also emerge.
The full extent of these issues may not be apparent until the child grows older and developmental milestones are assessed. Follow-up care is important, often involving multidisciplinary teams to provide rehabilitation therapies. Support services are also available for affected infants and their families.