Parents Of Babies Afflicted By Apnea Share Experiences

Posted: December 10, 1989

Jeanne Alper, mother of 2-month-old, dressed-in-pink Elizabeth Ann, doesn't mind when babies cry.

"You know they're breathing when their screaming," said the Audubon mother with a rueful smile.

While her comment might seem strange to outsiders, the group gathered recently at West Jersey Hospital-Voorhees knew exactly what she meant. They are parents of infants afflicted with apnea, a temporary cessation of breathing that can result in crib death.

At West Jersey, parents meet twice a month to discuss their experiences and hear speakers. Many come just to see that they are not alone in dealing with this sometimes terrifying condition.

"Parents can feel shut in and frightened. They come to the meetings to talk about it," said Dolores Young, a registered nurse and medical technician who runs the group.

Apnea is usually defined as a period during which a baby stops breathing for 15 seconds or longer, said Stephanie Chuipek, a pediatrician at West Jersey who spoke to the group about the causes and treatment of the condition.

Chuipek said about 3 percent of all babies born will experience apnea and that about 10 to 15 babies born at West Jersey each month have it. Most babies, however, outgrow the condition in a short time.

The most common cause is an underdeveloped or immature brain stem, that part of the brain that controls the baby's respiration - which, in effect, ''reminds him to breath," Chuipek said. For that reason, apnea is most common among infants born prematurely, said Chuipek, who specializes in neonatology, the care of newborn infants.

Other causes of apnea include illness; a stressful birth, such as one where there is oxygen deprivation; an underdeveloped, narrow throat passage that obstructs breathing, or a recurring reflex response in which the baby regurgitates and then inhales milk or formula, Chuipek said.

Since apnea often occurs in premature babies, it is usually discovered soon after birth as the hospital monitors the baby for many things, Chuipek said.

Sometimes, however, that is not the case.

"He stopped breathing on me at 6 weeks old. He turned blue," recalled Diane Plotkin of the day she learned that her son Ryan, who was not premature, was experiencing apnea. Thinking he was just choking, she turned him over her arm and banged his back, which prompted him to breathe again.

But later tests showed his brain stem was underdeveloped, and now he, like most other apnea babies, lives attached to a monitor 24 hours a day.

The monitor is a portable box that parents carry along with their brightly colored, quilted baby bags. Electrodes, in the form of a velcro-attached belt the baby wears around its chest, monitor the baby's chest expansion and heartbeat.

When the monitor senses a low rate of either, it emits a shrill alarm not unlike a smoke detector's high-pitched howl, that sends parents scrambling to their babies. Parents must then stimulate breathing with a gentle shake or flick of a finger on the heels.

Stimulants, such as caffeine, can also help by keeping babies from falling into the deep level of sleep in which they often experience apnea. But the babies are not the only ones being kept from a deep sleep.

"It makes sleeping very difficult," said Craig Alper, Elizabeth Ann's father, of the anxiety that the sound of an alarm, sometimes many times in a row, can provoke.

Alper said he is looking forward to the day when his daughter's apnea stops, hopefully at age 6 months. Although nearly all babies do outgrow the condition as their systems mature, there can be some very frightening episodes before they do.

Maryanne Klotz, a Pennsauken mother whose 7-month-old baby was born prematurely after she was in a car accident, had to administer CPR to save him after one apnea episode.

"You know you're the only one who's gonna save him," Klotz said as she told her story to the group.

"There's times you want to cry," Klotz said after the meeting of the fears and responsibilities an apnea parent can feel. "I need to realize there are other people going through these things."

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