My sister has a newborn baby who has been having some problems eating. He vomits a lot after feeding. There was a time when he even turned blue. He was diagnosed with infant apnea. Another doctor said it could be reflux. Is there a difference between the two? How do you take care of a baby that has infant apnea and reflux?
Infant apnea, also known as Apnea of Infancy (AOI), refers to an abnormally long pause, around 20 seconds or longer, in an infant’s breathing. It is also possible for the pause to be shorter. This is called a brief apnea event and is usually associated with bradycardia which usually happens after a stressful event or cyanosis, an episode that involves color change due to lack of oxygenation in the blood. There are three types of infant apnea: Central Apnea, Obstructive Apnea and Mixed Apnea. Central Apnea usually involves the lack of an infant’s effort to breathe. A baby that has this problem does not exhibit any chest movement. If you put your hand near his nose, you will also notice that air is not moving in and out of it. In the case of Obstructive Apnea, there will be some form of movement in the baby’s chest and abdominal areas because he is making an effort to breathe. You will also feel the movement of air in and out of his nose. Mixed apnea is the combination of these two cases. Reflux, on the other hand, is the movement of stomach contents into the esophagus or the tube that connects the mouth and the stomach. This usually happens to newborns because the circular muscle that covers the bottom of the esophagus and acts like a cap that stops stomach content from going up the tube is very lax. Unlike older children who have a bigger esophagus that can hold the stomach contents, newborns tend to vomit or spit refluxed feeding. Sometimes, reflex apnea may occur, causing the baby to stop breathing. Since it is possible for babies to have both infant apnea and reflux, it is very difficult to differentiate both cases. Usually doctors, test if the baby has reflux by giving him a special liquid that can be captured by x-rays as it moves down the esophagus. This will allow them to see if the liquid would return to the baby’s throat after it has reached the stomach. Sometimes, they also insert a catheter in the baby’s esophagus in order to measure the acid levels in this area. For infant apnea, the doctor usually prescribes theophylline or caffeine which can stimulate the baby’s breathing center. Getting a machine that monitors the baby’s breathing rate and heart rate would help you manage unwanted events before they become worse. For reflux, on the other hand, the solution can be as simple as thickening feedings by adding 1 tablespoon of rice cereal for every ounce of breast milk formula. Elevating the baby’s head by putting some pillows under the mattress can also prevent reflux. Sometimes, medication for preventing reflux can also be prescribed. Lastly, keep in mind that taking note of the events that happened before the episode can help your doctor diagnose the problem and suggest an action that you could take.