A & B Spells (Apnea and Bradycardia spells)

A & B spells (apnea and bradycardia spells) are episodes when the baby stops breathing for at least 15 seconds and the baby’s heart rate slows down to less than 100 beats per minute (normal is around 120-160 beats per minute). Premature babies have apnea and bradycardia spells more often than full-term babies, It’s not clearly understood what causes these spells. Some researchers think the spells are related to centers inside the brain that regulate breathing and that may not be fully developed. Touching your baby gently or rocking the incubator slightly will almost always get the baby to start breathing again, which increases the heart rate. Medications (theophylline or caffeine) can be used to treat these spells in babies if necessary.Apneic spells in fullterms babies are never normal and can be caused by such serious conditions as sepsis, seizures , drug withdrawal or bleeding within the brain.

There are two types of apnea (baby stops breathing):central and obstructive.

• Central apnea occurs when the centers in the brain that control breathing fail to function normally
• Obstructive apnea occurs when the upper airway is blocked or closed, preventing the passage of air into the lungs . The voice box can close in response to food refluxing up from the stomach or just because the infant is small and cannot keep the airway open or because the neck is in the flexed position. Prematurely born babies often have a combination of these two types of apnea.