The A’s & B’s of being a Preemie

Being a 32 weeker like Brennan means the Admiral and myself have to get used to the A’s & B’s of the NICU. A is for Apnea, specifically Apnea of Prematurity. And B is for Bradycardia, or slow heart rate. Apnea of prematurity is when an infant stops breathing for about 20 seconds. And Bradycarida is when is when their heart rate slows down below 80 bpm.

I call this scaring the crap out of your parents.

Here is a picture of the Captain monitors in his room. You can clearly see the dip in the green (heart rate), the blue (02 saturation ), and the white (respiratory rate) that happen at the same time.

When these dips happen we get a red alert and the machine records 2 mins before the event and 2 mins after the event. The recording allows the NNP’s (Neonatal Nurse Practitioners) to analyze how the event occurred and how he recovered. The Admiral and I were told not to interfere when these events happen, as obviously our first instinct is to rush to the Captain and poke him a little to remind him to breath. We are suppose to just wait and let him recover on his own. So like I said these “events” scare the crap out of us.

Why leave him alone? Well these As&Bs happen because his brain is still developing the basic function for breathing. So leaving him alone means we can all see that he recovers on his own. When these events happen the nurses watch the monitors and look at the baby, does the baby look blue, well that’s not good, then he needs help recovering. Is the baby moving, is he clearly breathing some? If so then they let him recover on his own. The nurses also say it’s important for us to watch B and know the signs of recovery, because when we go home we won’t have monitors to rely on (although they won’t let us go home he’s outgrown these As&Bs).

When he first arrived at the NICU the Captain was given straight caffeine in an IV as a stimulant to help remind him to breathe (these days both the Admiral and I both wish we could get some of that in the morning). Both his Umbilical Arterial line (UA) and his Umbilical Venous (UV) line were removed several days ago and his umbilical cord is now healing like a term baby, but that means the Captain got caffeine for a few days with his morning feeding.

Now that the Captain is 34 weeks gestation the caffeine has been discontinued because developmentally he should be out growing the As&Bs. It means more of these events for the Captain, but not as severe and with a quicker resolution that a week ago.

But when the monitor starts dinging and your watching your child’s heart rate drop from 150 bpm to 70 in couple seconds, it takes all our will power to refrain from rushing to the Captain. But we do it, because to worry is normal, and any normalcy is good in the NICU.