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Helping your premature baby breathe at home

Your premature baby may need support to help him breathe when you take him home.

If your baby had breathing problems in the baby unit, he may still have the occasional spell of periodic breathing (breathing pauses in otherwise well babies) or need oxygen support from time to time.

Do I need an apnoea alarm?

Babies are not usually discharged if they are still having apnoea (not having apnoea is one of the main criteria for letting the baby home from hospital) , although they may still have periodic breathing (see above). Some parents decide to buy an apnoea alarm once they return home in case their baby has an apnoea episode. This is a special pad that attaches to the mattress and monitors your baby's breathing, alerting you if your baby has not breathed for 20 seconds or more.

Healthcare professionals do not recommend these alarms, as they can raise anxiety unnecessarily (for example, if the baby rolls off the pad it may seem as if they have stopped breathing), and the evidence does not show that they reduce cot death.

Living with apnoea

If you think your baby is having a periodic breathing episode, you will usually only need to rub his feet to rouse him. If you are worried about any pauses in breathing, seek advice from your healthcare team. If your baby is having an apnoeic episode, get medical help.

Giving your baby extra oxygen at home

Some children need to continue receiving extra oxygen for months or even years, so taking them home 'on oxygen' enables you to begin normal family life at home while the treatment continues.

The prospect of giving your baby extra oxygen at home may be daunting, but for many parents the benefits of returning home outweigh the initial anxiety about using the equipment.

Your baby may be considered suitable for a home oxygen therapy programme if:

  • his oxygen needs are stable
  • he hasn't had apnoea for at least a fortnight
  • he can cope with short periods without oxygen if necessary
  • he is otherwise medically stable
  • you are willing to take on the responsibility
  • your home is suitable for this purpose and you have a reliable phone
  • You have told your home and car insurers.

How oxygen therapy works

The oxygen is usually provided through a machine called a concentrator. You plug it in and it extracts oxygen from the air in the room and feeds it to a mask or tube. You can set up tubes with several different outlets, so that you can move around your home. You will also be given some light, portable cylinders that you can take to the park, shops or friends' houses. These can also be used as back-up, in case there is a problem with the machine.

Learning how to use oxygen at home

Before receiving the equipment, you will be taught how to use it. The healthcare team may arrange for you to visit another family who are using the equipment, so that you can see how it works for them. The team will give you clear written instructions and a list of emergency numbers, and you will receive regular follow-up.

The oxygen equipment will be delivered by an engineer who will discuss your needs with you before installing it, and will explain how it should be used. You will get written instructions and clear information about what to do if there is any problem.

First aid for parents

Your unit may offer to train you up in techniques to resuscitate your baby or to cope with choking. If you would like to develop these skills further, ask your healthcare team, contact your local branch of the British Red Cross or search online for private courses.

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Taking your baby home:

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Sources

Abendroth, et al (1999) Do apnoea monitors decrease emotional distress in parents of infants at high risk for cardio-pulmonary arrest?, Journal of Pediatric Health Care, Vol 13, Issue 2, p50-57

Eichenwald EC, Aina A, Stark AR (1997) Apnoea frequently persists beyond term gestation in  infants delivered at 24 to 28 weeks, Pediatrics, Vol 100, No 3 Pt 1, p354-9

NHS Home Oxygen Service (accessed Feb 2012) About home oxygen therapy, Therapy and equipment,  http://www.homeoxygen.nhs.uk/26.php

Meeks M, Hallsworth M, Yeo H (2010) Nursing the neonate, Chichester, Wiley-Blackwell

Mupanemunda RH, Watkinson M (2004) Key topics in neonatology, p153-4


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