Taking Your Preemie Home With an Apnea Monitor

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Apnea is a common problem in preemies. When a baby has an episode of apnea, there is a pause in his breathing that lasts at least 20 seconds. During the pause, the baby’s heart rate may go down (bradycardia) and oxygen levels might drop.

In the neonatal intensive care unit (NICU), premature babies are hooked up to monitors with alarms that go off when the baby has apnea or bradycardia. Apnea typically improves as babies grow and mature, eventually going away.

Sometimes, a baby might be ready to go home from the hospital before the apnea is completely gone. If your baby is otherwise healthy, but continues to have occasional episodes of apnea, you might be discharged home with an apnea monitor.

Home Apnea Monitors

The home apnea monitor is called a cardiorespiratory monitor. An apnea monitor keeps track of your baby’s breathing and heart rate. It consists of a belt that goes around your child’s chest to measure how often they are breathing, as well as a set of electrodes or leads that attach to your baby's chest to detect and monitor their heartbeat.

Just like when you were in the NICU, an alarm will sound if your child has a long pause in breathing or if their heart rate goes down too low. 

Pros & Cons

After getting used to all the monitors in the NICU or special care nursery, it can be reassuring to have one at home. The monitor might give you a boost of confidence if you're feeling anxious or worried about leaving the security of the around-the-clock care in the hospital.

On the other hand, bringing home a monitor can be a source of stress and a constant reminder that your baby was born early. You might feel like you can’t leave the hospital and the preemie experience behind you.

Other potential challenges of having a home apnea monitor for your baby include: 

  • You need to learn how to use the monitor and take extra safety precautions. 
  • The false alarms can be scary and annoying.
  • Going out to run errands or visit friends and family is more of a hassle. The monitor does come with a battery pack which allows you to leave the house, but it's still something extra you have to carry (along with all the other baby equipment you need!)
  • When you are choosing child care providers, it might be more difficult to find someone who has the knowledge and the confidence to care for a baby who needs monitoring and could handle an emergency.
  • Going home with a monitor might add to your concerns that your child is not healthy. You might feel scared to leave your child and become overprotective of them.

Taking the Monitor Off

Some babies need to stay on the monitor as much as possible, except during bath time and lead changes. Other infants can spend time off of the monitor when they're awake as long as someone is watching them carefully.

Always ask your child’s doctor before taking the monitor off. Here are two examples of when your baby might not need to be on the monitor at home.

  • Bath time. You don’t have to bathe your preemie every day. When you do, you will need to either remove the leads or disconnect them from the monitor.
  • Playtime. If your baby’s doctor says it’s OK, you can take your baby off the monitor when they are awake and ready to play. It will be a welcome change to interact with your baby without the monitor, and you'll likely enjoy having a break from carrying the monitor around and dealing with wires.

Changing the Leads

Some monitors use electrodes that stick to a baby’s skin, while others use leads without adhesives that are held on by the chest belt.

Sticky electrodes tend to stay in place better (which can help prevent false alarms), but non-stick leads can work well for a baby with sensitive skin.

Here are some tips for working with leads that stick on your baby's skin.

  • Know when to change the electrodes. You don’t need to change the leads if they are securely in the right place and your baby’s skin is intact. However, if you are removing the leads before you give them a bath, they are no longer sticking, or your baby’s skin is red and irritated at the site of the electrode, it's time to put on a new set of leads.
  • Be gentle removing the leads. When it's time to take the electrodes off of your baby, remember to be gentle. If they are stuck on well, don’t pull them off. You can carefully remove the electrodes by soaking them with water—just make sure they are not attached to the monitor when you perform this task. You can also try using a baby-safe medical adhesive remover.
  • Check your baby's skin. Each time you change the leads, check your baby’s skin. If the area of skin looks red, bumpy, or blistered, do not put a new electrode on that exact spot. Instead, place it on an area of healthy skin that's close by (check to make sure that the new placement can get a reading on the monitor) and allow the irritated spot to heal.
  • Reusing leads. If you take the leads off for a bath, you can reuse them if they are still sticky. However, if they lose their stickiness and become loose, they’re more likely to trigger false alarms.
  • Sticky problems. Do not use oils, lotions, or creams on your baby’s chest unless their doctor tells you to do so. It's much harder to get the leads to stick on slippery skin.

If your baby has sensitive skin that becomes easily irritated from the leads, talk to your pediatrician.

Dealing With Alarms

It can be scary when that alarm goes off—especially the first few times it happens, or when it happens in the middle of the night. Do your best to stay calm and get to your baby as quickly as possible.

Here are some suggestions for "trouble shooting" alarms to determine if they are false alarms or the real thing.

False Alarms

One of the downsides of taking your baby home with a monitor is dealing with false alarms. False alarms may happen when:

If you check your baby, their color looks good, and you can see or feel that they are breathing, it’s probably a false alarm.

Even if you’re getting a lot of false alarms, always check on your baby. You never know when an alarm might be real. 

Real Alarms

Some real alarms will look like false alarms because by the time you rush to the baby, they will have already started breathing again on their own. In fact, just the sound of the alarm is all some babies need to end an episode.

If you get to your baby and they are having an episode, do your best to remain calm and start stimulating them to breathe.

Try gently rubbing their feet or pick them up and rub their back. That's often enough to get your baby to take a breath.

If your baby is pink and breathing, they are likely OK. Make sure you keep a log of any episodes your baby has to show to their doctor.

Emergencies

If you respond to an alarm and find your baby pale or turning blue (especially around the mouth) and they are not breathing or not responding, start CPR and call 911 or your local emergency number.

Preparing for Emergencies

Even though you hope you will never have to use your emergency plan, you should still have one. Take the time to prepare for an emergency, talk about it, and include all the people who care for your child in the plan.

  • Keep emergency phone numbers available. Place them near your home phone and program them into your cell phone. 
  • Take an infant CPR course, and have anyone who watches your child learn CPR, too. You can keep the CPR guide in an easily accessible place and hang the basic instructions in the house in case you need to refer to them. You’ll probably never have to use it, but it’s important to know how just in case. 
  • Notify the power company, telephone company, and emergency services in your area that you have a child with health concerns. In case you lose power, or there is a disruption in a necessary service, these companies keep a list of customers who need to have services restored first.
  • When you’re home, keep the monitor plugged in as much as possible so that it’s not running on battery power. If you have a separate battery pack, keep it charged and ready to go in case you need it right away. 
  • Keep a spare chest belt, and a few extra sets of leads on hand, too.  

Monitor Safety

Home cardiorespiratory monitors are very safe. Here are a few guidelines that you should follow to prevent unnecessary dangers. 

  • Use caution when dealing with the monitor’s wires. When you dress your baby, don’t put the electrode wires through the top (neck) of your child’s clothing. Wires around your child's neck can become a choking hazard. The safest way to dress a child on the monitor is to gently pull the wires down through the bottom of his onesie or shirt. 
  • Always disconnect the baby from the monitor before a bath or any other water activity to prevent an electric shock. 
  • Don’t leave your child alone with pets or other children. Young children and pets may find the monitor and wires interesting. Be sure to pay attention and keep the monitor and your child out of the way of danger.
  • Don’t vacuum, listen to loud music, wear headphones, or take a shower when you’re alone with the baby. Wait until you have someone with you to keep an eye on the baby before you do anything that might interfere with your ability to hear the monitor. 
  • When traveling with your child in a car, keep the baby on the monitor and position her correctly in the car seat so she can breathe freely. Since the monitor is heavy, be sure to secure it in a safe place. It can be dangerous if it gets thrown from an unsafe position during a sudden stop or a car accident. 

How Long Will Your Baby Need a Monitor?

There isn’t a set amount of time that a child uses a home monitor. How long your child stays on the monitor depends on her needs. Your child’s doctor will let you know when it’s safe to wean off the monitor or stop using it altogether.

It may be after a few months without any episodes, when your child reaches six months old, or when the doctor believes that your child no longer needs it. It’s different for every child because every child is unique. 

A Word From Verywell

After a long road in the NICU or special care nursery, it so exciting to finally take your baby home and leave the hospital behind. Going home from the NICU with an apnea monitor may be overwhelming, but it won’t take long to get the hang of it.

It is an extra load to lug around and deal with, but families can usually adjust to the change. It may even help you sleep better at night knowing that you don’t have to get up to continually check on the baby. Before you know it, your baby will grow and mature, and your doctor may say that you don’t need the monitor anymore. 

When you finally get the news that it’s time to get rid of the monitor, you may be delighted, but it’s still a big adjustment. Many parents are nervous about letting go of the monitor. Some families choose to continue to use the monitor even after the doctor gives them permission to stop.

Instead of giving it up all at once, you may want to wean yourself from the monitor. Try using the monitor a little less each day until you begin to feel more comfortable.

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Article Sources
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