Your Baby's Apnea Monitor: Friend or Foe
By: Kelly Feevey

A lot of preemies are now discharged from the hospital with apnea monitors.  It is sometimes hard to look at this hardware as a friend, when the high pitched chirping never seems to end.

Both of my sons were discharged on apnea monitors. This was the only way we could bring them home since our hospital's criteria for coming home was one week or seven days apnea and bradycardia free. Although our boys did not have a great deal of alarms, some of them did require gentle stimulation.

I was terrified when we were discharged from the hospital with our first son. He was doing well in the hospital, no A's (apnea alarms) or B's (bradycardia) in 6 days. He only had one night to go before he was discharged and he had a real alarm, one that required vigorous stimulation. I did not think that the monitor would be bad. He only had one alarm in 6 days. On the way home he had 6 alarms in one hour. I was ready to take him back to the hospital. I thought this is wrong, he is not ready for discharge.

At first his monitor was on him day and night except for baths and an occasional "skin rest".  Our first few weeks at home were horrid. I was up constantly checking him after alarms, and then nursing him every 1 1/2 to 2 hours. We filled countless pages of alarm records. His chest was beginning to break down from the constant irritation of the belt and various sticky electrodes. I became brave. I would start to nurse/feed  him and administer his meds without being attached to the monitor. These were things that caused him to alarm, just a choke would cause an apnea alarm.

Later, as a couple of months passed, and numerous alarms, I began to view my alarm record as my "excuse column". I told the doctor, "This baby is healthy and I know that not all of these alarms are real." I also began to take the monitor off more frequently. Our pediatrician reassured us that if you put a full term newborn on an apnea monitor that they too would have an occasional alarm.

By age four months, we were free from the monitor. The first few nights it was difficult, I slept less  than I did with our monitor constantly screeching. We soon were able to rest easy knowing that his body was growing and maturing.

It seemed like we had just gotten away from one monitor when our second son was born prematurely. I vowed that with a toddler running around I could not endure the sleepless nights of nursing and answering the calls of the alarms. I had told the NICU patient care advocate, "NO monitor this time."

When it came down to the only thing holding our second baby in the NICU was his apnea and brady alarms, we decided once again that together we could do it. My husband and I were a team.

After talking to our Neonatologist, and understanding his views of the monitor I knew I could be more independent. He explained that I did not have to be a "slave" to the monitor, but make it help me. I was able to keep the monitor off of the baby as long as he was in my arms, or very close to me or my husband while  he was sleeping. If he was in his bassinette or asleep where I could not eyeball him, I was to keep the monitor on.  I also knew with him the things that would trigger his alarms; sometimes bottle feeding as opposed to nursing, and his routine baby shots especially the synagis injections for RSV protection.  These were the times when I used the monitor the most. 

I also kept his monitor record as an "excuse record". Together the Neo and I would decide which alarms were real, and which were due to moving leads, or just a "choke".  I would keep a meticulous record of alarms and with the monitor company downloading the alarm information into their computer we were able to compare notes even over the phone.

Our second monitor experience was much less stressful than the first. It was not even due to the fact of one baby being worse than the other, it was my husband and my perception of the monitor. This time it was our friend not foe.

Some Helpful Tips to Making Your Baby's Monitor Your Friend:

No one is able to deal with stress when exhausted. Make a plan with your partner as to who will answer the alarms overnight. If you have to, sleep in another room so you don't hear the monitor. Even if you are nursing, take a pump to the other room, or have your partner bring the baby to you when it is time for a feeding. You will wake up better able to deal with motherhood, and may even have a better milk supply.

Give yourself and the baby a rest from the monitor. During those times you are able to take the monitor off and be with the baby, take it off. After bath time is a great time for kangarooing with baby and will give that tender skin a chance to breath. (ONLY take baby off of the monitor IF your baby's physician permits.)

Don't coop yourself up in the house if you are able to get out just because of the monitor. If traveling in the car, put the monitor where you can see it with out having to take risks driving. I placed the monitor on the back seat between our car seats. The cord is long enough that you can place it on the front seat as well. If you are afraid that it will fall, seat belt it in.

Always take a fresh, clean belt and extra electrodes while traveling. Sometimes the belt can get soiled when clothes do.

Always have extra alarm records and a pen/pencil for alarms. Keep a clipboard with alarm records and a pen in the front seat while traveling.

Always take your power cord with you. Don't rely on battery power when you can plug the monitor in.

Take family visit time as a chance to "break free" from the monitor as well. The monitor can be especially anxiety producing to family who have never seen or heard of apnea monitoring.

Do keep a CPR reference guide hanging on your nursery wall or where ever your baby and alarm spend most of their time. YOU may know CPR, but when you need to use it on your own child, you may need it as a reference.

Last but not least... CHECK YOUR BABY FIRST!!! The monitor is a machine.... the baby is a living being. If the monitor alarms and the baby is happy, playing and cooing while the alarm is ringing... then check the monitor.  

Kelly Feevey is an RN and the proud mother of two sons born premature. She enjoys the outdoors, spending time with her husband and most of all, learning about the world through the eyes of her precious sons.

Kelly is active in supporting other parents with children born prematurely and also promoting prematurity awareness. Please take a look at her sites dedicated to preemies and her sons.

Copyright 2000 Kelly Feevey. Please contact Kelly for permission to reprint.