CPAP treatment in the Maternity Ward and Recovery

CPAP supports the baby’s breathing

CPAP stands for 'continuous positive airway pressure' and is the preferred treatment for infants with breathing problems. CPAP causes excess pressure in the lungs, and the baby gets a constant pressure of air blown into the lungs through a small valve in the nose. The treatment supports the baby’s breathing; the baby is still breathing on its own.

The excess pressure helps the lungs to unfold which prevents the small air sacs (alveoli) in the lungs from collapsing, as well as improving the oxygenation of the blood. It also becomes easier for the baby to get any amniotic fluid out of the lungs (wet lungs), and breathing becomes more stable and regular.

CPAP has no side effects for the baby in the long term

CPAP can be given without adding oxygen, in many cases, only atmospheric air is provided. The small monitoring your baby has been wearing (a small LED that is typically placed around the foot) has measured the oxygen saturation in the baby's blood, and any supplementary oxygen has been dosed based on the values shown by the LED. There may have been a temporary need for extra oxygen, and the treatment does not have an impact on the baby in the long term.

If CPAP is needed for more than 2 hours

If the baby needs CPAP or oxygen (O₂) for more than 2 hours, they will be admitted to the Neonatal Unit for observation.

Often there are 2 symptoms that tell us that the baby needs CPAP:

• The baby "grunts" or has rapid breathing > 60 times per minute. The "grunt" is characterized by the appearance of a sound – a kind of squeaking – on the exhalation. The sound occurs when the baby presses the vocal cords together, thereby giving itself a slight excess pressure in the lungs. You could say that it is the body's own form of CPAP, but it is strenuous for the baby and therefore not a permanent solution. The sound tells you that the baby needs support for breathing. The sound can be confused with regular baby grunts/sounds, but if it is sustained and rhythmic, we support their breathing with CPAP.
• The baby's ribs stand out clearly. In addition, what are known as indentations under the ribs may occur, meaning that the ribs stand out clearly when the baby breathes. This shows that the baby is using auxiliary muscles to cope with breathing, and it can also show that they need CPAP.

Babies have an increased energy requirement

It is usually said that a newborn baby can survive by breastfeeding with its mother but if there have been complications or challenges right after birth, the baby may have become stressed and thus have an increased energy consumption in order to breathe. They may have therefore exhausted their sugar stores, so it may be necessary to ensure a stable blood sugar level through tube feeding.

Therefore, we give the baby formula via a small tube that goes directly into the stomach. This gives the baby extra energy without disturbing breastfeeding. It is often enough to give tube feeding once.

Blood tests give us a status

Before CPAP therapy is completed, the neonatal nurse will often take a blood test which can show whether your baby needs to be admitted to the neonatal unit. The blood test provides a status of the acid/base balance, which tells us how the baby's lungs are functioning. In the same sample, we also take a blood sugar level.

Based on the blood tests, we make a plan for whether your baby needs additional tube feeds or whether it is considered sufficient for the baby to be breastfed.

If you have any questions about the treatment, you are welcome to ask us.