Apnea (Pauses in Breathing) in Babies
Content reviewed against published AAP, AAP, NIH guidelines
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Apnea refers to a pause in breathing lasting more than 20 seconds, or a shorter pause accompanied by color change (blue or pale), limpness, or a drop in heart rate (bradycardia). Brief pauses of 5-10 seconds in breathing are normal in newborns (periodic breathing), but true apnea is always abnormal and requires medical evaluation. Apnea of prematurity is the most common type, affecting premature infants whose brainstem respiratory control is immature. In term infants, apnea can signal infection, airway obstruction, reflux, seizures, or other serious conditions.
Key takeaways
- Apnea refers to a pause in breathing lasting more than 20 seconds, or a shorter pause accompanied by color change (blue or pale), limpness, or a drop in heart rate (bradycardia).
- Most common cause: Apnea of prematurity (immature respiratory control)
- Emergency: Any apneic episode with color change (blue, gray, pale) or limpness
- Home care: There are no home remedies for true apnea — it always requires medical evaluation
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Any apneic episode with color change (blue, gray, pale) or limpness
- Breathing pause requiring stimulation or resuscitation to restart
- Apnea in a term newborn (always requires emergency evaluation)
- Apnea with seizure activity
- Recurrent apnea episodes in an infant
- Apnea with bradycardia (slow heart rate) or desaturation
Urgent — See doctor today:
- First-time apnea episode in any infant — even if baby appeared to recover
- Apnea during an illness (even if brief)
- Former premature infant with recurrence of apnea after it had resolved
- Witnessed apnea with pale color that self-resolved — still needs same-day or urgent evaluation
Same-day appointment:
- Suspected obstructive sleep apnea (loud snoring with pauses observed by parents)
- Parental concern about breathing patterns during sleep in a healthy baby — evaluation provides reassurance
Monitor at home:
- Normal periodic breathing in healthy newborn (5-10 second pauses with immediate self-resolution)
- Known breath-holding spells in a toddler (diagnosed by doctor, typical pattern)
- Premature infant on apnea monitor with no alarms and nearing discharge criteria
By Age
0-2 months (premature)
Normal: Periodic breathing (clusters of breaths with 5-10 second pauses, then breathing resumes) is normal in preterm infants and resolves by 43-44 weeks corrected gestational age.
Worry if: Pauses lasting more than 20 seconds. Any breathing pause with color change (blue, pale, or gray). Pauses requiring stimulation to restart breathing. Pauses associated with bradycardia or limpness.
0-2 months (term)
Normal: Periodic breathing with brief 5-10 second pauses is normal in healthy term newborns, especially during sleep. Baby should pink up immediately and resume regular breathing.
Worry if: Any apneic episode in a term infant is abnormal and requires urgent evaluation. True apnea (more than 20 seconds or with color change) in a term newborn may indicate sepsis, metabolic disease, or cardiac problem.
2-12 months
Normal: Apnea of prematurity should have resolved by this age (by 43-44 weeks corrected age). Brief breath-holding spells (triggered by crying or pain) may begin around 6 months.
Worry if: Any new apnea after apnea of prematurity has resolved. Apnea during illness (RSV or pertussis can present with apnea). Apnea occurring during sleep without known cause (apparent life-threatening event / BRUE).
1-3 years
Normal: Breath-holding spells (triggered by pain, frustration, or crying) are common and benign despite appearing frightening. Child resumes breathing spontaneously.
Worry if: Apnea during sleep with snoring and observed pauses (obstructive sleep apnea). Apnea not triggered by crying/emotion. Apnea with seizure activity. Apnea causing loss of consciousness beyond typical breath-holding spell.
Home Care
- There are no home remedies for true apnea — it always requires medical evaluation
- Learn infant CPR — all parents of babies at risk for apnea should be trained
- For premature infants discharged on monitors: follow all monitoring protocols exactly
- Place baby on back to sleep on a firm, flat surface (reduces SIDS risk)
- Avoid overheating, loose bedding, or soft objects in sleep area
- For diagnosed breath-holding spells in toddlers: lay child on side, do NOT shake or put water on face
- Keep baby in parents' room (but not same bed) for at least first 6 months
- If you witness apnea: stimulate gently by flicking feet or rubbing back. Call 911 if breathing does not restart immediately
- Do NOT use home apnea monitors as a substitute for medical evaluation of a concerning event
Frequently asked questions
What causes apnea (pauses in breathing)?
When is this an emergency?
What can I do at home?
When should I call the doctor?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of apnea (pauses in breathing) in babies are not emergencies. However, seek immediate care if any apneic episode with color change (blue, gray, pale) or limpness.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.