How is apnea defined in newborns?

• A. Respiratory pause greater than 20 seconds
• B. Breathing rate less than 20 breaths per minute
• C. No heartbeat
• D. Clinical signs of cyanosis

Answer: (A)

Apnea in newborns means a pause in breathing that is truly significant. The standard definition used in exams and clinical practice is a respiratory pause lasting 20 seconds or longer. Shorter pauses can occur normally as periodic breathing in healthy infants and don’t constitute apnea. So a pause greater than 20 seconds best captures the concept being tested.

Bradypnea, which is a slower-than-normal breathing rate (less than about 20 breaths per minute for newborns), isn’t the same as an actual pause in breathing. No heartbeat describes cardiac arrest, not apnea. Cyanosis indicates low oxygen but doesn’t define a breathing pause by itself.