Reviewed By: Pramod Kerkar, MD, FFARCSI

Does your little one grasp for air and turn blue frequently? Do you know that your baby could be suffering from bradycardia? Bradycardia is defined as a heart rate that is below the lowest normal value for a particular age. Learn about the causes of bradycardia in newborns, diagnosis and treatment.

About Bradycardia in Newborns:

Bradycardia in newborn is characterized by slowing down of the heart rate to below 100 beats per minute. Newborns, especially premature babies, commonly suffer from bradycardia, which can be accompanied with interruption in breathing. These pauses are termed as apnea. Such pauses in breathing mechanism last for a few seconds making the baby gasp for air. The lack of oxygen during this period generally makes the baby turn pale or blue. One of the main causes of bradycardia is hypoxia and there are many other triggering factors. Bradycardia is treated with medicines, which stimulate breathing and regularize heart beats. Pediatric bradycardia generally manifests as junctional bradycardia, sinus bradycardia, or atrioventricular block.

Bradycardia in Newborns

What Causes Bradycardia in Newborns?

Bradycardia in newborns can be triggered by intrinsic dysfunction of or damage to the conduction system of the heart, or by extrinsic factors influencing normal heart. Both intrinsic and extrinsic factors can impact any area of the heart’s conduction system.

One of the main causes of bradycardia is hypoxia. There are several other triggers like hypothermia, infections, hypovolemia, brain injury, that too can act as cause of bradycardia in newborns.

Generally, infants and newborns suffering from bradycardia also have accompanied apnea. This is more common in premature neonates. However, prematurity is not the sole reason for this illness. Some of the other causes of bradycardia in newborns can be conditions like low blood sugar, infection, insufficient oxygen in the body, etc.

In preterm, the main causes of bradycardia in newborns include the following,

  • Firstly, in premature babies, the nervous system is not completely developed and so the region in the brain that controls respiration does not function fully. Thus the baby may experience shallow or pauses in breathing.
  • Secondly, babies with low birth weight, especially ones weighing less than 5.5 pounds, have certain amount of apnea and can also lead to associated bradycardia.

In case of full term babies, some of the common causes of bradycardia in newborns include low body temperature, low blood sugar, serious infections, gastric reflux, obstruction in airway passage, enterocolitis, lung collapse, hole in the heart, increased intracranial pressure and drug addiction by expecting mothers. Further, even fluid accumulation in the brain, bleeding inside the brain due to injury and seizures can sometimes cause bradycardia in full-term babies.

How is Bradycardia in Newborns Diagnosed?

Diagnosis of bradycardia in newborns is done by clinical evaluation and monitoring. A newborn with a persistent heart rate of less than 90 beat per minute needs to be assessed for potential bradycardia. The doctor would need to enquire about the medical history of the child which even includes aspects like any illnesses suffered and the drugs taken by their mother during pregnancy, details of labor period etc.

They would also need to conduct an ECG test and keep the patient under 24-hour of monitoring. These details and results of examination help to make a diagnosis of bradycardia in newborns. Early diagnosis and appropriate management play in vital role in preventing sudden fatality in many cases.

What is the Treatment of Bradycardia in Newborns?

Treatment of bradycardia in newborns and eventual prognosis greatly depends upon the underlying cause. This illness is treated through administration of drugs like caffeine and theophylline which help to stimulate breathing and correct the heart rate. Along with medication, gently stroking the infant’s back and feet can also help to stimulate breathing. Mechanical ventilation using a breathing machine or CPAP may also be required to maintain correct the heart rate to treat apnea and aid the treatment of bradycardia in newborns.

Conclusion

Early diagnosis and treatment of bradycardia in newborns is essential to prevent long term damage, developmental problems and fatality in infants. While the causes of bradycardia in newborns are many, with proper approach, the exact cause can be detected and treated in time. These children should be given appropriate care to ensure that they grow up to live a normal, healthy and happy life.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: October 5, 2018

This article does not provide medical advice. See disclaimer

Sign Up for Our Newsletter

We'll help you live each day to the healthiest