Emily writes about "a one month old baby which has had three apnea episodes
where the baby has
stopped breathing and turned blue.  One of these occurred during a feed and
one two hours after a feed, the other I don’t know about."

The baby needs further testing. Wolf and Glass on Figure 4-5 page 171 call
for a history followed by a clinical feeding evaluation with a multichannel
pneumogram then move on to  videofluoroscopic swallowing study (VFSS) and/or
GER work-up and/or polysomnogram.  Depending on the results they might
diagnose central apnea, obstructive apnea, GER, structural problems or
swallowing disorders.  Treatment would vary depending on identified cause.

Without further testing they are just guessing about possible causes so
recommendations are based on guesses and may cause direct harm and/or
provide false sense of security.

Meanwhile mom should keep detailed records of when/if more episodes occur,
she (and anyone else who cares for the infant) should learn infant CPR.
Apnea monitoring would be a good idea - in case this happens during sleep
also.  Co-sleeping would be important but I'd be tempted to keep an adult
awake watching the baby until apnea monitoring could be started.

It is impossible to tell what these attacks are from without further
testing.  It sounds like the hospital believes it may be reflux based but if
so I don't think their advice about 3 hours feeds is good advice.  If it is
reflux, small and frequent feeds are better.  What might be a good plan
until they know the cause would be 2-3 hours on one side, then 2-3 hours on
the other.  But it is a shot in the dark.  They need to know why these
attacks are occurring.

Remind the mom how good it is that the baby is getting breastmilk.  Try to
help her keep it exclusive.  Aspirating rice or formula is much worse than
aspirating breastmilk (if that is what is happening)

Depending on local resources the parents may have to travel to get needed
testing.  They may need to argue and be assertive about the need for it.

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