Worldwide Shortage of CPAP Therapy for Premature Infants

According to the World Health Organization (WHO) there are an estimated 15 million babies around the world who are born preterm every year and this number is rising. More alarming is that a large number of hospitals don’t have the necessary oxygen therapy needed for these premature babies. Last year, CPAP.com was confronted with this reality when Sam Houston State University and the Huntsville Rotary Club reached out to our CEO, Johnny Goodman, for help at a hospital located in León, Nicaragua. They had no CPAP machines for babies or oxygen therapy for infants. Immediately we jumped at the chance to help and provided them with CPAP machines, infant nasal prongs, CPAP heated hoses, CPAP humidifiers and supplies that were needed for the CPAP equipment. Our thoughts around this issue are best reflected in our CEO’s own words:

Johnny Goodman, CEO of CPAP.com So we wondered, how many other hospitals are in need of CPAP equipment for premature babies and what other charities are out there to help? But before we could get the answers to these questions, first we needed to take a step back and understand what happens to a premature infants respiratory system when they are born and what equipment do they need?

According to the March of Dimes, some respiratory problems that may affect premature babies include:

• Apnea. A pause in breathing for 20 seconds or more. Premature babies sometimes have apnea and it may happen together with a slow heart rate.
• Respiratory distress syndrome (RDS). A breathing problem most common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have the protein surfactant that keeps small air sacs in the lungs from collapsing.
• Patent ductus arteriosis (PDA). This is a heart problem that happens in the connection (called the ductus ateriosus) between two major blood vessels near the heart. If the ductus doesn’t close properly after birth, a baby can have breathing problems or heart failure.

Standard clinical care for Apnea of Prematurity (AOP), usually includes infant nasal prong positioning and CPAP treatment to prevent the airway from collapsing. AOP is a developmental disorder that self-resolves in most cases.

All hospitals operate a little differently but this is typically the equipment they may use when treating respiratory problems in premature infants.

• Ambient oxygen analyser: This small appliance sits inside the incubator and measures the amount of oxygen in the air.
• CPAP machine: This machine delivers air to a baby’s lungs either through small tubes in the baby’s nose or through a tube that has been inserted into her windpipe and attached to the machine to help babies breathe but does not breathe for them.
  • The steady flow of air coming in through the tubes keeps enough pressure in their lungs to prevent the air sacs from collapsing after each breath.
• Infant CPAP Mask: Short prongs or a mask that is positioned by the nose to allow air (or oxygen) to enter the babies lungs.
• Ventilator: A breathing machine that delivers warm humidified air to a baby’s lungs. The mechanical ventilator temporarily breathes for babies while their lungs recover.
• Nasal Prong Oxygen: A pair of small prongs is used to deliver extra oxygen through the nostrils in infants. This option is used when the baby does not need pressure to keep the lungs open but needs a little extra oxygen to maintain sufficiently high oxygen levels in the bloodstream.

We have gathered three organizations that seek to provide resources to hospitals and families in need.

Every year, 2.6 million babies die before turning one month old. One million of them take their first and last breaths on the day they are born. Another 2.6 million are stillborn. Each of these deaths is a tragedy, especially because the vast majority are preventable. More than 80% of newborn deaths are the result of premature birth, complications during labor and delivery and infections such as sepsis, meningitis and pneumonia.

Nearly 5.6 million children die each year due to preventable and treatable causes, including 1 million babies who die on the day they are born. Save the Children is committed to improving maternal, newborn and child health by providing effective children’s health and nutrition programs that save children's lives.

ChildFund supports healthy pregnancies and safe deliveries both as a woman’s right and a prerequisite to a child’s strong start in life. We view the availability and quality of prenatal and birth services as a reflection of the value that society accords to women and children.

As technology progresses, big companies step up to bring advanced innovation to impoverished hospitals. Here are some of these top innovations: GE Healthcare created the Lullaby baby-warmer, to help regulate a premature baby’s body temperature as soon as they are born. Which is very important because a baby's body temperature drops as soon as they are outside the mother's womb and premature infants have very little body fat. Another new innovation is called the Embrace and was developed from a class assignment at Stanford's Institute of Design in 2007. This product helps women in villages who give birth at home and have little access to basic healthcare or electricity. For these women, keeping babies warm means wrapping them in layers of fabric and hot water bottles, or putting them under bare light bulbs. The Stanford Design class created a sleeping bag with a removable heating element. The product is not sold, but is donated to impoverished communities in need. The invention has now helped over 200,000 babies across 20 countries. You can find out more by visiting the Embrace website.

At CPAP.com we pride ourselves in all the choices and options we provide for patients diagnosed with Sleep Apnea. Sometimes we need to take a step back and remember that millions around the world don’t have access to any life-saving CPAP equipment. We were humbled and glad to help when the Rotary Club and Sam Houston State reached out to us and in the end, we realized that we want to do more. Lots can be done to help premature infants in developing countries and areas with little access to healthcare resources. Join us in helping other impoverished areas around the world by donating to one of the charities mentioned in this article. Or maybe you have a favorite charity that helps premature infants around the world, if so please mention it in the comments. We would love to hear about it.