Which of the following is a non-pharmacologic management technique to treat apnea in the preterm infant?

• A. Maintaining the head in neutral position
• B. Providing tactile stimulation
• C. Initiating caffeine citrate therapy
• D. Applying nasal CPAP

Answer: (A)

Keeping the head in a neutral position focuses on preventing airway obstruction, a common mechanical contributor to apnea in preterm infants. When the head is malpositioned or flexed, the airway can narrow or collapse more easily, triggering obstructive or mixed apnea. A neutral head position helps keep the airway aligned, supports consistent breathing, and can reduce the frequency of apnea episodes without involving drugs or devices.

Tactile stimulation can wake breathing during an episode, but it’s an episodic trigger rather than a preventive measure. Caffeine citrate is pharmacologic and works by stimulating breathing drive. Nasal CPAP provides airway pressure support, which is effective but involves equipment and monitoring beyond a simple positioning technique.