Patient education: Brief resolved unexplained event (BRUE) in babies (The Basics)

What is a brief resolved unexplained event? — A "brief resolved unexplained event," or "BRUE," is an episode in which an otherwise healthy baby stops responding normally for a short time. After the episode, they recover completely. It is called "unexplained" because there is no known cause, and it is not related to a specific health problem.

During a BRUE, the baby has at least 1 of the following:

●Looks pale, blue, or gray

●Stops breathing, or breathes abnormally

●Seems very stiff or floppy

●Does not respond normally to things around them

The episode usually lasts less than a minute, then the baby returns to normal.

Seeing a baby have an episode like this can be very scary. But most of the time, when BRUE happens, it only happens once and does not lead to any long-term problems.

Is BRUE related to SIDS? — No. Having a BRUE does not increase a baby's risk of SIDS, which is when a baby dies suddenly for no known reason.

Should my baby see a doctor or nurse? — Yes. If a baby has an episode like this, see a doctor or nurse as soon as possible. They will try to figure out if it was a BRUE or if something specific caused the episode.

Does a BRUE mean that my baby has a serious problem? — Not necessarily. Most of the time, a baby who has a BRUE does not end up having a serious health problem. But your baby should see a doctor or nurse to check for possible causes.

In general, a baby is considered "low risk" for a serious problem if they:

●Are older than 2 months

●Were not born very premature (before 32 weeks of pregnancy)

●Only had 1 episode that lasted less than 1 minute

●Recovered completely and did not need CPR

●Have no known health issues, recent illness or injury, or problems on their physical exam

If the baby has any of the following, they will probably need to be monitored in the hospital:

●Another episode in the past, or a sibling who had an episode like this

●A known health condition

●Symptoms like fever, repeated vomiting, trouble breathing, or seeming very sick

●Was completely unconscious, or needed to be given CPR during the episode by someone with CPR training

In the hospital, the baby's breathing and heart rate can be monitored. This helps the doctors decide what to do next.

Is there a test for BRUE? — No, there is no specific test to tell if a baby had a BRUE. When a baby has an episode like this, the doctor will ask questions and do an exam. During the exam, they check lots of different things. These include the baby's appearance, breathing and heart rate, alertness, and reflexes.

Most healthy babies should not need specific tests, like blood or urine tests. But if the baby might have another problem, the doctor can do tests to learn more. For example, things like a respiratory infection, feeding problems, or a seizure can sometimes cause brief episodes similar to a BRUE.

How is BRUE treated? — If an episode was confirmed to be a BRUE, and the baby is "low risk," no treatment is needed.

The doctor will tell you what to do if the baby has another episode or any other problems.

What else should I know?

●There is no specific way to prevent a BRUE from happening. Most healthy babies who had a BRUE do not have another episode.

●In most cases, doctors do not recommend using home devices or machines that check a baby's breathing or heart rate during sleep. For babies with certain conditions, the doctor might prescribe a special monitor. If you want to buy some other type of monitor, talk to your baby's doctor first. Studies have shown that these do not prevent SIDS.

●It's a good idea for all parents and caregivers to learn how to do CPR on a baby or child. Most people never need to use it, but it's good to be prepared if there is ever an emergency. If you want to learn more about this, ask your baby's doctor for more information.

●Never shake a baby to try to get them to react or wake up. This can cause serious injury.

●Even though BRUE is not related to SIDS, it's still important to learn safe sleep habits to lower the risk of SIDS. This includes always putting your baby to bed on their back in their own crib or bassinet. Keep pillows, stuffed animals, blankets, and other soft objects out of the crib (figure 1). Do not smoke or let anyone smoke near your baby.

More on this topic

Patient education: CPR for children (The Basics)
Patient education: Sudden infant death syndrome (SIDS) (The Basics)

Patient education: Sudden infant death syndrome (SIDS) (Beyond the Basics)