Bubble CPAP

Infant mortality is a serious concern across Sub-Saharan Africa, due to lack of availability of prenatal care, access to medical facilities for delivery, and follow-up care to measure growth and provide vaccinations.  In Kenya, the infant mortality rate decreased to 39 deaths per 1,000 live births in 2014 from 52 in 2008-09. Similarly, the under-five mortality rate decreased to 52 deaths per 1,000 live births in 2014 from 74 in 2008-09.  AIC Kijabe provides prenatal screenings and ultrasound, maternity services for vaginal and c-section delivery, and encourages regular growth checkups.  In addition AIC Kijabe is involved in Community Health Worker training – empowering community volunteers to recognize warning signs in pregnancy and infancy.

While the infant mortality rate in general is improving, low birth weight associated with prematurity still poses huge risks.  The Newborn Intensive Care Unit at Kijabe has a 50% mortality rate for babies born under 1000 grams compared with an >80% mortality rate nationwide.  This is likely due to multiple factors, but one is a technique called Bubble CPAP.


Extremely premature babies commonly have underdeveloped lungs, which need assistance to provide oxygen to the body.  Bubble CPAP (Continuous Positive Airway Pressure), provides oxygen to the patient through nasal prongs, and then positive pressure is used to keep the lungs inflated.  The method of achieving positive pressure is the brilliantly simple aspect of bubble CPAP – the expiratory tube is placed underwater and the depth of the tube determines the pressure in the infant’s lungs.  For example a tube 2 cm deep underwater creates 2 cm of positive pressure.

To understand how it works, exhale through a drinking straw – first into the air, and then into a cup of liquid to create bubbles.  As it is much harder to create bubbles underwater, you can feel how the machine works to keep the flow of oxygen in the infant’s lungs.


Research study continues as we work to improve care for our neonates and all of our patients.  Please keep our doctors and nurses in your prayers as we seek to provide world class health care amidst limited resources.

Additional Reading:

Study of 2006 NICU data at Moi Hospital

Childhood Mortality Rates for Kenya

Bubble CPAP study