A 2-day-old boy born without complication at 38 weeks’ gestation to a healthy mother via spontaneous vaginal delivery presented to the emergency department with 2 episodes of apnea and cyanosis after discharge from the newborn nursery. One episode had occurred during breastfeeding, and the other hours after feeding. Of note, his mother reported that a similar cyanotic event had occurred hours after the patient’s birth and improved with suctioning. In the newborn nursery he was noted to have some coughing with feeds but ultimately was deemed appropriate for discharge from the nursery without further evaluation.

On admission to the general pediatrics ward the patient continued to have episodic cyanosis and desaturations. The episodes each lasted a few minutes and seemed to resolve with suctioning of the airway. The events were often associated with oral intake but also occurred during periods of rest. Between episodes, the patient’s vital signs were within...

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