A 7-day-old term baby girl presented to her local A&E with a brief history of poor feeding associated with breathing pauses (apnoeas). She was hypothermic (skin temperature 34.9°C) and had a mixed metabolic and respiratory acidosis pH 7.21, pCO2 8.8 Kpa on a venous gas with a lactate level of 4.5 mmol/L. Heart rate and blood pressure were within normal limits and there were no signs of respiratory distress. Although saturations were difficult to measure due to temperature, the baby appeared pink in between apnoeic pauses.