Chronic Lung Disease in Premature Babies
Chronic lung disease is the
general term for long-term breathing problems in premature babies. It is also called
bronchopulmonary dysplasia (BPD).
Premature babies may need a
breathing machine (ventilator) and extra oxygen to breathe. Chronic lung disease
happens when a breathing machine or oxygen injures a premature baby’s lungs. The
lungs of premature babies are very fragile. They can be damaged easily.
With a lung injury, the tissues
inside your baby’s lungs get inflamed. The tissue can break down, causing scarring.
The scarring can cause trouble breathing, and your baby may need more oxygen. Lung
injury may be caused by:
Prematurity. A premature baby’s lungs aren’t fully formed. The
air sacs are the least developed.
amounts of surfactant.
This is a substance in the lungs that
helps keep the tiny air sacs open.
High amounts of oxygen can harm the cells in the
Breathing machine (mechanical ventilation). Air pressure can
harm the lungs. This pressure may come from breathing machines, suctioning of
the airways, and use of an endotracheal (ET) tube. An ET tube is a tube placed
in your baby’s windpipe (trachea) and connected to a breathing machine.
Chronic lung disease can happen
in premature babies who have used a breathing machine. These things may make it more
likely for a baby to have chronic lung disease:
How early the baby was
Babies born earlier than week 30 in pregnancy are at
Low birth weight.
A baby who weighs less than 2 pounds (less than 1,000 grams) at birth is at
This is a lung disease caused by a lack of
This happens when air leaks out of the
airways. It leaks into the spaces between the small air sacs of the lungs.
Patent ductus arteriosus
This condition occurs when a connection between the
blood vessels of the heart and lungs doesn’t close as it should after
Race and sex.
Premature white male babies have the greatest risk for chronic lung
If a woman has an infection called chorioamnionitis
during pregnancy, her baby is at a higher risk for chronic lung disease.
Heredity. A family
history of asthma can put a baby at higher risk.
Getting an infection during or soon after birth.
Symptoms can occur a bit differently in each child. They can
This includes fast breathing, flaring nostrils, grunting,
and sucking in of the chest (chest retractions).
help breathing for a longer period of time.
Some babies may
still need a breathing machine or oxygen after they reach an adjusted age of 36
The symptoms of chronic lung
disease may seem like symptoms of other conditions. Make sure your child sees their
healthcare provider for a diagnosis.
Chronic lung disease comes on
slowly. Your child’s healthcare provider may look at several factors. It may be
diagnosed when a premature baby with breathing problems still needs oxygen after
reaching 28 days of age.
Your child’s healthcare provider
may also do tests to confirm chronic lung disease. These can include:
Chest X-rays. A
healthcare provider may compare your child’s current chest X-rays with older
chest X-rays. If your child has chronic lung disease, their lungs may have a
bubbly, sponge-like appearance.
Blood tests. These
tests will show if there’s enough oxygen in your child’s blood.
echo uses sound waves to make a moving picture of the heart. This test can rule
out heart defects as a cause of breathing or oxygen problems.
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe your
child’s condition is. Treatment may include:
Extra oxygen. This
will make up for the decreased breathing ability of your child’s lungs. Your
child’s healthcare provider may also use a pulse oximeter. This device measures
how much oxygen is in your child’s blood.
Slowly weaning from the
As your baby's lungs grow, they can do more
of the work of breathing.
Surfactant is inserted into a tube placed in the
child’s provider may give them these medicines:
- Bronchodilators to open
- Steroids to reduce
- Diuretics to reduce
extra fluid in the lungs
- Antibiotics to fight an
IV (intravenous) fluids and
This will help your baby and their lungs grow. Your
child’s provider will watch your child’s fluid intake. Extra fluid can build up
in your child’s lungs. This can make it harder to breathe.
Radiant warmers or
These machines are used to keep a baby warm. They
can also lower the risk for an infection.
can reduce the risk for lung infections. These include the flu (influenza) and
respiratory syncytial virus (RSV).
Chronic lung disease can be a
long-term issue. Some babies need breathing machines for several months. Some babies
need oxygen when they go home from the hospital. But most babies wean off oxygen by
the end of their first year. Babies with this condition may have a higher risk for
lung infections. Some may even need to stay in the hospital again.
Having a healthy pregnancy may
keep your baby from being born before their lungs are fully formed. Not all causes
of premature births can be prevented. But you can increase the chance of having a
healthy pregnancy by:
- Keeping up with your prenatal
- Eating a healthy diet
- Not smoking, and staying away from
- Not using alcohol or illegal
- Preventing infections
- Taking care of any chronic health
problems you have
If it looks like your baby may
be born early, your healthcare provider may give you a shot (injection) of
medicine called betamethasone. This corticosteroid medicine can help your baby’s
lungs mature before they are born.
- Chronic lung disease is a general
term for long-term breathing problems in premature babies.
- This condition happens when a
breathing machine or oxygen injures your premature baby’s lungs.
- Symptoms include having trouble
breathing and needing oxygen after a premature baby reaches an adjusted age of
36 weeks' gestation.
- Treatment may include extra
oxygen, a breathing machine, and surfactant replacement.
- Most babies can be weaned off
oxygen by the end of their first year.
Tips to help you get the most
from a visit to your child’s healthcare provider:
- Know the reason for the visit and
what you want to happen.
- Before your visit, write down
questions you want answered.
- At the visit, write down the name
of a new diagnosis and any new medicines, treatments, or tests. Also write down
any new instructions your provider gives you for your child.
- Know why a new medicine or
treatment is prescribed and how it will help your child. Also know what the side
- Ask if your child’s condition can
be treated in other ways.
- Know why a test or procedure is
recommended and what the results could mean.
- Know what to expect if your child
does not take the medicine or have the test or procedure.
- If your child has a follow-up
appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your
child’s provider after office hours. This is important if your child becomes ill
and you have questions or need advice.