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.
use. 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:
early the baby was born. Babies born earlier than week 30 in
pregnancy are at greater risk.
birth weight. A baby who weighs less than 2 pounds (less than
1,000 grams) at birth is at higher risk.
respiratory distress. This is a lung disease caused by a lack
Pulmonary interstitial emphysema (PIE). This happens when air
leaks out of the airways. It leaks into the spaces between the small air sacs of
ductus arteriosus (PDA). This condition occurs when a
connection between the blood vessels of the heart and lungs doesn’t close as it
should after birth.
and sex. Premature white male babies have the greatest risk for
chronic lung disease.
Maternal womb infection. If a woman has an infection called
chorioamnionitis during pregnancy, her baby is at a higher risk for chronic lung
Heredity. A family history of asthma can put a baby at higher
Infection. Getting an infection during or soon after
Symptoms can occur a bit differently in each child. They can
Respiratory distress. This includes fast breathing, flaring
nostrils, grunting, and sucking in 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 his or
her 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:
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,
his or her lungs may have a bubbly, sponge-like appearance.
tests. These tests will show if there’s enough oxygen in your
Echocardiogram. An 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:
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.
weaning from the breathing machine. As your baby's lungs grow,
they can do more of the work of breathing.
Surfactant replacement therapy.Surfactant is inserted into a tube placed in the baby’s windpipe.
Medicines. Your child’s provider may give him or her these
- Bronchodilators to open
- Steroids to reduce
- Diuretics to reduce
extra fluid in the lungs
- Antibiotics to fight an
(intravenous) fluids and nutrition. This will help your baby
and his or her 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
warmers or incubators. These machines are used to keep a baby
warm. They can also lower the risk for an infection.
Vaccines. These 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 his or her 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 using 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 he or she is 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.