A full-term pregnancy lasts 40 weeks. This gives the fetus time to grow. At 40 weeks, the organs are usually fully developed. If a baby is born too early, the lungs may not be fully developed, and they may not function properly. Healthy lungs are crucial for overall health.
Neonatal respiratory distress syndrome, or neonatal RDS, may occur if the lungs aren’t fully developed, It is typically seen in premature babies.. Infants with neonatal RDS have difficulty breathing normally.
Neonatal RDS is also known as hyaline membrane disease and infant respiratory distress syndrome.
Surfactant is a substance that enables the lungs to expand and contract. It also keeps air sacs open. Premature infants lack surfactant. This can cause lung problems and trouble breathing.
RDS may also occur because of a developmental problem linked to genetics.
The lungs and lung function develop in utero. The earlier an infant is born, the higher the risk of RDS. Infants born before 28 weeks gestation are especially at risk. Other risk factors include:
- sibling with RDS
- multiple pregnancy (twins, triplets)
- impaired blood flow to the baby during delivery
- delivery by C-section
- maternal diabetes
An infant will typically display signs of RDS shortly after birth. However, sometimes symptoms develop within the first 24 hours after birth. Symptoms to watch for include:
- bluish tint to skin
- flaring of nostrils
- rapid or shallow breathing
- reduced urine output
- grunting while breathing
If RDS is suspected, lab tests are used to rule out infections that could cause breathing problems. A chest X-ray will be done to examine the lungs. A blood gas analysis will check oxygen levels.
When an infant is born with RDS and symptoms are immediately apparent, the infant is usually taken to a neonatal intensive care unit (NICU).
The three main treatments for RDS are:
- surfactant replacement therapy
- a ventilator or nasal continuous positive airway pressure machine
- oxygen therapy
Surfactant replacement therapy administers the surfactant an infant is lacking. It is delivered through a breathing tube. This ensures it goes into the lungs. After surfactant is given, the infant will be connected to a ventilator. This provides extra breathing support. The procedure may be repeated several times. It depends on the severity of the RDS.
A ventilator may be used alone for breathing support. A tube goes into the windpipe. The ventilator then breathes for the infant. A less invasive breathing support option is a nasal continuous positive airway pressure (NCPAP) machine. This administers oxygen through the nostrils.
Oxygen therapy delivers oxygen to the infant’s organs. Without adequate oxygen, the organs do not function properly. Oxygen can be administered through a ventilator or NCPAP.
Preventing premature delivery lowers the risk of neonatal RDS. To reduce the risk of premature delivery, get consistent prenatal care throughout pregnancy and avoid smoking, illicit drugs, and alcohol.
If a premature delivery is likely, corticosteroids are given to the mother. These drugs promote faster lung development.
An infant born with RDS may get worse over the first few days of life. RDS can be fatal. There may also be long-term complications either because too much oxygen was given or because organs lacked oxygen. Complications can include:
- air buildup in the sac around heart, or around the lungs
- mental retardation
- blood clots
- bleeding into the brain or lungs
- bronchopulmonary dysplasia, a breathing disorder
- collapsed lung
- blood infection
- kidney failure, in severe RDS
Talk with your doctor about the risk of complications. They depend on the severity of your infant’s RDS. Each infant is different. These are simply possible complications— they might not occur at all. Your doctor can also connect you to a support group or counselor. This can help with the emotional stress of dealing with a premature infant.