A preterm baby’s lungsLung Development and Infant Breathing Disorders »
- Caucasian race
- male sex
- family history
- maternal diabetes
Treatment for RDSFortunately, surfactant is now artificially produced and can be given to babies if doctors suspect they are not yet making surfactant on their own. Most of these babies also need extra oxygen and support from a ventilator.
Treatment for pneumoniaBabies with pneumonia often need to be treated with an increased amount of oxygen or even mechanical ventilation (a breathing machine), in addition to antibiotics.
- The baby “forgets” to breathe, simply because the nervous system is immature. This is called central apnea.
- The baby tries to breathe, but the airway collapses. Air can’t flow in and out of the lungs. This is called obstructive apnea.
Treatment for apnea of prematurityCentral apnea can be treated with a medication called aminophylline, or with caffeine. Both of these drugs stimulate the baby’s immature respiratory system and reduce the number of episodes of apnea. If they don’t, or if the episodes are severe enough to require the staff to frequently stimulate the baby’s breathing with a bag and mask, the baby may need to be put on a ventilator. This will be the case until the nervous system matures. Babies with purely obstructive apnea often need to be connected to a ventilator through an endotracheal tube to keep the airways open. Apnea of prematurity usually resolves by the time a baby is 40 to 44 weeks of age. This includes the number of weeks of pregnancy plus the number of weeks since the baby’s birth. Sometimes, it’s resolved as early as 34 to 35 weeks. But occasionally, apnea persists and the baby requires long-term therapy. Parents may need to give their baby aminophylline or caffeine, and use an apnea monitor at home. In that case, parents are trained to use the monitor and to give CPR to stimulate breathing. Babies are not sent home on a monitor unless they are otherwise stable and are having only rare episodes of apnea in a 24-hour period.
PneumothoraxBabies with RDS sometimes develop a complication known as a pneumothorax, or collapsed lung. A pneumothorax can also develop in the absence of RDS. This condition develops when a small air sac in the lung ruptures. Air escapes from the lung into a space between the lung and the chest wall. If a large amount of air accumulates, the lungs can’t expand adequately. The pneumothorax can be drained by inserting a small needle into the chest. If the pneumothorax accumulates again after being drained with a needle, a chest tube can be inserted between the ribs. The chest tube is connected to a suction device. It continuously removes any air that has accumulated until the small hole in the lung heals.
Bronchopulmonary dysplasiaAnother complication of RDS is bronchopulmonary dysplasia (BPD). This is a chronic lung disease caused by injury to the lungs. BPD occurs in about 25 to 30 percent of babies who are born before 28 weeks and weigh less than 2.2 pounds. It’s most common in very premature babies born between 24 and 26 weeks. The underlying cause of BPD is not well-understood. But it usually occurs in babies who are on ventilators and/or receiving oxygen. For this reason, doctors think that these treatments, while necessary, may injure a baby’s immature lung tissue. Unfortunately, BPD, in turn, can cause a baby to require continued oxygen therapy and ventilator support. When a baby is 3 to 4 weeks old, doctors sometimes use diuretic medications and inhaled medication. These can help wean a baby from the ventilator and reduce the need for oxygen. In the past, doctors frequently used steroid medications to treat BPD. But because the use of steroids has been linked to later developmental problems like cerebral palsy, doctors now use steroids in only the most severe cases. While BPD tends to improve as babies grow, it’s not unusual for babies with BPD to continue to receive diuretic therapy and/or oxygen at home for several months. Premature Birth Complications »
- the type of lung problem they have
- the severity of symptoms
- their age
- don’t smoke
- don’t use illicit drugs
- don’t drink alcohol
- eat a healthy diet
- talk to your doctor about getting good prenatal care