What is Bronchopulmonary Dysplasia (BPD)
Bronchopulmonary dysplasia is a lung disease that occurs in newborns or infants who need oxygen therapy. BPD affects the development of lung tissue. This condition causes breathing problems.
BPD usually affects infants who are born prematurely or experience breathing problems shortly after birth. This condition usually occurs during the first weeks after birth but can sometimes last longer. It is a serious condition that can require intensive medical care.
What are the causes?
This condition is caused by:
- Problems with lung development in premature infants. The lungs of a premature newborn are less developed and are at greater risk for damage from the environment.
- Damage to the lungs. The oxygen treatments that premature infants receive can damage the lungs. High levels of oxygen from ventilators or breathing tubes can irritate the lungs, causing inflammation, scarring, and reduced growth of blood vessels and air sacs (alveoli).
- Infections. Infections may cause damage to your baby’s lungs.
What increases the risk?
Your baby is more likely to develop this condition if:
- He or she was born prematurely.
- He or she had a severe illness as a newborn and required treatment with oxygen or a ventilator.
- He or she had an infection.
- There is a family history of BPD.
What are the signs or symptoms?
Symptoms of this condition include:
- Rapid, difficult breathing.
- Bluish skin and bluish mucous membranes, such as the linings of the mouth, nose, and eyelids.
- Coughing.
- Grunting sounds.
- Widening of the nostrils (nasal flaring).
How is this diagnosed?
Your baby’s health care provider may suspect BPD if your baby has an ongoing need for oxygen after he or she is born. Your baby may also have other tests to confirm the diagnosis. The tests may include:
- Chest X-ray.
- Test of blood gases.
- Chest CT scan.
- Echocardiogram. This is a test that uses sound waves to take pictures of the heart for examination. It is used to check for other conditions that could be causing your baby’s breathing problems.
How is this treated?
There is no cure for BPD. Treatment will focus on supporting the breathing and oxygen needs of your baby. Treatment usually occurs in a newborn intensive care unit (NICU) of a hospital until your baby is able to breathe well enough on his or her own. This can take several weeks. Treatment may include:
- Oxygen therapy. This may be continued by mask or nasal tube for several weeks or months.
- Use of a breathing machine (mechanical ventilator) to provide breathing help. A ventilator is a device that keeps the lungs blown up and helps the newborn to breathe in and out. Your baby will gradually be taken off (weaned) from the ventilator.
- Use of a continuous positive airway pressure (CPAP) machine to help keep the lungs blown up (inflated) and help your baby breathe.
- Feeding through tubes that are inserted into the stomach. Extra calories are needed because of the effort of breathing. Fluids may be limited (fluid restriction) to reduce fluid buildup in the lungs. Your baby may be given medicines that remove water from the body (diuretics) to prevent the lungs from filling with fluid.
- Other
medicines, such as:
- Corticosteroids. These will decrease inflammation in the lungs.
- Bronchodilators. These will relax the muscles of the airways.
- Surfactants. These will lower the surface tension of the lung.
- Even after leaving the hospital, your baby may require continued medicine, breathing treatments, or oxygen at home.
Follow these instructions at home:
It will take time for your baby’s lungs to strengthen even after he or she is healthy enough to leave the hospital.
Medicines
- Give your baby over-the-counter and prescription medicines only as told by his or her health care provider.
- If your baby was prescribed an antibiotic medicine, give it to him or her as told by the health care provider. Do not stop giving your baby the antibiotic even if he or she starts to feel better.
- Give your baby breathing treatments and additional (supplemental) oxygen exactly as instructed by your baby’s health care provider.
General instructions
- Keep your baby away from anyone who is ill with an infection in the lungs or airways (respiratory infection).
- Do notexpose your baby to any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you smoke and you need help quitting, ask your health care provider.
- Wash your hands with soap and water before taking care of your baby. If you cannot use soap and water, use hand sanitizer.
- Keep your baby’s sleep area clean and safe. Do notlet your baby sleep on his or her tummy (abdomen). Do not put soft objects or loose bedding (such as pillows, bumper pads, blankets, or stuffed animals) in the crib or bassinet. These objects can suffocate your baby.
- Keep all follow-up visits with your baby’s health care provider. This is important.
Follow recommendations from your health care provider about immunizations for your baby and family members who are around your baby.
Contact a health care provider if:
- Your baby has difficulty with feeding or is not gaining weight.
- You have concerns about your baby’s development.
Get help right away if:
- Your baby has a fever.
- Your baby is breathing faster than usual.
- You notice that the spaces between or under your baby’s ribs pull in when your baby breathes in.
- Your baby is short of breath or makes a grunting sound when breathing out.
- You notice nasal flaring with each breath.
- Your baby makes a high-pitched whistling noise when breathing out or in (wheezing orstridor).
- Your baby coughs up blood.
- You notice any bluish discoloration of your baby’s lips, face, or nails.
Summary
- Bronchopulmonary dysplasia (BPD) is a lung disease that occurs in newborns or infants who need oxygen therapy.
- Bronchopulmonary dysplasia is a serious condition that can require intensive medical care.
- Treatment will focus on supporting your baby’s breathing and oxygen needs.
