When babies are born prematurely, oftentimes they need help breathing. That’s because their lungs still need to grow and develop.
One health condition that may come up with premature babies is called bronchopulmonary dysplasia (BPD). It may also be called chronic lung disease of prematurity. It means your baby’s lungs need a little more time, and a lot of support, to help them get stronger.
Here’s what parents should know about BPD, how care teams can help and what to expect after your baby leaves the hospital.
What does it mean when a baby has trouble breathing after birth?
If your baby is born very early, they may not have fully developed lungs so it’s hard for them to breathe well on their own. “Their lungs aren’t developed the way they would be if they spent more time in the uterus,” said Cori Daines, MD, a pediatric pulmonologist with Banner - University Medicine.
Babies born prematurely are often cared for in the neonatal intensive care unit (NICU) initially. When a baby is born with lungs that are not fully developed, they often need the neonatologist to squirt a substance called surfactant into the baby’s lungs shortly after birth. Surfactant allows the lungs to stay open and makes breathing much easier.
Your baby might also need breathing support such as oxygen or a ventilator (breathing machine) so they can get enough air.
Treatments like surfactant and oxygen can be lifesaving. And they are a key reason why more premature babies survive now, compared to years ago.
But when babies need breathing support for several weeks or more, their lungs can get irritated or inflamed. That’s when they can develop bronchopulmonary dysplasia.
What is bronchopulmonary dysplasia (BPD)?
BPD is a condition that happens when a baby’s lungs are too premature and are still healing after breathing support. It happens in babies born before 32 weeks of pregnancy or those with very low birth weights. These babies continue to need oxygen after they turn a month old. The good news is that, with the right care and time, most babies with BPD improve as they grow.
“It is true that some very premature babies may have serious complications, but the great, great majority of these babies are sent home, and they can breathe by themselves,” Dr. Daines said.
How do care teams support babies with BPD?
Babies with BPD usually stay in the NICU at first, where they get care from a team that may include:
- Neonatologists who specialize in caring for newborns
- Respiratory therapists who manage breathing support
- Pediatric pulmonologists who monitor lung health
- Nurses and care coordinators who support your family every step of the way
Your baby may go home on oxygen and medications. After the baby is discharged from the hospital, a pediatric pulmonologist will follow your baby for the next few months. The goal is to help your baby breathe more easily while giving their lungs time to heal and grow. As your baby gets stronger, they may need less oxygen and fewer medications.
Dr. Daines said that your baby’s care team will focus on:
- Preventing infections, especially respiratory infections
- Making sure your baby is well-fed, because good nutrition helps your baby grow
- Supplementing oxygen, if they still need a little help for a while
What can parents expect going forward?
“The majority of these children do well. They may have to catch up with their peers, so for a certain period of time there are things they cannot do. But the majority can eventually do anything any other child can do,” Dr. Daines said. “Premature babies require a little bit more initial care but almost all of them can have a perfectly normal life.”
She points out how resilient these children are: “They look so small and fragile. It’s almost inconceivable for someone that fits in the palm of your hand to be able to overcome something as extraordinary as being born weighing not much more than a pound. I’ve seen these babies go on to become children who do perfectly well in school and other activities.”
Your baby might come home from the hospital with some type of breathing support, like oxygen or medications to help their lungs. That might feel scary at first but your care team will teach you how to manage everything safely at home. “Trust yourselves and trust your child. You can learn and understand what to do,” Dr. Daines said.
Going forward, your child may have asthma-like symptoms, especially when they get a cold, and need treatment. Some people who had BPD as babies have problems with lung function later in adulthood. “The good news is that there are treatments available for the long-term lung consequences,” Dr. Daines said. “And as science advances, these long-term issues are much less common and less severe.”
No matter what your journey looks like, you’ll have a team to help guide the way.
How Banner Children’s supports premature babies and their families
At Banner Children’s, we care for some of the most medically fragile newborns in our neonatal intensive care units (NICUs). Our teams are specially trained to care for premature babies with conditions like BPD, and we continue supporting babies and their families long after they leave the hospital.
Reach out to connect with a Banner Health expert who cares for newborns and children.
