Chronic Lung Disease in Infants - Topic Overview
What is chronic lung disease in infants?
Chronic lung disease in an infant means that damaged tissue in the newborn's lungs is causing breathing and health problems. The lungs trap air or collapse, fill with fluid, and produce extra mucus.
Most babies who have chronic lung disease survive. But symptoms may come back and need treatment into early childhood. In time, many children outgrow most of their lung problems.
Chronic lung disease is also known as bronchopulmonary dysplasia, or BPD.
What causes chronic lung disease?
Chronic lung disease is caused by problems in a baby's lungs. It is most common in premature babies who are born before 26 weeks of gestational age and weigh less than 1 kg (2.2 lb).1 A premature baby's lungs may not be fully developed. This makes the baby likely to have problems that can lead to chronic lung disease such as:
- Injury to the lungs from the use of a ventilator. Many premature babies need this treatment, especially if they have respiratory distress syndrome. But a ventilator's forced breathing and high oxygen levels can damage a baby's lungs.
- Fluid in the lungs. Premature babies may be born with this or develop it. Some full-term babies delivered by caesarean section also develop fluid in their lungs.
- Infections. Premature babies are more likely to get lung infections, often from respiratory syncytial virus (RSV).
Other problems that can lead to chronic lung disease include:
- Inherited problems that affect how the lungs develop.
- A heart condition called patent ductus arteriosus that affects blood flow to the lungs.
- Breathing meconium into the lungs during delivery. This causes lung irritation and inflammation that damage lung tissue.
- Lack of nourishment. Newborns who aren't able to get the proper nutrients, especially vitamin A, are more likely to have chronic lung disease.
What are the symptoms?
A baby with chronic lung disease may have symptoms as soon as 3 days after birth. The most common first symptom is trouble breathing. Your newborn may:
- Grunt or breathe fast.
- Flare the nostrils.
- Use the neck, chest, and belly muscles to breathe. This can look like your baby is "sucking in" air between or under the ribs.
- Wheeze, or make a high-pitched sound when breathing.
- Tire easily during and after feeding.
- Have pale, gray, or blotchy skin, especially on the tongue, lips, earlobes, and nail beds.
How is chronic lung disease diagnosed?
There is no single test to diagnose chronic lung disease. A doctor may first suspect it if your baby has trouble breathing. The diagnosis is confirmed if your baby needs extra oxygen for at least 28 days after birth. Based on your baby's gestational age and how much longer your baby needs extra oxygen, your doctor will know how severe the disease is. Gestational age is the number of weeks since the start of pregnancy.
A doctor may order tests to rule out other causes of breathing trouble or to check for other problems caused by chronic lung disease.
For example, your baby might have:
- Blood tests, including a blood gas test, to see how well the lungs are working.
- Lung function tests to see how much damage has been done to the lungs.
- Heart tests, such as an echocardiogram, to see how well the heart is working.