What Is Bronchopulmonary Dysplasia?

Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in infants who need help breathing in the early days of their life. In some cases, it can cause long-term breathing problems. Babies born prematurely are more likely to get this condition, sometimes called chronic lung disease (CLD).

How It Happens

When a baby is born prematurely, the lungs sometimes aren’t fully formed. They can’t take in and absorb enough oxygen to stay alive on their own. They also might not produce enough of a fluid called surfactant, which helps keep the lungs open. When this happens, doctors give the baby extra oxygen.

But that treatment carries risks for the newborn. Using a machine like a ventilator to pump more oxygen into the baby’s lungs can irritate the airways and scar the still-fragile air sacs that line the lungs. High levels of oxygen can cause more damage as well.

The irritation and scarring makes it harder for the premature infant to breathe on her own. That can mean the baby will have to stay on a ventilator longer to get oxygen. The damage also can spread to the blood vessels that pick up oxygen from the air sacs. That means the baby’s tiny heart has to pump harder. And because so much of the body’s effort is spent breathing, the baby might grow slowly. That can cause problems with other still-developing organs.

How Common Is BPD?

  • About 10,000 babies a year develop the condition.
  • It’s most common in babies who are born more than 10 weeks before their due dates and weigh less than 2 pounds.
  • Doctors are getting better at keeping those babies alive, but the result may be more cases of BPD in children who survive.
  • In some cases, babies born with a type of heart defect called patent ductus arteriosus, or who have a blood infection called sepsis, may develop BPD.

Diagnosis and Treatment

The best treatment for BPD is to prevent it in the first place. If your baby is premature and is having trouble breathing, doctors and nurses try to treat the problem in a way that reduces the risk of BPD.

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If doctors believe you’re likely to give birth prematurely, they may give you a steroid to boost the fluid that helps keep your baby’s lungs open. The better your newborn can breathe, the less likely he’ll need treatments that could lead to BPD.

There’s no single test that can identify the condition, but his lungs may appear spongy or bubbly in chest X-rays.

In addition to X-rays, doctors might use an echocardiogram to take images of his heart and look for defects. They may also take blood samples to make sure your baby is getting enough oxygen.

If your baby develops BPD, he may need to stay in the hospital for several weeks, even months. Doctors might insert a tube into his throat so a ventilator can help provide oxygen. If he needs to stay on a ventilator for a long time, a doctor might cut a small hole in his neck to insert a breathing tube directly into the windpipe.

Some doctors also encourage using a mask to deliver a stream of warmer, moist air that’s easier on a baby’s lungs.

In addition to mechanical help, your doctor might use several kinds of medicines to treat BPD:

  • Diuretics (water pills) can help reduce the amount of liquid that builds up around the air sacs in the lungs. This is different from the fluid that helps keep the lungs open.
  • Bronchodilators relax the muscles around your baby’s airways. That lets them open wider.
  • Corticosteroids keep down swelling and prevent inflammation inside the lungs.

Your baby might also get antiviral drugs to prevent infections like the flu, or medicines that open up the blood vessels that carry oxygen from his lungs to rest of his body.

Long-Term Care

Most babies who get BPD get better -- but it takes time. And the long-term effects can include asthma, chronic wheezing and more trips to the hospital in later years.

As your newborn’s lungs grow, he’ll gradually be weaned off a ventilator. But he may still need additional oxygen for months, either through a mask or a hose that blows into his nostrils.

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He’s also more likely to get respiratory infections like colds or the flu as he gets older, and may have to go to a hospital for treatment. A cough, fever or a runny nose might require a call to the doctor. You can lower the odds of these problems through basic steps like washing your hands frequently and keeping irritants like smoke and dust away from your baby.

Your child may grow more slowly than other children, and he’s likely to be smaller than other children his age. He might have problems with coordination, or have weaker muscles.

He also may have problems swallowing, making it harder for him to feed. He could have neurological problems like vision or hearing difficulty or learning disabilities, but these are rare.

WebMD Medical Reference Reviewed by Neha Pathak, MD on March 10, 2017

Sources

SOURCES:

National Heart, Lung and Blood Institute: “Bronchopulmonary Dysplasia.”

Boston Children’s Hospital: “Bronchopulmonary Dysplasia in Children.”

American Lung Association: “Bronchopulmonary Dysplasia.”

Respiratory Care: “Bronchopulmonary Dysplasia.”

American Family Physician: “Newborn Respiratory Distress.”

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