All preterm babies (especially the very small ones)
are at the risk of developing bronchopulmonary dysplasia
or BPD because of immature lungs, infection and the
prolonged need for supplemental oxygen and or mechanical
ventilation. BPD symptoms can last from few months
to a few years. Proper nutrition and sufficient oxygen
can protect the lungs and prevent respiratory illnesses.
Though the condition in the preemie improves with
time as the lungs mature, babies with BPD are at an
increased risk for respiratory infections.
Did you know
• According to experts a child will outgrow
BPD when the lungs outgrow old tissues and new tissues
take over the function of the damaged ones. The growth
of new lung tissues continues until age eight and
even more
• A child who will need oxygen beyond 36 weeks
gestational age and/or for more than 4 weeks after
being born is considered to have BPD.
• Fortunately preemies lungs heal much sooner.
Unfortunately even with new lung tissue some children
continue to exhibit signs of BPD. But with proper
nutrition and adequate oxygen, the lungs receive the
necessary protection to prevent the frequency of respiratory
illnesses.
• Babies with BPD usually gain weight slowly
and are subject to apnea
BPD Symptoms
Chest retracts when breathing: Retractions
are the spaces you notice between or below the ribs
and/or at the top of the chest in front of the neck
when the child breathes. Caused by stiff lungs, retractions
can occur occasionally, intermittently when the child
is unwell or on everyday basis.
Breathing
rate is increased: A child with BPD when
ill or kept too warm will have an increased breathing
rate which can be observed while the child is sleeping.
Wheezing: This is the high-pitched
sound produced when the child exhales. The lungs are
working harder just to push out the air. Wheezing
can occur when your preterm baby is unwell, when there
is an inflammation of the lungs or when the lungs
are exposed to irritants such as cigarette smoke.
Wheezing is known to occur intermittently or on a
daily basis.
Coughing: Coughing helps to expel the accumulated
mucus that collects in the lungs and makes breathing
difficult. Coughing tends to occur when there is extra
mucus in the lungs, if the child is refluxing or when
the child has a respiratory illness.
The need for supplemental oxygen:
Since a child with BPD cannot keep the oxygen saturation
at an appropriate level, he may require supplemental
oxygen. Fortunately the need for oxygen drops as the
lungs heal. Supplemental oxygen is very important
for baby's lungs and overall growth
Feeding problems: Feeding difficulties
do not manifest in all children with BPD but many
face this problem. Because breathing is hard work
and doing both breathing and eating at the same time
can be really tedious on the child, many babies with
BPD face feeding problems. Preemies will require additional
calories to compensate for the energy spent on doing
both tasks.
Treatment for BPD
Oxygen Therapy: Even after coming
home babies with the more severe BPD will require
supplemental oxygen. For preemies with BPD who are
not gaining weight adequately, added oxygen will be
prescribed to help the baby gain weight as he develops
new lung tissue. Supplemental oxygen may be given
on doctor's instructions throughout the day or during
feeding and sleeping time for a period of time (again
at your doctor's discretion).
Medications: Many preemies with BPD
face a tightening and narrowing of the airways called
bronchoconstriction. Medications can be given on a
daily basis or on a need-to basis, in both liquid
and pill form. Bronchodilators are medications given
to relax the muscle bands and open up the airways.
A child may be on a bronchodilator on a daily basis
or intermittently during a respiratory illness.
Steroid medications are commonly administered
to reduce lung inflammation and make breathing simpler.
They are particularly helpful to ease the periodic
wheezing and coughing and given through a hand-held
inhaler.
Diuretics are medications given daily
to remove excess fluid through elimination via the
kidneys. Extra fluid in the lungs will interfere with
the oxygen flow.
