Posts Tagged ‘lungs’

RDS and BPD – breathing problems in preemies

Wednesday, October 28th, 2015

NICU sign 1If your baby was born prematurely, you are probably concerned about his lungs. A baby’s lungs are not considered to be fully functional until around 35 weeks of pregnancy. If your baby was born before that, it is possible that he may struggle with breathing.

 

RDS

A serious breathing problem called respiratory distress syndrome (RDS) is the most common illness in the NICU. But, the good news is that due to medical advances, babies with RDS have a 99% survival rate.

Babies with RDS struggle to breathe because their immature lungs do not produce enough surfactant, a protein that keeps small air sacs in the lungs from collapsing. March of Dimes grantees helped develop surfactant therapy, which was introduced in 1990. Since then, deaths from RDS have been reduced by half.

Babies with RDS also may receive a treatment called C-PAP (continuous positive airway pressure). The air may be delivered through small tubes in the baby’s nose, or through a tube that has been inserted into his windpipe. As with surfactant treatment, C-PAP helps keep small air sacs from collapsing. C-PAP helps your baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a mechanical ventilator to breathe for them while their lungs recover. Learn more about the differences between C-PAP and a ventilator, as well as causes, symptoms and treatment of RDS.

BPD

BPD (bronchopulmonary dysplasia) is a chronic lung disease common in preemies who have been treated for RDS. These babies may develop fluid in the lungs, scarring and lung damage. Medications can help make breathing easier for them. Usually babies with BPD improve by age 2 but others may develop a chronic lung condition similar to asthma. Learn about asthma, including questions to ask your child’s health care provider and how to help your child understand his breathing problems.

Even though the outlook for babies born prematurely has improved greatly, many babies still face serious complications and lasting disabilities. Many March of Dimes grantees seek new ways to improve the care of these tiny babies, while others strive to prevent premature delivery.

Have questions?  Email or text AskUs@marchofdimes.org. We are here to help.

 

Respiratory distress syndrome (RDS)

Friday, October 29th, 2010

On average, a developing baby’s lungs are considered to be mature and fully functional around 35 to 36 weeks after conception.  For babies born before that, breathing can be a serious challenge.  Respiratory distress syndrome (RDS) is the most common illness in the NICU.  RDS can be mild or quite severe, but the good news is that 99% of babies with RDS survive.  The babies who don’t survive usually are the youngest, smallest babies born before 26 weeks of gestation.

Surfactant is a foamy substance that lines the lungs in mature babies and keeps them from collapsing, making breathing in and out easier. Premature babies lack surfactant and their lungs collapse between breaths.  This makes inhaling air and exhaling carbon dioxide very difficult.  The energy it takes to expand and contract the lungs can be exhausting and overwhelming for these tiny babies.

Research has shown us that the earlier a baby is born the less surfactant is likely to exist in the lungs and the more likely it is for him to develop RDS.  Boys are more likely to get RDS than girls because their lungs mature more slowly. Preemies with mothers who have diabetes  or with Rh blood-type incompatibilities are at greater risk for RDS because their lungs are slower to produce surfactant.  Babies with mothers who have severe preeclampsia are more vulnerable to RDS because their normal lung development is disrupted. Babies born via cesarean delivery and without labor are at increased risk for RDS.  This is because labor produces hormones that promote lung maturation and uterine contractions may help squeeze excess fluid from a baby’s lungs, making breathing easier.

Most babies who will get RDS show symptoms within a few hours of birth.  RDS usually gets worse for a couple of days and then improves as the baby starts to produce more surfactant.  Treatment includes giving a dose or two of man-made surfactant and providing breathing assistance with oxygen, C-PAP or mechanical ventilation, depending on each baby’s needs.

While the survival rate is extremely high, severe RDS may lead to longer-term health problems.  Mechanical ventilation can be life-saving, but it is harsh. Chronic lung disease, also known as bronchopulomonary dysplasia (BPD), comes as a result of inflammation and scaring of the lungs that may result from ventilation.  Children with severe RDS also have an increased likelihood of asthma.

In the NICU – what is surfactant?

Thursday, July 29th, 2010

We were recently asked about surfactant and how it helps a premature baby’s lungs.

“Surfactant” is a condensed form of the term “surface-active agent,” meaning something that reduces the surface tension of liquids. So what does that really mean? Example:  Detergents are surfactants – their lowering of the natural surface tension of water is what keeps bubbles from collapsing, and lets dishwater foam.  Mature lungs are foamy organs, largely composed of tiny, bubble-like air sacs that are prevented from collapsing by lung surfactant.  This complex mixture of fatty substances and specialized proteins is produced in the lungs, starting many weeks before birth.

Premature babies often lack lung surfactant.  The more prematurely a baby is born, the less likely it is to be producing enough surfactant to enable normal lung function.  Immature lungs resist inflation and collapse after each exhale.  The effort of breathing under these circumstances – called “respiratory distress syndrome,” or RDS – can exhaust a very small, premature newborn and lead to severe complications and even death.  Survivors of RDS may have brain damage due, in part, to being unable to get enough air.  In recent decades, respiratory treatments have contributed to the improved survival rates for premature babies, but the lungs of some babies have been injured in the process.

Lung surfactant was identified in the 1950s. During the 1980s, many research groups around the world studied surfactant from human amniotic fluid and synthetic varieties.  Such studies showed the safety and effectiveness of both rescue treatment (given to babies already developing RDS) and preventive treatment (given to very premature infants before they show signs of RDS.)

The March of Dimes is pleased to have supported early research on lung surfactant for premature infants.  Widespread use of surfactant has contributed to a significant drop in deaths from RDS and a drop in the U.S. infant mortality rates. In the past decade, the March of Dimes has invested over $2.6 million in research involving lung surfactant.

 

Updated October 2015.

Pregnancy: How many weeks are best for baby?

Monday, November 23rd, 2009

pregnant2Did you know that it’s usually best for the baby if pregnancy lasts 39-40 weeks?

Today, researchers published a study showing that many women are confused about the length of  full-term pregnancy. This isn’t surprising since there’s a lot of mixed up info out there.

In the study, one out of every four women thought a full-term pregnancy lasts 34-36 weeks. Half of the women said it’s 37-38 weeks.

Only one out of every four gave the “right answer”: 39-40 weeks. That is the time recommended by most medical experts.

What’s the most important thing that happens during the last few weeks of pregnancy? The baby’s brains and lungs are still developing. It’s usually best if that development happens inside mom’s uterus, rather than outside in the world.

To learn more, read the March of Dimes article “Why at least 39 weeks is best for your baby.”

This new study was published in the medical journal Obstetrics & Gynecology.