Bronchopulmonary Dysplasia

BPD is most common in babies born early (before 37 weeks of pregnancy), When babies are born before 37 weeks, their lungs and airways may not be functioning as well as they should. But even full-term babies can develop breathing problems soon after birth.

How serious BPD is can be different for each baby. In the U.S., 10,000 to 15,000 babies develop it each year, according to the American Lung Association.

A baby with BPD needs extra oxygen. How serious a baby’s BPD is depends on how much oxygen by the time of their original due date.

Symptoms of BPD

• Fast, shallow breathing (tachypnea)
• Flaring of the nostrils
• Cyanosis (bluish color to the skin)
• Coughing and wheezing
• Increased heart rate
• Difficulty feeding
• Retractions (when the skin between and around the ribs and chest sinks in when inhaling)

Risk factors for BPD

Although the cause of BPD is unknown, we do know the risk factors. These risk factors help determine a diagnosis of BPD over the first month of a baby’s life. The risk factors of BPD include:

• Gestation age and weight
• How much oxygen the baby needs
• Length of time on a ventilator
• Infection (lung infections and maternal infection prior to delivery)
  
• Congenital heart diseases

Diagnosis of BPD

Babies with BPD are usually diagnosed before leaving the hospital. However, after going home, a parent may notice rapid or labored breathing, wheezing or difficulty feeding. An apnea monitor or pulse oximeter may also alert a parent or caregiver to an issue.

The pediatric pulmonology team at Riley Children's Health will conduct tests to diagnose BPD and related conditions. These may include:

• Chest x-ray: Doctors may order a chest X-ray to see how the lungs are developing. This can also rule out certain causes of the baby’s symptoms. The images may show large areas of air in the chest, lung infection or inflammation.
• Blood tests: Neonatal blood tests check blood oxygen level and can also look for signs of infection.
• Echocardiogram: In an echocardiogram, a technician uses a hand-held sonogram wand on the baby’s chest. The sound waves create a picture of the heart's valves and chambers to show the doctor how the heart is functioning.

If your baby is born prematurely, he or she will remain in the hospital’s neonatal intensive care unit (NICU) until at least the expected due date. Depending on your baby’s condition, he or she may stay much longer. Neonatologists (doctors who specialize in caring for newborns) provide care for your baby in the NICU. The care team also includes registered dietitians, respiratory therapists, speech therapists, physical and occupational therapists and social workers.

Your baby must be able to breathe without a ventilator or oxygen mask before he or she can go home. A pulmonologist will see your child prior to discharge from the hospital and work with you to develop a care plan for when your child returns home. He or she will need to return to the hospital frequently for follow-up visits with a pulmonologist or nurse practitioner who will check his or her lung development and overall growth.

Although some babies with BPD require lifelong monitoring, most need hospital follow-ups only for the first one or two years of their lives. After that, their primary care doctor sees them. You should follow your child’s doctor’s recommendations to make sure your infant has the best opportunity to grow and develop properly.