What is bronchopulmonary dysplasia?
Long-term respiratory problems faced by babies born prematurely are known, generally, as either bronchopulmonary dysplasia (BPD) or chronic lung disease (CLD).
Some premature babies require the use of a mechanical ventilator and extra oxygen to breathe; because their lungs are fragile, they may sustain injury in the process, and if the tissues inside the lungs become inflamed, they can break down, causing scarring. BPD is more common in Caucasian male babies. Babies with BPD may be at increased risk for respiratory infection.
What are the risk factors for developing BPD?
BPD may occur if your child:
- is born at less than 34 weeks gestation
- has a birthweight of less than 4 pounds, 6.4 ounces
- has a family history of asthma
- other associated conditions include:
- pulmonary interstitial emphysema, a problem in which air leaks out of the airways into the spaces between the small air sacs of the lungs
- patent ductus arteriosus, a connection between the blood vessels of the heart and lungs that doesn’t close (as it should) after birth
- maternal womb infection
Bronchopulmonary Dysplasia | Symptoms & Causes
What are the symptoms of BPD?
Each baby may experience different symptoms, but common symptoms of BPD include:
- respiratory distress (rapid breathing, flaring of the nostrils, chest retractions)
- continued need for mechanical ventilation or oxygen after your premature baby reaches 36 weeks gestation
What causes bronchopulmonary dysplasia?
Bronchopulmonary dysplasia can be caused by any of the following:
- prematurity: when your baby is born before the lungs, and especially the air sacs, are fully developed.
- oxygen use: high concentrations of oxygen can damage the cells of the lungs
- mechanical ventilation: some premature babies require breathing machines, suctioning of the airways, and the use of a endotracheal tube, which is placed in the trachea and connected to a breathing machine
Bronchopulmonary Dysplasia | Diagnosis & Treatments
How is bronchopulmonary dysplasia diagnosed?
BPD is a chronic disease and appears gradually, so your baby’s physician will consider several factors. Chest x-rays may show a bubbly, sponge-like appearance in affected lungs.
Your baby's physician will determine a course of treatment based on your baby's gestational age, overall health, the extent of the disease, your baby's tolerance for specific medications, procedures, and therapies, and your opinion or preference.
How do we treat BPD?
Treatment for BPD may include:
- extra oxygen
- mechanical ventilation with gradual weaning as your baby's lungs grow
- medications such as bronchodilators, which help open your baby's airways, and steroids, which will reduce inflammation
- limiting fluids, as excess fluid can worsen breathing ability
- proper nutrition
- immunization against lung infection by influenza
Some babies with BPD require mechanical ventilators for several months. Some will continue to require oxygen even after they leave the hospital, but most can be weaned by the end of their first year.
How we care for BPD
The Boston Children’s Hospital Center for Healthy Infant Lung Development (CHILD) offers a comprehensive, team-based approach to maximize the growth and development of the lungs. CHILD is staffed by an experienced team of clinicians, all with specialized training in the care of infants and toddlers with lung disease. And our unique NICU Growth and Developmental Support Programs (GraDS) track children from the time they leave the hospital until they are 3 to 4 years old.
Babies with BPD aren’t just newborns with underdeveloped lungs. Each infant is unique, and every aspect of their care is important. Our “whole baby” approach to treatment pays attention to their growth and long-term neurodevelopment.