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Chronic lung disease
is a condition in which damaged tissue in a newborn baby's lungs causes
breathing and health problems. The lungs trap air or collapse, fill with fluid,
and produce extra
Most babies who have chronic lung
disease survive. And many children outgrow most of their lung problems.
Chronic lung disease is also known as bronchopulmonary dysplasia
alone or in combination can lead to chronic lung disease include:
Symptoms of chronic lung
disease may develop as soon as 3 days after birth.
common first symptom of chronic lung disease is difficulty breathing. You may
notice your newborn:
There is no
one test to diagnose chronic lung disease. A doctor may first suspect it if
your baby has difficulty breathing. The diagnosis is confirmed when one of the
following is present:
A doctor may order other tests to rule out other causes
of breathing trouble. A baby who has been already diagnosed with chronic
lung disease may have more tests to help doctors check for
Treatment for chronic lung
disease depends on how severe it is. Treatment does not cure chronic lung
disease, but it does help the newborn breathe more easily. This minimizes the
stress on the newborn's body while the lungs mature and heal on their own.
Treatment begins in the hospital, with
oxygen therapy and other treatments, and usually
continues at home. Before the parents and baby leave the hospital, doctors and
nurses train the parents on how to care for their child.
children who have chronic lung disease outgrow most of their lung problems.
While they have the disease, they need to get enough nutrients to help them
grow and develop and to help prevent complications of the disease.
Frequently Asked Questions
Learning about chronic lung disease in infants:
Living with chronic lung disease:
The symptoms of
chronic lung disease may appear as early as 3 days
after a baby is born. Usually this disease develops while the newborn
is still in the hospital.
Symptoms of difficulty breathing can
Infants who have chronic lung disease often need to stay in
the hospital for several weeks to months, because they need extra oxygen. Some
may require oxygen for a while after they go home.
infants with chronic lung disease have less trouble breathing by early
childhood. But many teens and young adults who had chronic lung disease as
newborns have mildly decreased lung function. They may tire easily or notice
they are short of breath during exercise. Many children have symptoms that
are similar to those of
asthma in early childhood. These symptoms may improve
as the child grows. A few children have
moderate to severe breathing problems, including
difficulty breathing when they are resting.
Infants who have
chronic lung disease may have
There is no one test to diagnose
chronic lung disease. A doctor may first suspect it if
your baby has trouble breathing. The diagnosis is confirmed when one of the
following is present:
Babies with chronic lung disease usually have regular blood
a blood gas test) to monitor how well their lungs are
working. These tests may be done until the baby can breathe without extra
A number of tests may be done to rule out other causes of
difficulty breathing and to learn whether complications of chronic lung disease are present.
chronic lung disease depends on how severe the
condition is. Treatment usually includes
oxygen therapy and sometimes using a
ventilator, as well as medicines and nutritional
therapy. Treatment does not cure chronic lung disease. But it helps a newborn
breathe more easily while the lungs mature and heal on their own. Babies who are born with this condition may need some form of treatment
throughout their lives.
Most newborns who have chronic lung disease recover from it. But the
symptoms may last a long time and may require treatment into early childhood.
Occasional setbacks from difficulty breathing are common.
treatment includes one or more of the following:
Your baby will be treated by medical
specialists such as a
neonatologist or a
pulmonologist. Your newborn may need to spend time in
the hospital, from several weeks to several months. During this time, visit
your baby often and ask to be involved in his or her care.
and long-term treatment of chronic lung disease varies greatly, depending
If your newborn has mild to moderate chronic lung disease and can breathe without the use of a
ventilator, he or she will be given additional oxygen (which is inhaled, not
forced, into the lungs). Oxygen therapy helps your baby:
Your baby may need continued oxygen therapy for the first
few months after birth. Inhaled oxygen may be administered by:
Your baby may use an
apnea monitor if he or she needs only oxygen therapy
and does not need a ventilator. The monitor helps you and other caregivers
detect any problems with your baby's breathing patterns.
newborn will need a ventilator if he or she is diagnosed with severe chronic lung disease. The use of a ventilator may
continue for a few days to a few months. For some children, it is needed for as
long as 2 years.
In addition to oxygen therapy or ventilators,
your baby may need:
You may be able to continue treatment for
your baby at home, even if he or she needs oxygen therapy. Treating your baby
at home helps you bond with the baby and can help you to be more relaxed and
comfortable. Leaving the hospital can also minimize your medical care expenses.
Before you take your newborn home, you will need to learn how
Your baby may need other treatments in
addition to oxygen therapy.
A smooth transition from the hospital to your home will
help you feel more secure about caring for your newborn. Discharge planning helps to make sure that your baby leaves the hospital safely and smoothly and gets the right care after that. Routine follow-up
visits with your doctor will be an important part of this transition.
for a condition that's getting worse or for
complications of chronic lung disease varies depending
on the exact problem.
High blood pressure and
growth problems are examples of problems that can
occur. Make sure you know the signs that show the disease is getting worse or
complications are developing. If you know these signs, you will be able to help your child get needed medical
Some of these problems include:
It is normal for parents to feel
nervous at first about caring for their baby who has
chronic lung disease, especially if the baby will need
oxygen therapy at home. You may be scared that you do
not have the skills to give your baby the right care. You may be afraid that
when you hold or touch your child, you will pull out his or her
nasal cannula (the tube that delivers extra oxygen
through your baby's nose) by mistake.
While your baby is still in
Your baby may only need to have oxygen therapy for a short
time. After this treatment is no longer needed, your daily routine may become
easier. But you will still need to protect your child from infections. Think about
The American Lung Association provides programs of
education, community service, and advocacy. Some of the topics available
include asthma, tobacco control, emphysema, infectious disease, asbestos, carbon monoxide, radon,
The American Thoracic Society provides information for
professionals and consumers about the prevention and treatment of lung
diseases. Its website provides educational materials for the consumer.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The March of Dimes tries to improve the health of babies
by preventing birth defects, premature birth, and early death. March of Dimes
supports research, community services, education, and advocacy to save babies'
lives. The organization's website has information on premature birth, birth
defects, birth defects testing, pregnancy, and prenatal care.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Banks-Randall BA, Ballard RA (2005). Bronchopulmonary
dysplasia. In HW Taeusch et al., eds., Avery's Diseases of the Newborn, 8th ed., chap. 49, pp. 723–736. Philadelphia:
Halliday HL, Ehrenkranz RA(2010). Early (<8 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants. Cochrane Database of Systematic Reviews (1).
Halliday HL, Ehrenkranz RA (2009). Late (>7 days) postnatal corticosteroids for chronic lung disease in preterm infants. Cochrane Database of Systematic Reviews (1).
Other Works Consulted
American Academy of Pediatrics (2010). Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia. Pediatrics, 126(4): 800–808.
Baraldi E, Filippone M (2007). Chronic lung disease
after premature birth. New England Journal of Medicine,
Bhandari A, Bhandari V (2009). Pitfalls, problems, and progress in bronchopulmonary dysplasia. Pediatrics, 123(6): 1562–1573.
Lestrud S (2007). Bronchopulmonary dysplasia. In RM
Kliegman et al., eds., Nelson Textbook of Pediatrics,
18th ed., pp. 1840–1841. Philadelphia: Saunders Elsevier.
Thilo EH, Rosenberg AA (2011). Chronic lung disease in the premature infant section of The newborn infant. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., p. 35. New York: McGraw–Hill.
Watterburg KL, Perkett EA (2006). Bronchopulmonary
dysplasia in the neonate. In FD Burg et al., eds., Current Pediatric Therapy, 18th ed., pp. 252–256. Philadelphia: Saunders
April 27, 2011
Sarah Marshall, MD - Family Medicine & Jennifer Merchant, MD - Neonatal-Perinatal Medicine
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