Preterm lung disease, or bronchopulmonary dysplasia (BPD), is abnormal development of the lungs and airways. BPD appears most often in premature babies—those born before 37 weeks gestation. It can also occur in late preterm infants born at 36 weeks or even in full-term babies who have respiratory problems in the first few days or weeks of life.
Symptoms of BPD include:
- 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)
Your newborn will not be diagnosed with BPD immediately. 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
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.
Diagnosis of Preterm Lung Disease
Doctors at Riley at IU Health diagnose BPD and assess its severity based on your baby’s need for oxygen. Diagnostic tests for BPD include:
- Chest X-ray. These images may show large areas of air in the chest, lung infection or inflammation. Doctors may also perform a chest X-ray to monitor lung development.
- Blood tests. Blood tests check the blood oxygen level and can also determine if infection is present.
- Echocardiography. Echocardiography is a type of ultrasound used to detect heart defects or pulmonary hypertension.
The severity of BPD depends on how much oxygen therapy your baby needs by the time of their original due date.
Treatments
Treatments
Depending on your baby’s condition, treatment for BPD may include:
- Oxygen therapy. A mask called a nasal cannula delivers pressurized, measured oxygen.
- Ventilator (positive pressure ventilation). This machine moves air into and out of your baby’s lungs.
- Continuous positive airway pressure (CPAP). A mask delivers a constant supply of pressurized air.
- Tracheostomy. Usually temporary, this surgical incision in the windpipe allows free breathing.
- Nebulized respiratory medicines. Delivered as a fine spray, these oral steroids open the airways and relieve congestion.
Key Points to Remember
Key Points to Remember
- BPD is abnormal development of the lungs and airways.
- BPD can occur in preterm, late preterm (36 weeks) and also full-term babies with respiratory problems.
- Although the cause of BPD is unknown, risk factors are known.
- Some babies with BPD require lifelong monitoring but most do not.
- Follow the doctor’s recommendations to care for your baby.
Support Services & Resources
Support Services & Resources
Visit the online sources below to learn more about preterm lung disease (bronchopulmonary dysplasia).
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
Discover more information about bronchopulmonary dysplasia, including its causes, symptoms and treatments and what it is like living with the condition.
The National Institutes of Health shares in-depth information about BPD.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.