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Bronchopulmonary Dysplasia
(BPD)

Definition:
Bronchopulmonary dysplasia (BPD) is a chronic lung disease that mainly affects infants born prematurely. Babies with BPD have trouble breathing because their lungs don’t work properly. The condition usually develops during the first four weeks after birth.

Most babies who get BPD recover, but this is a serious condition that requires care from your doctor.

Causes:
Several factors contribute to BPD, including:
  • Immature lungs
  • Baby receives a high concentrations of oxygen for long periods of time
  • Baby is put on a ventilator—a breathing machine—for an extended time period
  • Infections
  • Pneumonia
Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition. The following factors increase your child’s chances of developing BPD:
  • Lung infection
  • Premature birth
  • Respiratory infection
  • Congenital heart disease
  • Respiratory distress syndrome (RDS) – a lung disorder often affecting premature babies that causes difficulty with breathing
  • Any severe illness requiring oxygen therapy and/or the use of a ventilator
Symptoms:
If your infant experiences any of these symptoms do not assume it is due to BPD. These symptoms may be caused by other, less serious health conditions.
  • Rapid, shallow breathing
  • Difficulty breathing
  • Retractions – with each breath, the chest appears to sink in between the ribs or under the ribcage
  • Cough
  • See-saw breathing – movement of the chest and stomach in opposite directions with each breath
  • Wheezing or noisy breathing
  • Wet or cracking sound in the lungs, heard with a stethoscope
  • Raising or stretching the neck to push more air into the lungs
  • Poor posture of the trunk, shoulders, and neck
  • Bluish color to the skin
  • Slower than average growth rate
Diagnosis:
Your doctor will review your child’s medical history, and may perform the following tests:
  • Arterial blood gas test – a small amount of blood is drawn to determine how much oxygen is in it
  • Chest x-ray – radiation is used to take a picture of the inside of the chest; done to check for respiratory problems
  • Chest CT scan – a type of x-ray, which uses a computer to create images of structures inside the chest; performed to check for respiratory problems.
  • Pulse-oximetry monitoring – a piece of tape containing an oxygen sensor is placed on the baby’s foot; it is connected to a monitor that tells the doctor how well the lungs are working
Treatment:
There is no specific treatment for BPD. Symptoms are treated to help the baby get strong and to allow the lungs to mature. Your child will most likely be treated in a hospital’s neonatal intensive care unit. He or she may need to stay in the hospital for an extended period of time.

Talk with your doctor about the best treatment plan for your child. Treatment options include the following:

Ventilator support
A breathing machine is used until the baby can breathe well enough on his or her own.

Supplemental oxygen
Once the baby no longer needs a ventilator, he or she may be given extra oxygen through a mask or a nasal tube. Treatment could continue for weeks or even months. Your baby might still need to receive oxygen after coming home from the hospital.

Medication

  • Antibiotics – to control infections
  • Bronchodilators – to make it easier for air to get in and out of the lungs
  • Corticosteroids – to reduce swelling and inflammation of the airways
  • Diuretics – to help remove extra fluid from the lungs
  • Surfactants - to help the baby’s lungs expand the way they should

Supplemental feedings
An intravenous (IV) line that delivers food may be attached to a vein. Or, a feeding tube may be inserted into the stomach. Special formula might also be given to the baby. This extra nutrition should help the baby get stronger and healthier.

Physical therapy
Special “exercises” help the baby’s muscles get stronger and help keep the lungs clear of mucus.

Prevention:
There are no set guidelines for preventing BPD because the exact cause is not known. However there are some things you can do to help ensure you will give birth to a healthy baby:
  • Eat a healthful diet, one that is low in saturated fat and rich in low-fat dairy, lean protein sources, whole grains, fruits, and vegetables.
  • Have regular prenatal check-ups.
  • Don’t smoke. If you smoke, quit.
  • Avoid drugs and alcohol.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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