Chronic Lung Disease in Premature Babies

What is Chronic Lung Disease?  

Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity, is a term used to describe a long-term condition which develops in some premature (neonatal) babies who suffer from respiratory problems. It is most often recognised when ex premature babies are sent home from the nursery in oxygen,

Anatomy of Chronic Lung Disease

Chronic lung disease can occur in premature babies occurs because their lungs, normally filled with fluid until birth, are exposed to the outside world at an earlier stage and when the lungs have not fully developed. Exposure to necessary medical treatments such as oxygen and artificial ventilation can cause further inflammation and damage. The more premature the baby is born the higher the risk of chronic lung disease.

How Might Chronic Lung Disease Affect your Child?

Children born prematurely have abnormal lungs which may not be as good at transferring oxygen and carbon dioxide. There are at higher risk of becoming unwell when exposed to things like viruses and bacteria. They are also more likely to develop wheeze than babies born at term.  

What are the causes of chronic lung disease?

Chronic lung disease in premature babies is contributed to by:

  • Abnormal or underdeveloped lungs (prematurity)
  • Insufficient surfactant (a substance which helps the lungs expand)
  • Lung infections
  • Oxygen use (too much may result in cell damage to the lungs)
  • Mechanical ventilation

What are the Symptoms of Chronic Lung Disease?

Ex premature babies with chronic lung disease may present the following symptoms:

  • Recurrent wheezing
  • Recurrent coughing
  • Severe Bronchiolitis
  • Poor exercise tolerance
  • Recurrent lung infections

How is Chronic Lung Disease Diagnosed?

The diagnosis of chronic lung disease is confirmed if a premature infant ( born < 32 weeks) still requires additional oxygen 28 days after birth. The doctor will be able to determine the severity of the condition based on the gestational age of the baby and the length of time breathing support is needed.

What are the Stages of Chronic Lung Disease?

There are three levels of chronic lung disease:

  • Mild (needing breathing support at 28 days old, but breathing air by 36 weeks of age)
  • Moderate (needing breathing support at 36 weeks old)
  • Severe (needing breathing support and pressurised ventilation at 36 weeks old)

Chronic Lung Disease Treatments

In the nursery lung disease may be treated with oxygen, steroids and diuretics. Some children may be discharged from hospital on oxygen.   If your child is sent home from hospital in the nursery then you will need to attend a specialist respiratory clinic in order to wean the oxygen.

Other treatments may be needed as your child grows such as;

  • Vaccines
  • Bronchodilators
  • Inhaled steroids
  • Antibiotics
  • Nutritional input (to ensure growth and best possible health)
  • Physiotherapy