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Breathing Support for Infants with BPD

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Premature infants who develop BPD usually recover. They often require breathing support while in the hospital, but the majority do not need that breathing support as they leave the NICU. Once babies no longer need support from a ventilator or CPAP (continuous positive airway pressure) machine, most start learning how to drink their milk, gain more strength, and often go home around the time of their mother’s original due date. However, some infants with BPD have a longer NICU hospitalization. These sicker infants may need to stay in the hospital much longer - sometimes for many months - after their mother’s due date.

About 10% of infants with BPD go home with some respiratory (breathing) support, like oxygen through a nasal cannula (plastic tubing with short prongs that sit in each nostril) as seen in the picture below. This is typical for infants who are growing and breathing well on their own but who need a little extra support to maintain safe oxygen levels. Babies can be on a nasal cannula at home for several months and must be followed very closely by their pediatrician and pulmonologist. This option can be safe but is not for everyone.

An even smaller number of infants with BPD may need to have additional respiratory support. Some infants need more time for their bodies and lungs to grow and will need ongoing breathing support, either on a ventilator or on CPAP. This is especially true for babies who have pulmonary hypertension, heart problems, or conditions that required surgeries. For some of these infants, their lung disease can be chronic (long-term), serious, and sometimes life-threatening.

Even fewer infants may need chronic respiratory support even after going home. This requires extensive planning, and means your child will need to have a surgery to place a tracheostomy tube in their neck/airway (or windpipe) – this tracheostomy tube will help your child breathe with the ventilator.

This may sound scary at first, but this would be a gradual discussion with lots of time to process information, and form a partnership between your family and our hospital for the long-term. You will be provided with additional details of this pathway, if it applies to your baby, and when you are ready.

Illnesses happen to all kids in infancy. However, infants with BPD may get sick more easily because their lungs are still growing and developing. Viral illnesses and recurrent cough and wheezing are common, but should be monitored closely. Some of these illnesses can cause infants with BPD to need oxygen again temporarily. Because of that, infants with BPD are frequently visiting urgent care centers, emergency departments; and sometimes need to be readmitted to the hospital several times in the first year of life.

Because many of these illnesses are contagious, it is very important for infants with BPD to receive their regular vaccinations, flu shots, and other preventive immunizations on time.

Caregivers and family members must also receive all of the needed vaccinations and do their best to avoid infections (frequent hand-washing is key!).