Bronchopulmonary Dysplasia

Causes

When a baby’s lungs have not had enough time to develop in the womb, they will have fewer air sacs. The air sacs are where oxygen is transferred from a baby’s lungs to their blood. To give a baby’s lungs time to finish growing, a doctor may place them on oxygen or a special machine, such as a ventilator, to help them breathe. The pressure of the oxygen flowing into the baby’s lungs can cause the fragile tissues to stretch, which then damages the lining of the airways and the small blood vessels surrounding them. This then causes BPD.

Risk Factors

The risk factors of BPD and oxygen therapy are:

• Being born more than 10 weeks early. The earlier a baby is born, the greater the risk
• Weighing less than one kilogram at birth
• Need for oxygen therapy or mechanical ventilation at birth
• Mother who smoked cigarettes during pregnancy
• Mother with significant exposure to air pollution during pregnancy
• An infection of the placenta

Diagnosis

The diagnosis of BPD will be based on a full medical examination, the degree of the baby’s maturity, and their need for oxygen after a certain age.  In order to identify the baby’s, need for oxygen, the doctor will evaluate the following:

• Chest x-ray – provide a visualization of the lungs, if the lungs look spongy that is an indicator of BPD
• Echocardiogram – helps rule out heart defects that may cause breathing difficulties
• Blood tests- provides information on oxygen level in the blood and identifies infections
• Oxygen level monitoring with a pulse oximeter (a small device attached to a baby’s hand or foot)
• Oxygen level monitoring with a transcutaneous monitor (a small device taped to a baby’s body)

Complications

Baby’s who have had BPD have an increased risk for recurring respiratory infections.  In addition, based on the length of time the baby is on oxygen therapy or a ventilator and the time it takes to heal, additional complications may arise.  Some of these complications are:

• Heart failure
• Delays in growth
• Gastro-oesophageal reflux disease (GORD)
• Delayed speech
• Problems with vision or hearing
• Learning difficulties
• Severe infections
• Sepsis
• Lung problems later in life
• Getting more lung infections than normal
• Having to go to hospital a lot

Treatment

Most children diagnosed with BPD will get better with time and will no longer need oxygen therapy after they reach age one. If a baby’s case is mild, they may only need extra oxygen. If a baby’s case is more severe, they may need a ventilator to help them breathe.

A doctor may also prescribe medications to help, such as:

• Anti-inflammatory medications to give a baby’s lungs time to fully develop. The most common type is steroids.
• Inhaled medications to open a baby’s airways.
• Surfactant replacement therapy. Surfactant is a substance which helps keep a baby’s lungs open. Premature babies often do not have enough of this.

A parent can help their baby by doing the following:

• Keep the child away from second-hand smoke (cigarettes or vaping).
• Keep them away from polluted air as much as possible.
• Watch their breathing closely if they become ill with a respiratory infection such as a cold or the flu.
• Make sure their vaccinations are up to date.
• Have a low threshold for seeking medical help if their child appears unwell.

Prevention

While premature birth is not always preventable, there are some things a mother can do to help a baby start life as healthy as possible. The mother can give up smoking, vaping, drugs, and alcohol. She can attend prenatal appointments, strive for a healthy diet and take prenatal vitamins as prescribed.