BPD is a type of neonatal respiratory disease that develops as a result of a newborn's lungs not developing normally while the baby is growing in the womb or not developing fully if the baby was born premature. These babies’ lungs are fragile and can be easily irritated or inflamed after birth. Ventilation, high levels of oxygen, or infections can also damage premature newborns' lungs.
Newborns who have breathing problems or cannot breathe on their own may need ventilator support. Ventilators are machines that use pressure to blow air into the airways and lungs.
Although ventilator support can help premature newborns survive, the machine's pressure might irritate and harm the babies' lungs. For this reason, doctors only recommend ventilator support when necessary.
Newborns who have breathing problems might need oxygen therapy. This treatment helps the newborns' organs get enough oxygen to work well.
However, high levels of oxygen may inflame the lining of the lungs and injure the airways. Also, high levels of oxygen can slow lung development in premature newborns.
Infections may inflame the lungs. As a result, the airways narrow, which makes it harder for premature newborns to breathe. Lung infections also increase the babies' need for extra oxygen and breathing support.
The more premature a newborn is and the lower his or her birth weight, the greater the risk of BPD. Most newborns who develop BPD are born more than 10 weeks before their due dates, weigh less than 2 pounds at birth, and have breathing problems. Infections that occur before or shortly after birth also can contribute to BPD.
The number of babies who have BPD is higher now than in the past. This is because of advances in care that help more premature newborns survive.
Many babies who develop BPD are born with serious respiratory distress syndrome (RDS). However, some babies who have mild RDS or do not have RDS also develop BPD.
Studies show that genetic factors may also play a role in causing BPD, but more studies are needed. Learn more about NHLBI research on BPD and neonatal respiratory diseases.
Taking steps to ensure a healthy pregnancy might prevent your newborn from being born before his or her lungs have fully developed. These steps include:
Your doctor may give you injections of a corticosteroid medicine if he or she thinks you may give birth too early. This medicine can speed up development of the lungs, brain, and kidneys in your baby and surfactant production. Usually, within about 24 hours of your taking this medicine, the baby's lungs start making enough surfactant. This will reduce the newborn's risk of respiratory distress syndrome, which can lead to BPD.
Many babies who develop BPD are born with serious respiratory distress syndrome (RDS). A first sign of BPD is when premature newborns—usually those born more than 10 weeks early—still need oxygen therapy by the time they reach 36 weeks gestation.
Newborns who have severe BPD may have trouble feeding, which can lead to delayed growth. These babies also may develop:
Newborns who are born early—usually more than 10 weeks before their due dates—and still need oxygen therapy by the time they reach their original due dates are diagnosed with BPD.
BPD can be mild, moderate, or severe. The diagnosis depends on how much extra oxygen a baby needs at the time of the original due date. It also depends on how long the baby needs oxygen therapy.
To help confirm a diagnosis of BPD, doctors may recommend tests, such as:
Treatment in the NICU is designed to limit stress on newborns and meet their basic needs of warmth, nutrition, and protection. Treatment of BPD usually includes breathing support with a nasal continuous positive airway pressure (NCPAP) machine or a ventilator, other supportive treatments, and other procedures and treatments.
Once doctors diagnose BPD, some or all of the treatments used for RDS will continue in the NICU.
Newborns who have BPD often need breathing support, or oxygen therapy, until their lungs start making enough surfactant. Until recently, a mechanical ventilator usually was used. The ventilator was connected to a breathing tube that ran through the newborn's mouth or nose into the windpipe.
Today, more and more newborns are receiving breathing support from NCPAP. NCPAP gently pushes air into the baby's lungs through prongs placed in the newborn's nostrils.
Treatment in the NICU helps limit stress on babies and meet their basic needs of warmth, nutrition, and protection. Such treatment may include:
As BPD improves, babies are slowly weaned off NCPAP or ventilators until they can breathe on their own. These newborns will likely need oxygen therapy for some time.
Newborns who have BPD may spend several weeks or months in the hospital. This allows them to get the care they need, which may include:
After your baby leaves the hospital, he or she will likely need follow-up care. It is important to follow your child’s treatment plan and get regular care. It is also important to take care of your mental health as you care for your baby at home.
Your child will likely continue on all or some of the treatments that were started at the hospital, including:
Your child also should have regular checkups with and timely vaccinations from a pediatrician, a doctor who specializes in treating children. If your child needs oxygen therapy or a ventilator at home, a pulmonary specialist might be involved in his or her care.
Newborns who have BPD may have health problems even after they leave the hospital. These include:
Babies who have very severe BPD also may develop other problems, such as:
The risk of these complications increases in newborns who are very small at birth.
You can take steps to help manage your child's BPD and help him or her recover.
Caring for a premature newborn can be challenging. You may experience
You can take steps to help yourself during this difficult time.
Learn about the following ways the NHLBI continues to translate current research into improved health for babies who have bronchopulmonary dysplasia. Research on this topic is part of the NHLBI’s broader commitment to advancing lung disease scientific discovery.
In support of our mission, we are committed to advancing bronchopulmonary dysplasia research in part through the following ways.
Learn about exciting research areas the NHLBI is exploring about BPD.
We lead or sponsor many studies related to bronchopulmonary dysplasia. See if you or someone you know is eligible to participate in our clinical trials.
After reading our Bronchopulmonary Dysplasia Health Topic, you may be interested in additional information found in the following resources.