Neonatal Respiratory Diseases

Also known as Neonatal Respiratory Distress, Neonatal Respiratory Conditions, Respiratory Distress in the Newborn
Neonatal respiratory diseases are breathing disorders that affect newborns.

Neonatal respiratory diseases are common in premature newborns born before 32 weeks of pregnancy, because their lungs are not able to make enough surfactant, a foamy substance that keeps the lung fully expanded.

Neonatal respiratory diseases include:

In addition to premature birth, risk factors for neonatal respiratory diseases include low or high birth weight for gestational age; infections, either congenital or acquired during passage through the birth canal; complications during pregnancy or birth; congenital lung or heart defects; and having a mutations in the genes that controls surfactant production.

To prevent or lower the chance of neonatal respiratory disease caused by premature birth, your doctor may prescribe medicines called corticosteroid to help speed up your baby’s lung development if you show signs of going into labor early.

After birth, your doctor will check your baby for signs and symptoms of respiratory diseases, such as very slow or irregular breathing, rapid breathing, noisy or gurgled breathing, a weak cry, a rapid heart rate, grunting, flaring of the nostrils with each breath, a bluish tone to your baby’s skin and lips, or a pulling inward of the muscles between the ribs when breathing.

Your newborn’s doctor may diagnose a respiratory disease based on a physical examination, levels of oxygen and carbon dioxide in the blood measured by a skin sensor, or a chest X-ray. An echocardiogram may be performed to check for a possible heart problem that may be causing your baby’s symptoms.

If your newborn has a respiratory disease, treatment may include suction of secretions in the mouth and throat, oxygen therapy, or a continuous positive airway pressure (CPAP) device applied to the nose or mouth. Your baby may also be intubated, which involves placing a small tube in the airway that is attached to ventilator support. For severe respiratory disease, your baby may need a heart-lung machine called extracorporeal membrane oxygenation. Depending on the neonatal respiratory disease, other treatments may include surfactant replacement therapy and nitric oxide to the lungs to improve blood flow there, caffeine to regulate breathing, or antibiotics or other medicine to treat an infection.

Neonatal respiratory diseases could lead to low levels of oxygen to the body, affecting vital organs such as the heart, brain, and kidney. They can also lead to long-term lung damage, frequent lung infections, and developmental delays. With careful treatment, the complications of neonatal respiratory diseases may go away over time. Learn more about research studies to improve the quality of life for newborns who have respiratory diseases in Research for Your Health.

Research for Your Health

The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including neonatal respiratory diseases. Learn about current and future NHLBI efforts to improve health through research and scientific discovery.

Improving health with current research
- Neonatal Respiratory Diseases

Learn about the following ways the NHLBI continues to translate current research into improved health for newborns who have respiratory diseases. Research on this topic is part of the NHLBI’s broader commitment to advancing lung disease scientific discovery.

  • Pioneering Advances in Critical Care for Newborns Who Have Respiratory Diseases. Ground-breaking research funded by the NHLBI has helped establish the standard of care for neonatal respiratory diseases. Our research helped develop the use of corticosteroids to accelerate lung development in babies at risk for premature birth. We also funded studies to develop the use of surfactant replacement therapy to improve breathing in premature newborns and the use of nitric oxide to treat pulmonary hypertension. These treatment methods continue to significantly improve the survival and long-term quality of life for premature newborns.
  • Preventing the Long-Term Complications of Neonatal Respiratory Diseases. The NHLBI has organized several workshops to help direct future research into neonatal respiratory diseases. These workshops have focused on research to improve our understanding of the development of Chronic lung disease and eliminate health disparities in the survival and long-term quality of life for newborns who have respiratory diseases. View NHLBI Workshop on Prenatal and Perinatal Determinants of Lung Health and Disease in Early Life and NHLBI and NICHD Workshop on Adults Born Preterm: The Epidemiology and Biological Basis for Outcomes for more information.
  • Using Vitamin D to Help Reduce Wheezing in Premature Newborns. Wheezing is a common complication of neonatal respiratory diseases. Research funded by the NHLBI has shown that premature newborns who received regular vitamin D supplements had a lower risk of wheezing than those who did not receive supplements. This finding may help improve clinical care to prevent the complications of respiratory diseases in newborns.
  • Identifying the Complications of Oxygen Therapy. NHLBI-funded research helped determine that forceful and prolonged oxygen therapy in newborns can cause chronic lung disease. This finding helped change the guidelines for the use of oxygen therapy to treat newborns who have respiratory diseases.
  • Advancing the understanding of lung development. The NHLBI-funded Molecular Atlas of Lung Development Program (LungMAP) is integrating many datasets to build a molecular map of the developing lung in both humans and mice. The program is helping advance lung research, in part through its web-based data resource, called BREATH, that allows users to access LungMAP data and findings.

Advancing research for improved health
- Neonatal Respiratory Diseases

In support of our mission, we are committed to advancing neonatal respiratory diseases research, in part through the following ways.

  • We fund research. The research we fund today will help improve our future health. Our Division of Lung Diseases, which includes the Lung Biology and Disease Branch, oversees much of the research on neonatal respiratory diseases we fund, helping us to understand, prevent, and manage neonatal respiratory diseases. Search the NIH RePORTer to learn about research the NHLBI is funding on neonatal respiratory diseases.
  • We stimulate high-impact research. The NHLBI Strategic Vision highlights ways we may support research over the next decade.

Learn about exciting research areas the NHLBI is exploring about neonatal respiratory diseases.

Participate in NHLBI Clinical Trials

We lead or sponsor many studies on neonatal respiratory diseases. See if you or someone you know is eligible to participate in our clinical trials.

Has your newborn been diagnosed with patent ductus arteriosus?

Patent ductus arteriosus (PDA) is a condition in which a connection between two major blood vessels close to the heart does not close properly after birth. This affects blood flow to the lungs and may cause neonatal respiratory diseases. PDA may correct itself, but sometimes treatment may be necessary. This study aims to identify ways by which doctors can predict which cases of PDA need to be treated. To participate in this study, your newborn must have been born between 23 and 29 weeks’ gestation and have been diagnosed with PDA. This study is located in Columbus, Ohio.

Is your premature newborn in a neonatal intensive care unit in Chicago, Illinois?

This study is investigating how brain development affects breathing in premature newborns. To participate in this study, your newborn must have been born prematurely between 24 and 29 weeks’ gestation and admitted to the neonatal intensive care unit within a week of birth. This study is located in Chicago, Illinois.

Is your newborn in the NICU at Holtz Children’s Hospital in Miami?

Newborns born very prematurely often need oxygen therapy or ventilation to help them breathe and survive. This study will help doctors understand how changes in oxygen and carbon dioxide levels while newborns are getting treatment affect how their lungs develop. While your newborn is in the newborn neonatal intensive care unit (NICU), researchers will record his or her oxygen and carbon dioxide levels, heart rate, and other measures. To participate in this study, your newborn must have been born prematurely between 23 and 28 weeks’ gestation, be less than 28 days old, and be receiving oxygen therapy. This study is located in Miami, Florida.

Was your newborn born prematurely?

This study aims to better understand the effects of premature delivery on a baby’s lungs during his or her first year of life. To participate in this study, your newborn must have been born prematurely between 24 and 36 weeks’ gestation and not have any congenital heart or lung defects. This study is located in Indianapolis, Indiana.

Is your newborn in the neonatal intensive care unit at St. Louis Children’s Hospital?

This study aims to better understand breathing problems and blood flow through the heart in premature newborns to better detect conditions such as pulmonary hypertension. To participate in this study, your newborn must have been born prematurely between 24 and 29 weeks’ gestation and be a patient in the Neonatal Intensive Care Unit at St. Louis Children’s Hospital. This study is located in St. Louis, Missouri.

Have you been diagnosed with high blood pressure while pregnant?

This study is investigating whether a mother’s blood pressure during pregnancy affects her newborn’s lung development. To participate in this study, your newborn must have been born either prematurely at more than 25 weeks’ gestation or at full term to a healthy mother or a mother who was diagnosed with high blood pressure during pregnancy. This study is located in Indianapolis, Indiana.

More Information

After reading our Neonatal Respiratory Diseases Health Topic, you may be interested in additional information found in the following resources.

NHLBI resources
- Neonatal Respiratory Diseases

Non-NHLBI resources
- Neonatal Respiratory Diseases


Microscope view of the lungs
Research Feature
Might pave the way for new and improved treatments for a wide variety of respiratory diseases Maps may be great tools for helping you find your way around unfamiliar places, but in the future, a new type of map well might help save your life. Welcome to the Molecular Atlas of Lung Development Program, or LungMAP, a historic effort to help...