Pediatric Chronic Lung Disease (CLD)
Chronic lung disease means that there is damage to the newborn’s lungs. The lungs trap air, collapse, fill with fluid or produce extra mucus, making it hard for the infant to breathe.
Respiratory problems immediately following birth (also known as neonatal) most often are seen in premature babies. This is because their lungs have not had enough time to develop fully. However, even full-term infants can have breathing concerns if they have other illnesses. With the help of our doctors, nurses, and other staff, most babies with chronic lung disease at birth will survive. In time, many outgrow most of their lung problems.
What causes chronic lung disease? It’s not an easy question to answer. Sometimes it’s because the lungs are not fully developed if the child is born early. They often lack surfactant, a lubricant found in healthy lungs. It prevents lung collapse and allows for the rise and fall of the lungs when breathing in and out. Another cause is when there are few alveoli, tiny air sacs where the oxygen leaves the lung and gets into the blood steam.
For babies that are born at full term, other illnesses or defects may cause lung disease. These include:
- Aspiration syndrome (breathing in fluids)
- Diaphragmatic hernia
- Heart defects present at birth
- Pulmonary hypertension
Tests and Diagnosis
There may be a number of tests for your child, both to establish a diagnosis and to monitor treatment. All of the doctors, nurses, and technicians involved in your child’s care have specialized training. In addition, they are all highly experienced in the special techniques needed to safely work with even the tiniest baby.
Your pediatrician will perform a medical exam of your infant, looking for any symptoms of lung deficiency. These will include how fast the child breathes, if breathing is hard work, nasal flaring or the use of muscles in the chest that aren’t normally used to breathe. The doctor will also see if there is any blueness of the lips. Tests can confirm suspected cases and help determine specific problems.
Your child will probably have a blood gas test done at intervals. This measures the levels of oxygen and carbon dioxide to see how well your child’s lungs are getting oxygen into the blood and carbon dioxide out.
Spirometry is another commonly used lung test. Your child will breathe into a mouthpiece attached to a recording device called a spirometer. The test looks at things such as the amount of air exhaled with force after inhaling deeply, how quickly air is exhaled, and the amount of air left in the lungs after a normally exhaled breath.
The main focus of the treatment team will be on helping your child breathe more easily. This reduces stress on the body and helps the lungs mature and heal on their own.
Oxygen will be given to help your baby breathe better. It may be given through a tube in the nose or mouth. Another option is using a hood that covers the head entirely. If needed, a machine called a ventilator helps babies who can’t breathe on their own.
Your child’s doctor may prescribe medications to treat specific conditions.
- Bronchodilators may be used to open up the airways.
- Corticosteroids are often used to lessen inflammation.
- Diuretics are given to keep fluid from building up in the lungs.
Nutritional support is another important part of your child’s treatment plan. Babies with breathing problems burn a lot of calories. They need extra proteins and calories to keep growing at a normal rate. In addition, they may not be able to eat directly from bottle or at the breast. High-calorie and -protein mixtures may be given directly through a tube put in the stomach, in the nose, or into a vein.
What is chronic lung disease?
By definition, any newborn suffering from lung problems has chronic lung disease. Neonatal respiratory problems most often affect premature babies who have underdeveloped lungs but they also can affect full term babies who have underlying illnesses.
How common is chronic lung disease in infants?
Bronchopulmonary dysplasia (the most common type of chronic lung disease) occurs in 20% percent of the 60,000 newborns in the U.S. who weigh less than 1,500 grams at birth.
What are the causes of chronic lung disease in infants?
Among other complex causes are prematurity, illness or infection and side effects of needed mechanical ventilation and supplemental oxygen.
What are the symptoms of chronic lung disease in infants?
Among other symptoms, there is rapid and difficult breathing and grunting; flared nostrils and weight loss.
How is chronic lung disease diagnosed?
It is diagnosed following a physical examination, testing for blood gases, and chest X-rays.
What are the treatments for chronic lung disease?
Treatment includes breathing support and medications to treat infections and inflammation.
What are some risk factors of chronic lung disease in infants?
Some risk factors include: prematurity, low birth weight, infections in the mother and secondary inflammation in the mother and womb, following an infection.