BRONCHOPULMONARY DYSPLASIA
(BPD)
CONTENT
What is Bronchopulmonary Dysplasia
What causes Bronchopulmonary Dysplasia
What are the signs and symptoms
How is it treated
Growth & Development
Feeding & Special Formula
When will my baby feel better
What can a parent do
WHAT IS BRONCHOPULMONARY DYSPLASIA (BPD)
1. BPD is a chronic lung disease. It happens to babies who:
a. Had severe Respiratory Distress Syndrome (RDS)
b. Received high levels of oxygen for a long time
c. Were on a mechanical ventilator (breathing machine) for a long time
d. Had a lung infection
e. Were born very prematurely and had immature lungs—especially if he was less
than 30 weeks’ gestation at birth. The earlier a baby is born the greater the
chance that he or she will have immature lungs and have BPD.
WHAT CAUSES BPD
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BPD is a reaction of the lungs to the oxygen and ventilator that were needed to
treat the baby’s lung disease. However, without the oxygen and ventilator the baby
might have died.
In the latter stages of BPD the bronchi (pipes that carry air to the lungs),
bronchioles (smaller bronchi) and lungs become scarred.
Damaged and scarred lungs make it hard for the baby to breathe in oxygen and
exhale (breathe out) carbon dioxide.
Sometimes very premature babies get BPD even if they did not need much extra
oxygen or a ventilator after birth.
BPD makes the heart and the lungs work hard. The word for a heart that works
hard is “cor pulmonale.” Not all babies with BPD have cor pulmonale.
BPD gradually improves over the first several years of life.
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WHAT ARE THE SIGNS AND SYMPTOMS
1. The baby does not show improvement in his breathing during the first few days of
life despite mechanical ventilation and oxygen.
2. The baby continues to require more and higher levels of oxygen and ventilator
pressures to keep his oxygen levels within a normal range.
3. Symptoms may include:
a. Tachypnea (breathing fast)
b. Tachycardia (fast heart rate)
c. Retractions (the chest sinks in at the ribs and breastbone)
d. Desaturation episodes (drop in oxygen levels)
e. Edema (swelling of face, hands, feet)
f. Decreased urine output
g. Increased secretions (seen sometimes)
h. Difficulty gaining weight.
HOW IS IT TREATED
1. Each baby is treated individually since each baby has different needs.
2. The doctors will continue to support your baby’s breathing with oxygen and the
necessary mechanical ventilation.
3. When your baby is ready to come off of respiratory support, we will “wean” (slowly
lower) him from the ventilator but keep him in oxygen for a while longer.
4. Based on your baby’s response to the weaning, a plan is made day by day (and
sometimes minute by minute) for your baby.
a. The length of time a baby needs oxygen is different for each baby
b. Some babies may be discharged home on oxygen.
c. The doctors will talk with you about your baby’s needs.
5. If your baby was less than 30 weeks’ gestation at birth, he/she will be given Vitamin
A.
a. Vitamin A is a medication (drug) that helps the baby’s lungs grow and develop
b. This medication is given by injection every Monday, Wednesday and Friday for a
total of 12 doses
c. The doctors and/or nurse practitioners will talk with you about this medication.
Please don’t hesitate to ask any questions you may have.
6. Other support/treatments may include:
a. IVs used for giving fluids & medications or for drawing lab specimens
b. Developmental care
c. Parental teaching
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d. Medicine to help get rid of the extra water in the baby’s lungs and body
e. Discharge planning so your home will be ready for the baby when he comes home.
GROWTH AND DEVELOPMENT
1. Babies with BPD often do not grow or gain weight as fast as other infants the first 2
years of life.
a. Breathing uses energy and calories needed for growth.
b. The baby’s doctor will make sure your baby grows and gains weight.
2. Some babies roll over, sit, reach or walk late. Many catch up after their health is
better. It is important your baby be seen at a special developmental follow-up
program due to his prematurity and the problems he had in the NICU.
3. Talk to your baby; smile at him; play music for him; hang bright mobiles in his sight
and other usual baby stimulation.
4. Babies with BPD are often more cranky and fussy than the average baby. They cry
more and may be hard to calm. Be patient and gentle.
5. Too many people handling your baby is a problem. Your baby may need a quiet room
with dim lights to quiet him. Many babies do better when they are swaddled or
wrapped snugly in a blanket.
6. Signs of stress include a baby who turns blue or pale, breathes fast, becomes limp,
stops feeding, or closes his eyes as if to say, “Time to rest.”
FEEDING AND SPECIAL FORMULA
1. You will be told how much to feed your baby. Too much milk or fluid may make your
baby work harder to breathe.
2. Special formula or additives may be used to give your baby extra calories needed for
growth without giving him too much liquid. If you are on WIC, you will need a
prescription for special formulas or additives.
3. Your baby may be slow to feed. He may breathe hard when you feed him. If he
turns pale, blue, or tires remove the bottle from his mouth and let him rest. Your
baby’s doctor will help you decide if it is necessary to increase your baby’s oxygen
with feedings.
4. Some babies with BPD cannot suck the entire feeding. They become too tired and do
not grow well. They are fed with a gavage tube (tube put into the nose or mouth
that goes to the stomach) or a gastrostomy tube (tube placed through the skin into
the stomach).
5. Most babies can suck their feeding once their health gets better.
6. Your baby’s doctor will help you decide when to increase your baby’s feeding or
additives.
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WHEN WILL MY BABY FEEL BETTER
1. Some babies get better more quickly than others.
2. It is very common for a baby to have ups and downs in their oxygen needs.
3. It is also common for a baby to wean off some of the breathing support equipment
but need it again later.
4. If you have older children, you might compare weaning to an older child learning to
ride a bike—some get right on and ride right away—others just have to keep trying
for awhile before they learn to ride.
WHAT CAN A PARENT DO
1. Keep up with your baby’s progress each time you visit or call.
2. An important part of the baby getting better is the parents’ love and concern.
3. We encourage you to talk and sing to your baby, gently touch them and hold them
close if possible. Talk with your baby’s nurse about this.
4. Your love and attention will go a long way in helping your little one on the road to
recovery.
Reviewed/Revised:
07/01, 2/03, 8/05, 9/05, 4/07, 12/09
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