Breathing and lung conditions

This section describes some of the most common breathing and lung conditions babies have in the NICU:

• Apnea
• Bronchopulmonary dysplasia
• Meconium aspiration syndrome
• Persistent pulmonary hypertension of the newborn
• Pneumonia
• Pneumothorax
• Respiratory distress syndrome
• Transient tachypnea of the newborn

apnea (AP-nee-uh)
What it is: A breathing problem in which a baby stops breathing for more than 15 seconds. A baby with apnea may take a long breath, then a short one, then pause for 15 to 20 seconds before starting to breathe again. This breathing problem can cause a slow heart rate, called bradycardia. NICU staff may talk about apnea and bradycardia as A’s and B’s.

Treatment: NICU staff put sensors on the baby’s chest. These sensors do not hurt the baby. They send information about his breathing and heart rate to a monitor. If the baby stops breathing, an alarm beeps. A nurse helps the baby start breathing by patting him gently or touching the soles of his feet. If the problem is severe, the doctor may give the baby medicine or use equipment to help him breathe.


bronchopulmonary dysplasia (bron-koh-PUHL-moh-nair-ee diss-PLAY-zhuh)
What it is: Also called BPD. A long-term lung problem. Premature babies (born before 37 weeks of pregnancy) who have a serious breathing problem called respiratory distress syndrome (also known as RDS) and full-term babies (born between 39 weeks and 40 weeks, 6 days) who have infections (illnesses you get from some viruses, bacteria or other germs) like pneumonia can get BPD.

Treatment: Treatment includes giving the baby oxygen from a continuous positive airway pressure machine (also called CPAP, a machine that helps a baby breathe) or a mechanical ventilator (a machine that breathes for a baby when he is not breathing on his own or needs help breathing) to help her baby breathe. Babies also can get medicine to help them breathe.

Treatment includes giving the baby oxygen from mechanical ventilator (a machine that breathes for a baby when she is not breathing on his own or needs help breathing) or a continuous positive airway pressure machine (also called CPAP) to help her baby breathe. Babies also can get medicine to help them breathe.


meconium aspiration syndrome (muh-KOH-nee-uhm ass-puh-RAY-shuhn SIN-drohm)
What it is: Meconium is a baby’s first bowel movement (also called stool or poop). Sometimes babies pass their first stool while still in the uterus or during birth. If this happens, the baby may breathe in some of the stool in the amniotic fluid (fluid around the baby in the womb). This can block the baby’s airways and make it hard for her to breathe.

Treatment: Treatment includes suctioning out the meconium and giving the baby oxygen. Babies with a more serious case may need antibiotic medicine to treat any infections (an illness caused by some viruses, bacteria or other germs) and a machine called a mechanical ventilator to help them breathe.


persistent pulmonary hypertension of the newborn (pur-SIS-tuhnt PUHL-moh-nair-ee hye-pur-TEN-shuhn)
What it is: Also called PPHN. A breathing problem in which a baby can’t get enough oxygen because he doesn’t have enough blood flowing through his lungs. When most babies are born, the blood vessels in the lungs relax and open up so the blood can flow through. Once the blood flows well, it can pick up more oxygen. For babies with PPHN, the blood vessels don’t relax and the blood doesn’t flow well. When this happens the blood can’t pick up enough oxygen.

Treatment: Treatment includes using a machine, called a mechanical ventilator, to help the baby breathe and giving the baby nitric oxide. This gas helps blood vessels in the lungs relax so more blood can flow through.


pneumonia (noo-MOH-nyuh)
What it is: A lung infection common in premature (born before 37 weeks of pregnancy) and other sick newborns. Infections can be caused by viruses, bacteria or other germs. Signs of pneumonia include trouble breathing, changes in breathing rate and having more frequent episodes of apnea (when a baby stops breathing for 15 seconds more more).

Treatment: To check for pneumonia, a doctor listens to the baby’s lungs and does a chest X-ray (a test that uses small amounts of radiation to take pictures of the inside of the body) to check for an infection and fluid in the lungs. The doctor may insert a tube into the baby’s airway to take a sample of fluid to check for bacteria or a virus. Treatment includes antibiotics (medicine that kills infections caused by bacteria). Some babies need help to breathe until the infection clears up.


pneumothorax (noo-moh-THOR-aks)
What it is: A breathing problem that happens when air from the lungs leaks out into the space between the lungs and chest wall. Once it leaks out, the air can’t get back into the lungs for normal breathing. Premature babies (born before 37 weeks of pregnancy), and babies who breathe in meconium (a baby’s first bowel movement) may get this condition.

Treatment: Small leaks may not cause problems or need treatment. Larger leaks may cause serious problems, like collapsed lungs. If the baby has a larger leak, the provider places a needle or thin tube (called a catheter or chest tube) in his chest to remove the air that has leaked into the chest.


respiratory distress syndrome (ress-puhrah-TOR-ee diss-STRESS SIN-drohm)
What it is: Also called RDS. A serious breathing problem that happens more often in premature babies born before 34 weeks of pregnancy. Babies with RDS don’t have enough surfactant in their lungs. Surfactant is a substance that helps prevent the lungs from collapsing at the end of each breath. Babies with RDS may need help to breathe.

Treatment: One treatment for RDS is giving a baby surfactant to help the lungs work properly. Another treatment uses the continuous positive airway pressure machine (also called a CPAP, a machine that helps a baby breathe), which sends air into the lungs through small tubes put in the baby’s nose or windpipe.


transient tachypnea of the newborn (TRANS-ee-uhnt ta-KIP-nee-uh)
What it is: Also called TTN. When a baby has trouble breathing after being born. Babies with TTN breathe faster than normal, and they may make a grunting sound.

Treatment: Providers use blood tests and X-rays (a test that uses small amounts of radiation to take pictures of the inside of the body) to check for TTN. Treatment includes providing oxygen, using a mask or a continuous positive airway pressure machine (also called CPAP) to help the baby breathe better. The CPAP machine sends air into the lungs through small tubes put in the baby’s nose or down his windpipe. Once TTN goes away, most babies get better quickly and don’t have other breathing problems.