What is respiratory distress syndrome in premature babies?
Respiratory distress syndrome (RDS) is a common problem in premature babies. It causes babies to need extra oxygen and help with breathing. The course of illness with RDS depends on:
RDS typically gets worse over the first 2 to 3 days. It then gets better with treatment.
RDS occurs when there is not enough surfactant in the lungs. Surfactant is a liquid made by the lungs that keeps the airways (alveoli) open. This liquid makes it possible for babies to breathe in air after delivery. An unborn baby starts to make surfactant at about 26 weeks of pregnancy. If a baby is premature (born before 37 weeks of pregnancy), he or she may not have made enough surfactant yet.
When there is not enough surfactant, the tiny alveoli collapse with each breath. As the alveoli collapse, damaged cells collect in the airways. They further affect breathing. The baby has to work harder and harder to breathe trying to reinflate the collapsed airways.
As the baby's lung function gets worse, the baby takes in less oxygen. More carbon dioxide builds up in the blood. This can lead to increased acid in the blood (acidosis). This condition can affect other body organs. Without treatment, the baby becomes exhausted trying to breathe and over time gives up. A ventilator must do the work of breathing instead.
RDS occurs most often in babies born before the 28th week of pregnancy. Some premature babies get RDS severe enough to need a breathing machine (ventilator). The more premature the baby, the higher the risk and the more severe the RDS.
Most babies with RDS are premature. But other things can raise the risk of getting the disease. These include the following:
These are the most common symptoms of RDS:
The symptoms of RDS usually get worse by the third day. When a baby gets better, he or she needs less oxygen and mechanical help to breathe.
The symptoms of RDS may look like other health conditions. Make sure your baby sees his or her healthcare provider for a diagnosis.
RDS is usually diagnosed by a combination of the following:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment for RDS may include:
Babies sometimes have complications from RDS treatment. As with any disease, more severe cases often have greater risks for complications. Some complications of RDS include:
Preventing a premature birth is the main way to prevent RDS. When a premature birth can’t be prevented, you may be given corticosteroids before delivery. These medicines may greatly lower the risk and severity of RDS in the baby. These steroids are often given between 24 and 34 weeks of pregnancy to women at risk of early delivery. They may sometimes be given up to 37 weeks. But if the delivery is very quick or unexpected, there may not be time to give the steroids. Or they may not have a chance to start working.
Tips to help you get the most from a visit to your child’s healthcare provider:
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