Living With Bronchopulmonary Dysplasia
BPD tends to cause the most symptoms during infancy and early childhood. As affected children grow healthy new lungs they gradually improve, and by 3 to 5 years of life most of them are just like normal healthy children of the same age. However, the lungs may not be completely normal, and may contribute to problems later in adulthood.
What to Expect
In general, infants with BPD tend to get better as they grow older. This is because most of the lung growth takes place after birth and throughout childhood. However, how fast and to what degree they will get better, as well as the amount and type of care each patient will need, varies.
Infants with mild BPD may not need any special treatment. Others may need medications given either as an aerosol or by mouth either daily or when they get sick.
Premature infants with even mild BPD are at risk for pauses in breathing (apnea), especially during sleep, causing temporary drops in the oxygen levels in the blood and in the heart rate (bradycardia). This is because the part of the brain that controls the breathing is not fully developed until about 44 weeks after the beginning of the pregnancy (in other words, about 1 month after a healthy normal baby is born). Infants with pauses in breathing and low heart rates are often discharged to go home with monitors that continuously check their breathing and heart rate. They may also be sent home with devices that monitor the oxygen levels in the body (pulse oximeters).
Patients with more severe disease may need oxygen given with nasal prongs for several months. They may also need some form of support with a machine that delivers pressure through the nose through special prongs or a mask. These machines provide either continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP). A small number of patients with very severe disease may need to stay on a ventilator for a long time, in which case they will need to receive a tracheostomy (a breathing tube inserted into the lungs through the neck).
It is highly recommended that infants with BPD be evaluated and followed by a pediatric lung specialist at least during the first few years of life.
Infants with BPD do not necessarily get sick more often than other infants. However, they tend to develop more severe symptoms than infants who have the same infections, their recovery lasts longer and illnesses may set them back in their progress (e.g., infants who had been taken off oxygen may require oxygen again). Frequent hospitalizations are common, especially among those with moderate to severe BPD.
Infants with severe BPD frequently experience additional problems, including feeding difficulty (that may be severe enough to require placement of a permanent feeding tube), acid reflux, pulmonary hypertension, neurologic complications, vision or hearing problems and various learning disabilities. Most of these complications are rare in those with mild to moderate BPD.
The frequent ups and downs in the health of infants with severe BPD can result in challenges for the caretakers who may experience psychological problems (e.g., anxiety, depression) of their own.
Managing Bronchopulmonary Dysplasia
Early treatment centers on helping your child's lungs to develop and preventing respiratory symptoms. You should contact your doctor if your child has a cough, cold, irritability, runny nose or fever.
Many respiratory infections can be prevented with simple measures, such as washing your hands before you touch the infant and discouraging those who are sick from visiting. It is also important to follow your doctor's advice regarding vaccinations for the infant and the siblings, as well as for the caregivers.
Reducing lung irritants such as cigarette smoke, dust and pollution will help the lungs to grow and develop. Don't allow smoking within the house or anywhere else near the baby.
Most babies with BPD get better over time. As your child's lungs improve and mature, they will have fewer problems with their breathing. Symptoms can settle down by 2 to 3 years old and may not require any further medical treatment.
Family and friends are great sources of support. Additionally, hospital personnel such as doctors, nurses, case managers and social workers will provide useful insight into your child's needs after leaving the hospital. They may also be able to direct you to support groups for parents of premature infants.
The Lung Association recommends patients and caregivers join our Living with Lung Disease Support Community to connect with others facing this disease. You can also call the Lung Association's Lung HelpLine at 1-800-LUNGUSA to talk to a trained respiratory professional who can help answer your questions and connect you with additional support.