Bronchopulmonary dysplasia (BPD) is a breathing problem that can affect babies born prematurely. BPD is sometimes called chronic lung disease of prematurity or chronic neonatal lung disease.
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What is bronchopulmonary dysplasia (BPD)?
Bronchopulmonary dysplasia (BPD) can happen to babies as a complication of being born prematurely (before 37 weeks of pregnancy).
BPD is diagnosed if your baby still needs help breathing after they are 28 days old, or around the time of their original due date.
Bronchopulmonary dysplasia (BPD) means:
Broncho - it affects your child’s airways
Pulmonary - it affects your child’s lungs
Dysplasia - your child’s airways and lungs are not fully developed
BPD is sometimes called chronic lung disease of prematurity or chronic neonatal lung disease.
How common is it?
BPD affects babies born prematurely. The earlier a baby is born, the more likely they are to be affected by BPD.
Up to 45% of babies born at 29 weeks or less will develop BPD.
How does BPD affect babies and children?
Babies born very prematurely usually have breathing problems from birth and may need:
- a machine to support their breathing, called a ventilator
- oxygen
- surfactant.
What is surfactant?
Surfactant is a mixture of fats and proteins that help make sure the air sacs in your lungs don’t collapse when you breathe out.
It’s produced as babies’ lungs develop in the womb, but premature babies may not have enough surfactant. They are given replacement surfactant to help their lungs develop after they are born.
BPD in babies
Your baby may go home from hospital on oxygen. This will help them grow and stay healthy. Babies with BPD usually get better with time. Most children no longer need oxygen by the age of one. If your baby has more severe BPD, then they may need oxygen for longer.
It’s really important your baby gets enough calories to grow properly, so their lungs can develop. Your baby’s weight should be regularly monitored. That’s because they use more energy for breathing than most babies and are often smaller than average.
BPD in children
BPD can lead to problems with lung health in later life. This often depends on how severe it is and whether your baby develops any complications. Read more about the long-term effects of BPD.
More information for parents of premature babies
The Bliss website has information on:
What causes BPD?
BPD happens when the lungs are underdeveloped in babies born very early. When they are born prematurely, babies have very few tiny air sacs. These are not usually mature enough to work as they should. You can find out more in our information on how children’s lungs grow.
Premature lungs and respiratory distress syndrome (RDS)
Premature babies’ lungs are not yet fully developed. They may have fewer air sacs or less surfactant. This makes the lungs stiff and harder for your baby to breathe. This causes them to develop respiratory distress syndrome (RDS). RDS does not usually last long. Sometimes treatment of RDS causes bronchopulmonary dysplasia (BPD).
Oxygen therapy causing BPD
Babies born very prematurely usually have breathing problems from birth and may need oxygen therapy. As premature babies’ lungs aren’t fully developed they may be stiff, and so are more likely to be damaged by oxygen therapy or ventilation treatment. The high levels of oxygen your baby’s body needs can cause harmful chemical reactions in their lungs, and this may be a factor in developing BPD.
Even though too much oxygen can cause harm, it’s a crucial part of the treatment for premature babies.
How is BPD diagnosed?
Your child may have a chest X-ray to check for BPD and any damage to their lungs. They may also have their blood oxygen levels monitored using a pulse oximeter - a little device clipped onto your baby’s finger, ear or toe. This is used to make sure your baby is getting enough oxygen. Pulse oximetry will not hurt your baby.
Your child’s doctor may not be able to diagnose BPD from an X-ray alone. They will likely be observed further and have other tests to see how well they respond to oxygen therapy. If your child is born premature, they will likely have other health issues which will be taken into consideration during diagnosis.
Can BPD be prevented?
BPD may happen if your baby is born before their lungs have fully developed. While premature birth cannot always be avoided, exposure to tobacco smoke and air pollution are some of the things that make it more likely to develop.
If you’re at risk of premature labour, you may be given steroids to help mature your baby’s lungs.
Preventing damage from breathing support
Although life-saving, some of the treatments for BPD your child might need can also cause damage. Breathing support such as oxygen and ventilation may damage your child’s air sacs and other parts of their lungs.
If your child needs oxygen or ventilation, doctors will do all they can to prevent or reduce damage. They will use gentler breathing support if possible. They may give your child replacement surfactant and medication.