Patient education: Respiratory distress syndrome in newborn babies (The Basics)

What is respiratory distress syndrome in newborn babies? — 

Respiratory distress syndrome, or "RDS," is a condition that causes breathing problems in newborn babies.

Normally, there is a substance called "surfactant" inside the lungs that helps them stay inflated. Most often, RDS happens when there is not enough surfactant in the lungs. It can also happen when the surfactant does not work as well as normal. These problems can be caused by:

●Lungs that are not fully developed – This is most common in babies born premature. Pregnancy normally lasts about 40 weeks. Babies born before 37 weeks of pregnancy (3 or more weeks before the due date) are called "premature" or "preterm."

●A genetic problem

What are the symptoms of RDS? — 

Symptoms usually start within the first few hours after birth. They include:

●Fast breathing – This means more than 60 breaths a minute. This is more than 1 breath every second.

●Looking blue or gray in the face, or having blue or gray skin, lips, fingernails, or toenails

●Hard breathing – This can include:

•Nostrils that open wide when the baby takes a breath

•Skin and muscles that look like they are caving in – This can happen between the baby's ribs or under their ribcage.

•Grunting when the baby breathes out

Symptoms of RDS usually last less than 1 week.

Will my baby need tests? — 

Yes. The doctor or nurse will do a chest X-ray or ultrasound to check for RDS. These are imaging tests that create pictures of the inside of your baby's body.

Other conditions, such as pneumonia, can cause breathing problems similar to those of RDS. The doctor can order other tests to help figure out if a baby has RDS or a different condition. These can include blood tests or other imaging tests.

How is RDS treated? — 

RDS usually goes away by the time a baby is 1 week old. Until that happens, babies with RDS will usually stay in the neonatal intensive care unit, or "NICU." This is a part of the hospital where doctors and nurses take care of babies who are sick or who were born too early.

In the NICU, doctors can help the baby get enough oxygen and nutrition if they need it. Treatments might include:

●Extra oxygen – This helps make sure the baby has enough oxygen in their blood. It can be given through:

•2 plastic tubes put in the baby's nostrils, called a "nasal cannula"

•A mask over the baby's mouth and nose – Sometimes, the mask only covers their nose. This is called "continuous positive airway pressure," or "CPAP."

•A breathing tube – This is a tube that goes down the throat and into the lungs. The other end is attached to a ventilator (breathing machine).

●Surfactant – This helps the baby's lungs inflate normally.

●Temperature control – This keeps the baby from getting too hot or too cold.

●Feeding tube or IV – If the baby has trouble breathing, they might not be able to nurse or drink from a bottle. A feeding tube is a small tube that goes into the baby's mouth or nose, down their throat, and into their stomach. It can be used to put breast milk or formula right into the baby's stomach.

An IV is a thin tube that goes into a vein. It can put fluids and medicines into the baby's bloodstream.

●Medicines through an IV – For example, the doctor might give antibiotics to try to prevent infections or stop them if they happen.

Can RDS be prevented? — 

Sometimes. The most important thing you can do is to lower your risk of preterm labor. During pregnancy, avoid smoking, recreational drugs, and medicines not prescribed by your doctor or midwife. It's also important to see your doctor, nurse, or midwife regularly. They will monitor your health and watch for problems that might need treatment.

If you have preterm labor, you might get steroid medicines, especially if you are fewer than 34 weeks pregnant. Steroids speed up the growth of your baby's lungs. This makes it less likely for them to get RDS.

Babies born very early (before 32 weeks) can get CPAP shortly after birth. In some cases, this can help them get enough oxygen so they do not develop RDS.

More on this topic

Patient education: Respiratory distress syndrome in newborn babies – Discharge instructions (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: When a baby is born premature (The Basics)
Patient education: Pneumonia in children (The Basics)