WHAT YOU NEED TO KNOW: What is respiratory distress syndrome? Respiratory distress syndrome (RDS) is a condition that causes breathing problems in newborns. This condition is also called hyaline membrane disease. It may start within minutes to hours after your baby is born. It is most common in premature infants because their lungs may not be fully developed. What causes RDS? Lungs that are not fully developed may not make enough surfactant. Surfactant is a substance made inside the tiny air sacs of the lung tissue. Surfactant keeps the tiny air sacs open so your baby can get enough oxygen as he breathes. Without enough surfactant, the air sacs collapse and cause breathing problems. What increases my child's risk for RDS? - He was born before 37 weeks.
- He was born to a mother with diabetes.
- His sibling had RDS.
- He did not get enough oxygen before, during, or just after birth.
What are the signs and symptoms of RDS? Your baby may have any of the following: - He has fast breathing, or periods of no breathing.
- He makes grunting sounds, especially when he exhales.
- The skin between and around the ribs pulls in when your baby inhales, or the middle of your baby's chest may sink deeply in as he breathes.
- His nostrils flare as he breathes.
- He has pale or blue skin, lips, and nails.
How is RDS diagnosed? Your baby's healthcare provider will do a physical exam on your baby. Your baby may need the following tests: - Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
- Blood tests: Blood may be taken to learn if your baby has an infection or other problems. Your baby may need to have blood taken many times.
- Chest x-ray: This is a picture of your baby's lungs and heart. Healthcare providers may do x-rays to learn if your baby has RDS or other problems.
- Pulse oximeter: This is a machine that tells how much oxygen is in your baby's blood. Healthcare providers use this machine to see if your baby needs more oxygen.
How is RDS treated? Babies with RDS are usually taken to a neonatal intensive care unit (NICU). Your baby may lie in an incubator or on a warming bed. Healthcare providers will watch your baby closely. They will do tests, watch bedside monitors, and check your baby often. Your baby may need any of the following: - Breathing support:
- Oxygen: Your baby will need extra oxygen to help him breathe better. The oxygen may be warm and humidified (mixed with water vapor). Healthcare providers may place a clear oxygen hood over your baby's head. Your baby may need CPAP (continuous positive airway pressure) given through nasal prongs. The nasal prongs are gently inserted into your baby's nostrils and taped in place. CPAP helps your baby keep his lungs filled with air.
- Endotracheal tube (ET) tube: Your baby may have an ET tube put down his throat or nose. A long plastic tube connects the ET tube to a breathing machine called a ventilator. As your baby gets better, healthcare providers will wean your baby from the ventilator. This means they will check to see if your baby can breathe without help from the ventilator. Once your baby is able to breathe without the help of a ventilator, healthcare providers will remove the ET tube.
- Chest physiotherapy and suctioning: Chest physiotherapy (CPT) and suctioning may be done often. Healthcare providers do this to loosen the mucus in your baby's lungs and keep his airways clear. This will help your baby breathe easier. A healthcare provider will tap on your baby's chest, then remove any loose mucus.
- Medicines:
- Surfactant replacement therapy: Surfactant is given to your baby through an ET tube. It may help prevent RDS or make it less severe. Your baby may receive 1 or more doses.
- Bronchodilators: This may be given to open up your baby's airways so that he can breathe easier.
- Diuretics: This may be given to help your baby's body get rid of extra fluid or water. This may help your baby breathe easier.
- Pain medicine: This may help keep your baby calm and comfortable if he has pain.
- Sedatives: This helps keep your baby calm while he gets better.
What are the risks of RDS? - Rarely, an ET tube may cause your baby's vocal cords to stop working for a while. Your baby may develop air leaks into his lung tissue or chest. Umbilical catheters used during treatment may cause a blood clot.
- Without treatment, your baby's breathing problems will get worse. Your baby may have bleeding inside his head or lungs. He may get an infection or develop stomach and heart problems. RDS may cause your baby to develop long-term medical problems. These include lung problems, bad vision, and blindness. These also include learning and coordination (movement) problems or brain damage. With or without treatment, severe RDS may be life-threatening.
What can I do to help my baby while he has RDS? - You may sit at your baby's bedside to give him comfort and support. You may talk to your baby or stroke him gently. Ask your healthcare provider about the best ways to comfort your baby.
- If you plan to breastfeed, it is important to start pumping your breasts as soon as possible. Ask healthcare providers for information about using a breast pump to collect your milk, and how to store the milk for your baby to drink later.
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