What is infant chronic lung disease?

Chronic lung disease (CLD) in infants refers to long-term breathing and lung problems in premature babies. It is also known as bronchopulmonary dysplasia (BPD).

Chronic lung disease is a serious complication of prematurity resulting from poor lung growth and lung injury. It can occur when babies are born prematurely and need respiratory support to help them breathe.

The rate of chronic lung disease of infancy has been increasing worldwide as more babies have survived being born earlier.

The causes of infant chronic lung disease are not entirely clear. In general, lung prematurity with poor lung growth after birth and injuries or damage to a baby’s lungs are considered to be the main reason for premature infants developing chronic lung disease.

What are the symptoms of chronic lung disease?

Every baby may experience different signs of the condition, but the most common symptoms of CLD of infancy may include:

• Respiratory distress (rapid breathing, flaring of the nostrils, grunting, chest retractions)
• Continued need for positive pressure respiratory support or oxygen after a premature baby reaches 36 weeks of gestation

The symptoms of CLD in infants may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis.

Treatment of chronic lung disease in infants

Specific treatment for your baby’s chronic lung disease will be determined by your child's doctor based on:

• Your baby's gestational age, overall health, and medical history
• Extent of the disease after a thorough evaluation
• Your baby's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease

CLD can be a long-term condition. To achieve the best outcome for your child, it is important that their care be provided by a multidisciplinary team with experience and specialized training. At Children’s Hospital of Philadelphia (CHOP), children with chronic lung disease of infancy are cared for by a dedicated Newborn and Infant Chronic Lung Disease Program.

Our goal is to provide lifesaving therapy to all children with CLD, without compromising their long-term quality of life.

Our multidisciplinary team includes specialists from all the areas a child with CLD might need – neonatology, pulmonary medicine, cardiology, ENT, general surgery, nutrition, respiratory/physical/occupational/speech-language therapy, and more.

Treatment of infant CLD may include:

• Respiratory support
  • Extra oxygen (to make up for the decreased breathing ability of the damaged lungs) and a pulse oximeter to measure how much oxygen is in the blood
  • Breathing support through a ventilator or other devices
• Medications such as:
  • Bronchodilators (to help open the airways)
  • Steroids (to help to reduce inflammation)
  • Diuretics (to help reduce excess fluid in the lungs)
  • Vasodilators (to help decrease blood pressure in the lungs)
  • Antibiotics (to fight an infection)
• Management and treatment of related complications such as reflux or pulmonary hypertension
• Radiant warmers or incubators to keep the infant warm and decrease the risks of developing an infection
• Nutrition (to help the baby and the lungs grow)
• Immunization against lung infection by respiratory syncytial virus and influenza and other bacteria that can cause lung infections