Babies who come into the world before their usual time will have their own set of problems to deal with. But with the specialized care available for preemie babies at the present times, they are able to thrive and keep up with their peers with some effort.
A huge health obstacle that a preemie will need to confront is chronic lung disease.
Chronic Lung Disease in a Preemie, What is it?
This is a respiratory condition, marked by long duration or frequent recurrences, that preemies are generally known to suffer from.
Babies born before completing 30 weeks of gestational age, weighing less than three pounds at birth are usually the ones who develop this condition. Every internal organ of a preemie will be in a fragile condition, more so with their respiratory system, since this gets fully developed only towards the final stages of pregnancy.
- Obviously, difficulty in breathing
- Rapid breath rate
- Nostrils spreading outward
- Grunting sounds
- An injury to the preemie’s lungs occurring at the time of birth can lead to chronic lung disease (CLD). The injured lung tissues can become inflamed or collapse causing scarring, which will in turn cause difficulty in breathing for the infant.
- The lungs have not developed fully, which is the case with almost all preemies.
- Deficiency in a substance (surfactant) in the lungs, which is essential for keeping the air sacs in an infant open.
- When on mechanical ventilator support, accidental administration of high levels of oxygen can damage the infant’s lung cells and cause CLD.
- If the infant develops any kind of an infection shortly after birth, this can possibly trigger CLD in them.
- If there is a family history of asthma, there is a possibility for a preemie to develop CLD.
- Birth problems like patent ductus arteriosus (a link between the blood vessels of the heart and lungs fails to close after the birth of the infant), or pulmonary interstitial emphysema (leakage of air from the airways into the spaces between the small air sacs situated in the lungs) can lead to CLD.
This condition should be suspected in a preemie when an infant continues to require additional oxygen supply even after four weeks of stay in the neonatal intensive care unit. Diagnostic tests like x-ray examinations and blood tests will need to be done. If the x-ray report displays the lung to appear like a piece of sponge, and if blood test reports show low blood oxygen levels, then in all probability the infant will be suffering from CLD.
The treatment plan will be decided upon by the medical team. The treatment as such will depend on the overall health condition of the preemie, its gestational age, its tolerance levels to procedures and medications, and the extent of the disease condition itself.
Treatment usually involves –
- To replenish the baby’s lungs with surfactant
- Providing extra nutrition, aiming at improving the growth of the infant’s respiratory system
- The baby will be put on mechanical ventilator support and given extra oxygen supply.
- Supply of essential fluids intravenously with regular monitoring done to prevent fluid build up
- Medications like bronchodilators, diuretics, antibiotics and steroids to be given to open the airways and fight any infections occurring within
In very severe cases, extra care and continued additional oxygen supply will need to be given even after the baby’s discharge home from NICU. Even though this is a cause of worry, by the end of its first year of life, the condition will resolve completely.