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Respiratory Distress Syndrome

What Is Respiratory Distress Syndrome?

Respiratory distress syndrome (RDS) is a breathing problem that affects newborns, mostly those who are born more than 6 weeks early. The earlier a baby is born, the more likely the baby will have RDS.

Many babies get better in 3 to 4 days. Those who are very premature may take longer to recover.

What Are the Signs & Symptoms of Respiratory Distress Syndrome?

Within minutes or hours of being born, a baby with RDS will have breathing problems. These problems get worse over time, and include:

  • fast breathing
  • noisy breathing or grunting
  • retractions (a tugging in of the muscles between the ribs, under the ribcage, and at the neck) while trying to breathe
  • a blue tint in the lips, nailbeds, and skin from lack of oxygen, called cyanosis

What Happens in Respiratory Distress Syndrome?

RDS happens when a baby's lungs don't make enough of a fatty substance called surfactant (ser-FAK-tent).

Surfactant is made in the last few weeks of pregnancy. It helps tiny air sacs in the lungs called alveoli (al-VEE-oh-lye) open more easily. These sacs fill with air when a baby breathes after birth. Surfactant also helps keep the alveoli open when air leaves the lungs.

So, when a baby with RDS tries to breathe:

  • many of the alveoli cave in and can't open
  • oxygen can't get to the blood
  • carbon dioxide can't leave the body

If untreated, this can damage a baby's brain and other organs.

How Is Respiratory Distress Syndrome Diagnosed?

A doctor will suspect RDS in a premature baby who has trouble breathing soon after birth. A chest X-ray of the lungs can confirm the diagnosis.

How Is Respiratory Distress Syndrome Treated?

To help prevent respiratory distress syndrome, doctors can give steroid medicines to pregnant women who are likely to deliver their babies early. Steroids help the baby's lungs mature and make more surfactant before the baby is born.

Doctors give oxygen to a newborn who has trouble breathing. A baby who gets extra oxygen but still struggles to breathe might need continuous positive airway pressure (CPAP). With CPAP, a baby wears a special nasal cannula or a mask around the nose while a machine continuously pushes a stream of air or oxygen into the nose. CPAP opens the alveoli and keeps them from collapsing. Sometimes, a baby with RDS will need to be on a breathing machine (ventilator).

Babies with RDS may need treatment with surfactant. Doctors give surfactant through a breathing tube directly into the lungs.

Babies with RDS are cared for in a neonatal intensive care unit (NICU). In the NICU, a team of experts — including doctors who specialize in newborn care (neonatologists), nurses, and respiratory therapists (who help with breathing) — give treatment.

Many babies get better within 3 to 4 days, as their lungs start to make surfactant on their own. Some babies — especially very premature babies — will need longer treatment until they can breathe on their own.

What Else Should I Know?

Long-term breathing help with oxygen and mechanical ventilation can damage a premature baby's lungs. This condition is called bronchopulmonary dysplasia (BPD).

Besides breathing problems, premature babies can have other health problems that need specialized care in the NICU.

Reviewed by: Mary L. Gavin, MD
Date Reviewed: 12-02-2019

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