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Babies who still need oxygen at 4 weeks before their original due date are considered to have bronchopulmonary dysplasia (BPD) – one of the most common chronic lung diseases in infants in the United States.
Bronchopulmonary dysplasia happens for different reasons. It can happen in full-term as well as premature infants. Doctors believe that it's due to an individual infant's response to a number of factors.
The combination of the premature baby's immature lungs and the treatments (including machines and oxygen) to help the little one breathe is thought to cause damage (or scarring) to the lungs. Infections and pneumonia also can lead to BPD. As the babies mature, they grow more lung tissue, which can improve their breathing over time.
BPD usually isn't diagnosed until 2 to 4 weeks after birth. At that point, doctors make a diagnosis based on whether there was lung damage or an injury at birth and whether the baby has needed extra oxygen for a long period of time. Chest X-rays also can help determine the extent of lung damage.
Bronchopulmonary dysplasia is sometimes treated with steroids to decrease scarring. Because steroids can cause side effects, doctors usually wait as long as possible to begin steroid treatment. Steroids are generally not used without a complete discussion with the family about potential benefits and risks.
Other, more commonly used medicines include diuretics (which make the baby urinate, or pee, and help eliminate excess fluid that can build up in the damaged lungs) and bronchodilators (which relax the muscles that surround the airways and allow them to open up).
Babies with BPD also sometimes need ventilators (breathing machines) at home to help them breathe. And although it's not common, in severe cases the surgical insertion of a breathing tube in the neck (called a tracheostomy) may be done so the baby can go home on a ventilator. Some babies need home oxygen therapy for several months.
Bronchopulmonary dysplasia is a serious condition that calls for longer stays in the NICU, sometimes up to several months. The smallest infants are usually the ones who develop the disease, so their stays are longer to make sure they're stable before they're sent home.