Bronchopulmonary Dysplasia

WHAT YOU SHOULD KNOW:

• Bronchopulmonary (brong-ko-PUL-mo-nar-e) dysplasia (dis-PLA-zhah), or BPD, is a long-term condition that affects the lungs. BPD is also called chronic lung disease (CLD). This usually occurs in a premature baby who had lung problems shortly after birth and received treatment with high oxygen concentrations. A baby is premature if he is born earlier than 37 weeks gestation (time spent in womb). The lungs may have had an injury that causes inflammation (swelling) and damage. These prevent the baby's lungs from working properly leading to serious breathing problems. The less the baby weighs and the more premature he is, the more likely he will have BPD.
  
  
• Signs and symptoms of BPD are cough, irritability, trouble breathing, and poor sucking or feeding. BPD may be diagnosed by having a chest x-ray, computerized tomography (CT) scan, echocardiogram, or blood tests. Treatment will depend on how bad your baby's BPD is. Your baby may need medicine or oxygen treatment to help him breathe easier. Most babies with BPD get better after a few weeks or months. With proper treatment and care, your baby is more likely to outgrow BPD without having further serious problems. Ask your caregiver for more information about these tests and treatment.

AFTER YOU LEAVE:

Medicines:

• Keep a list of your child's medicines: Keep a written list of the medicines your child takes, the amounts, and when and why they are taken. Bring the list of your child's medicines or the medicine bottles when you visit your child's caregivers. Ask your child's caregiver for more information about the medicines. Do not give any medicines to your child without first asking your child's caregiver. This includes prescriptions, over-the-counter drugs, vitamins, herbs, or food supplements.
  
  
• Give your child's medicine as directed: Always give your child's medicine as directed by his caregivers. Call your child's caregiver if you think your child's medicines are not helping. Call if you feel your child is having side effects. Do not quit giving the medicines to your child until you discuss it with your child's caregiver.

Ask your child's caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you and your child may have. This way you will remember to ask these questions during your child's next visit.

Breathing:

• Run a cool mist humidifier. This will help increase air moisture in your child's room. Follow the humidifier instructions carefully for running and cleaning it. Direct the mist stream towards your child's face, but keep the humidifier out of your child's reach.
  
  
• Oxygen: Your baby may need extra oxygen to help him breathe easier. It may be given through a plastic mask over his mouth and nose. It may also be given through small tubes placed in his nose instead of a mask. Ask your baby's caregiver about giving extra oxygen at home.
  
  
• Pulse oximeter: Your baby may need to be monitored at home with a pulse oximeter. A pulse oximeter is a machine that tells how much oxygen is in your baby's blood. A cord with a clip or sticky strip is placed on his ear, finger, or toe. The other end of the cord is hooked to a small machine. You may use this machine to see if he needs more oxygen. Ask your caregiver for more information on pulse oximeter.

Cardiopulmonary resuscitation (CPR): If your baby appears to have stopped breathing, try to stimulate him by rubbing him with your hand. You may also try rubbing your baby's back or striking the soles of his feet. Never pick up and shake your baby. If your baby still does not cry or move, begin CPR and send someone to call 911 for help. If you are alone, begin the steps of CPR and do them for 1 minute. After 1 minute, call 911 yourself. Remember that CPR on a baby is different from an adult. Ask your caregiver for more information on baby CPR.

Feeding:

• A caregiver, called a dietitian, may talk to you about your baby's feeding and nutrition. A dietitian can help you to increase the amount of calories your baby gets. You may also discuss with him if it is OK to breastfeed your baby or what milk you should feed him. Ask your baby's caregiver about high-calorie liquid feeding.
  
  
• During feeding, hold your baby so his head is higher than his stomach. Feed your baby in a place with enough light which will let you see any skin color changes. Stop from time to time to allow him to take enough breaths between sucks on the bottle or breast. Your baby may become tired easily when feeding, always check for signs of fatigue (tiredness). Stop the feeding if he looks tired.

Wellness hints:

• Do not let anyone smoke around your child. Smoking can harm your child's heart, lungs, and blood. If you smoke around your child, he is more likely to get certain types of infections. He is also more likely to get lung disease and cancer later in his life. If you smoke, you should quit. You will not only help yourself, but also those around you. If you are having trouble quitting, talk to your caregiver about ways to quit.
  
  
• Keep your child away from people who have colds and the flu. Also try to keep your child away from large groups of people while he is recovering from surgery. This decreases your child's chance of getting sick or getting an infection.
  
  
• Wash your hands and your child's hands often. This will help prevent the spread of germs. Encourage everyone in your house to wash their hands with soap and water after going to the bathroom. Also wash hands after changing diapers and before preparing or eating food.

For support and more information: Having a baby with bronchopulmonary dysplasia may be difficult for you and your family. Accepting that your baby has BPD may be hard. You and those close to you may feel sad or frightened. These feelings are normal. Talk to your baby's caregivers, family, or friends about your feelings. Contact the following for more information:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org
  

• American Lung Association
  61 Broadway, 6th floor
  New York City, NY 10006
  Phone: 1-800-586-4872
  Web Address: http://www.lungusa.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda, MD 20824-0105
  Phone: 1-301-592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

CONTACT A CAREGIVER IF:

• Your child has a fever (increased body temperature).
  
  
• Your baby has chills or a cough.
  
  
• Your baby's skin is swollen or has a rash.
  
  
• You have any questions or concerns about your baby's condition, treatment, or care.

SEEK CARE IMMEDIATELY IF:

• Your baby has trouble breathing.
  
  
• Your baby is more sleepy, irritable, or more fussy than usual.
  
  
• Your baby is unable to eat or drink anything for 24 hours.
  
  
• Your baby's skin, lips, or fingernails are pale or bluish in color.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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