Skip to main content

Respiratory Distress Syndrome in Newborns

Medically reviewed by Last updated on Aug 31, 2022.

What is respiratory distress syndrome?

Respiratory distress syndrome (RDS) is a condition that causes breathing problems in newborns. This condition is also called hyaline membrane disease. It may start within minutes to hours after your baby is born. It is most common in premature infants because their lungs may not be fully developed.

What causes RDS?

Lungs that are not fully developed may not make enough surfactant. Surfactant is a substance made inside the tiny air sacs of the lung tissue. Surfactant keeps the tiny air sacs open so your baby can get enough oxygen as he or she breathes. Without enough surfactant, the air sacs collapse and cause breathing problems.

What increases my baby's risk for RDS?

  • He or she was born before 37 weeks.
  • He or she was born to a mother with diabetes.
  • His or her sibling had RDS.
  • He or she did not get enough oxygen before, during, or just after birth.

What are the signs and symptoms of RDS?

Your baby may have any of the following:

  • He or she has fast breathing, or periods of no breathing.
  • He or she makes grunting sounds, especially when he or she exhales.
  • The skin between and around the ribs pulls in when your baby inhales, or the middle of your baby's chest may sink deeply in as he or she breathes.
  • His or her nostrils flare as he or she breathes.
  • He or she has pale or blue skin, lips, and nails.

How is RDS diagnosed?

Your baby's healthcare provider will do a physical exam on your baby. Your baby may need the following tests:

  • Blood gases may be checked if your child has trouble breathing. Blood is taken from an artery, usually in the wrist.
  • Blood tests: Blood may be taken to learn if your baby has an infection or other problems. Your baby may need to have blood taken many times.
  • Chest x-ray: This is a picture of your baby's lungs and heart. Healthcare providers may do x-rays to learn if your baby has RDS or other problems.
  • Pulse oximeter: This is a machine that tells how much oxygen is in your baby's blood. Healthcare providers use this machine to see if your baby needs more oxygen.

How is RDS treated?

Babies with RDS are usually taken to a neonatal intensive care unit (NICU). Your baby may lie in an incubator or on a warming bed. Healthcare providers will watch your baby closely. They will do tests, watch bedside monitors, and check your baby often. Your baby may need any of the following:

  • Breathing support:
    • Oxygen: Your baby will need extra oxygen to help him or her breathe better. The oxygen may be warm and humidified (mixed with water vapor). Healthcare providers may place a clear oxygen hood over your baby's head. Your baby may need CPAP (continuous positive airway pressure) given through nasal prongs. The nasal prongs are gently inserted into your baby's nostrils and taped in place. CPAP helps your baby keep his or her lungs filled with air.
    • Endotracheal tube (ET) tube: Your baby may have an ET tube put down his or her throat or nose. A long plastic tube connects the ET tube to a breathing machine called a ventilator. As your baby gets better, healthcare providers will wean your baby from the ventilator. This means they will check to see if your baby can breathe without help from the ventilator. Once your baby is able to breathe without the help of a ventilator, healthcare providers will remove the ET tube.
    • Chest physiotherapy and suctioning: Chest physiotherapy (CPT) and suctioning may be done often. Healthcare providers do this to loosen the mucus in your baby's lungs and keep his or her airways clear. This will help your baby breathe easier. A healthcare provider will tap on your baby's chest, then remove any loose mucus.
  • Medicines:
    • Surfactant replacement therapy: Surfactant is given to your baby through an ET tube. It may help prevent RDS or make it less severe. Your baby may receive 1 or more doses.
    • Bronchodilators: This may be given to open up your baby's airways so that he or she can breathe easier.
    • Diuretics: This may be given to help your baby's body get rid of extra fluid or water. This may help your baby breathe easier.
    • Pain medicine: This may help keep your baby calm and comfortable if he or she has pain.
    • Sedatives: This helps keep your baby calm while he or she gets better.

What are the risks of RDS?

  • Rarely, an ET tube may cause your baby's vocal cords to stop working for a while. Your baby may develop air leaks into his or her lung tissue or chest. Umbilical catheters used during treatment may cause a blood clot.
  • Without treatment, your baby's breathing problems will get worse. Your baby may have bleeding inside his or her head or lungs. Your baby may get an infection or develop stomach and heart problems. RDS may cause your baby to develop long-term medical problems. These include lung problems, bad vision, and blindness. These also include learning and coordination (movement) problems or brain damage. With or without treatment, severe RDS may be life-threatening.

What can I do to help my baby while he or she has RDS?

  • You may sit at your baby's bedside to give him or her comfort and support. You may talk to your baby or stroke him or her gently. Ask your healthcare provider about the best ways to comfort your baby.
  • If you plan to breastfeed, it is important to start pumping your breasts as soon as possible. Ask healthcare providers for information about using a breast pump to collect your milk, and how to store the milk for your baby to drink later.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's healthcare providers to decide what care you want for your baby. 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.

© Copyright IBM Corporation 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Learn more about Respiratory Distress Syndrome in Newborns

Treatment options

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.