Patient Education
What is Neonatal Respiratory distress (RD)?
Neonatal Respiratory distress (RD) is the most common disease of newborns, characterized by fast and noisy breathing, indrawing of the chest, and occasionally complicated by bluishness of skin and mucous membranes. Normal lung has multiple air sacs for oxygen exchange. For the baby, in intrauterine life, the lungs are filled with water (amniotic fluid). These sacs open up at birth and during this transition, they become functional. In case of a transition getting delayed or hampered, it leads to an incomplete opening of the air sac, causing RD.
What Causes Neonatal Respiratory disease?
Any cause affecting delay in clearing of the fluid-filled lung can lead to RD. It is more common amongst prematurely born babies as they have surfactant deficiency. Occasionally, being born to a mother with Diabetes, born by C-section, of having aspirated meconium while inside the womb, may increase chances for the baby to have RD.
How do we know baby had RD?
A baby with RD will have
- Fast breathing
- Indrawing of chest - pulling in of the ribs with each breath
- Grunting - noisy breathing “Uhh” with each breath
- Nasal flaring - widening of nostrils with each breath
- Cyanosis - bluishness of lips, tongue, mucous membranes
The baby will appear sick, and not want to feed on breast or bottle.
How RD is diagnosed?
The diagnosis of RD is based on clinical symptoms which are promptly picked by your doctor/midwives. On clinical suspicion, they will check the baby’s blood oxygen (SPO2) by placing a probe on his/her right hand. Spo2 often will guide the management further.
The Investigations in RD often helps in knowing the severity, and/or cause of disease. The baby may have some blood test (blood gas, septic workup), chest Xray and occasionally echocardiography of the heart to assist in the same.
What is the Treatment for RD?
In the immediate treatment, Oxygen therapy to maintain optimum Spo2 is aimed. Depending on the severity, oxygen may be given through a mask on the face or pipe across the nostrils (CPAP). In some scenarios, the baby may need a tube through a breathing pipe and may require artificial respiratory machine (Ventilator). Surfactant as medicine may be given to the baby’s lungs. Your doctor shall explain to you the best for your baby. Timely intervention is needed.
How long does RD last for?
Every RD and baby is different, and so no generalization can be made. Most RD shall resolve in the next 48-72 hours. But before resolution, they are likely to worsen and with diuresis (increase urine output), RD will resolve. Your doctor/nurse will be the best source of information about your baby’s progress.
How to know baby is improving with RD?
The clinical picture will improve, with baby breathing easier and rate slowing. The oxygen need will taper and will come down to breathe in room air which is 21% oxygen. The need for pressures on both CPAP/ventilator shall gradually come down. Your doctor/nurse will be the best source of information about your baby’s progress.
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