Bronchopulmonary Dysplasia Symptoms and Diagnosis

What Are the Symptoms of Bronchopulmonary Dysplasia?

The symptoms of BPD vary depending on its severity and adequacy of administered breathing support. The most common symptoms of bronchopulmonary dysplasia are:

• Rapid breathing
• Labored breathing (drawing in of the lower chest while breathing in)
• Wheezing (a soft whistling sound as the baby breathes out)
• The need for continued oxygen therapy after the gestational age of 36 weeks
• Difficulty feeding
• Decreased tolerance of developmental care
• Repeated lung infections (viral bronchiolitis or bacterial pneumonia) that may require hospitalization

How Is Bronchopulmonary Dysplasia Diagnosed?

The diagnosis of BPD is based on the clinical evaluation, the degree of prematurity, and the need for oxygen or supplemental breathing support after a certain age.

As the treatment of BPD primarily involves supplemental oxygen and other breathing support, infants are typically still in the hospital when BPD is diagnosed. Regardless, you should contact your pediatrician if:

• Your infant/child is breathing much faster than usual.
• The breathing is labored (pulling in of the skin between the ribs, below the chest or at the bottom of the neck just above the chest).
• There is bluish discoloration around the mouth or lips.
• There are frequent alarms of the apnea monitor and/or pulse oximeter.

BPD is customarily diagnosed based on treatment with oxygen therapy or need for breathing support such as CPAP or mechanical ventilation when an infant reaches 36 weeks’ postmenstrual age (approximately 4 weeks prior to the expected due date). BPD severity is graded at the time based on the level of support required. One common grading criteria defines BPD severity at 36 weeks’ based on the following criteria:

• Grade 1 BPD: Treatment with nasal cannula at less than or equal to 2L/min flow
• Grade 2 BPD: Treatment with nasal cannula at greater than 2L/min flow or non-invasive positive airway pressure such as with CPAP
• Grade 3 BPD: Treatment with mechanical ventilation using a breathing tube placed in the trachea or windpipe

Preventing Bronchopulmonary Dysplasia

Delivering your baby after the lungs are fully developed (close to your due date) is the best strategy for preventing bronchopulmonary dysplasia. Healthy pregnancy practices may increase this likelihood. Steps every mother should take are avoiding smoking, alcohol and drugs, eating a balanced nutritious diet, trying to prevent infections, and seeing your healthcare provider regularly to monitor your pregnancy.

If there is a risk of delivering your baby prematurely, your provider may give you injections of a corticosteroid medicine that speeds up the development of the baby’s lung ability to produce surfactant. This will lower the risk of your baby developing respiratory distress syndrome, which can lead to BPD.