Neonatal Respiratory Distress Syndrome

Neonatal respiratory distress syndrome (RDS) is a condition that makes it hard for babies to breathe. It happens when the air sacs (alveoli) in your baby’s lungs can’t open fully. This means they can’t get enough oxygen to their blood.

RDS happens most often in babies born early, especially in babies born before 32 weeks. Most cases are treatable. But it doesn’t make it any easier to see your baby going through it.

Signs of neonatal respiratory distress syndrome

Signs of neonatal RDS are usually noticeable within a few hours of birth. Your baby’s breathing might be fast and/or shallow. Or there might be pauses in their breathing. You might also notice:

• Bluish or greyish skin, lips or nails
• Flaring nostrils
• Grunting
• Skin pulling in between their ribs when they breathe (retractions)

Neonatal RDS causes

A lack of surfactant in your baby’s lungs causes RDS. Surfactant is a slippery substance that helps keep small air sacs open. Blood flowing in nearby vessels can pick up oxygen from the air sacs and take it to the rest of your body.

Surfactant develops in the third trimester of pregnancy. Babies born before term haven’t had the chance to fully produce it. Their alveoli can’t stay open to fill with air.

Rarely, babies born at 39 weeks or later can develop RDS. A variety of reasons can cause this, such as a mother’s high blood sugar during pregnancy, pneumonia, some complications during birth or genetic changes.

Risk factors

The biggest risk factor for neonatal respiratory distress syndrome is preterm birth. It’s most common in babies born before 32 weeks gestation, but not uncommon after 32 weeks and before term. Your baby might be at higher risk if:

• You have diabetes while pregnant.
• They have a biological sibling with RDS.
• It’s a multiples pregnancy (like twins or triplets).

How to lower your risk

If your child is at higher risk for RDS, your pregnancy care provider might give you corticosteroids while pregnant. This can help increase the level of surfactant in the fetal lung.

Complications

Neonatal respiratory distress can cause complications in your baby’s organs. These include:

• Bleeding in their brain, which can cause permanent damage
• Bleeding in their lungs
• Buildup of air around your baby’s lungs, between their lungs or between their heart and the sac around it (pneumothorax)
• Lung inflammation and scarring (bronchopulmonary dysplasia)
• Vision issues

How doctors diagnose neonatal respiratory distress syndrome

A healthcare team checks your baby’s health when they’re born. They’ll look for signs of neonatal RDS. They may also perform:

• Chest X-rays or other imaging
• Blood tests for oxygen and carbon dioxide levels

How is RDS treated?

A healthcare team will monitor your baby closely if they have respiratory distress syndrome. They’ll give your baby surfactant to help open their alveoli. There are different techniques that their provider might use to do this. They’ll let you know what option is safest.

Your baby will need help breathing. They’ll get extra oxygen, usually through a CPAP machine. This gently pushes air into your baby’s lungs. In severe cases, your baby might need a ventilator to breathe for them.

When should I see my healthcare provider?

Talk to your baby’s healthcare team if you notice anything that seems off with their breathing, or if they have any signs of RDS.

What can I expect if my baby has RDS?

If your baby has respiratory distress syndrome, they might get worse before getting better with treatment. As they get better, they should begin to breathe easier. They’ll eventually need less oxygen and breathing support. How long this takes will be different for each baby.

What’s the life expectancy of neonatal RDS?

In areas where access to healthcare is common, like in the U.S., almost all babies survive neonatal respiratory distress syndrome. But some children have ongoing health conditions.