Newborn Breathing Conditions Causes and Risk Factors

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When a baby is born, they go from living in the womb to living in the outside world. This requires many changes to occur in their body, especially in the lungs. To breathe outside the womb, a newborn’s lungs must adapt immediately after birth.

• In the womb, the lungs of a fetus are filled with fluid. Instead of the fetus “breathing,” blood that flows through the placenta supplies oxygen and other nutrients to the fetus.
• The lungs are usually not fully formed until week 36 of pregnancy.
• When a baby is born, hormonal changes and labor itself stops a baby’s lungs from producing fluid. When a newborn takes their first breaths, the air they breathe into the lungs squeezes out any remaining fluid and blood can flow to the lungs. In addition, newborn lungs make a foamy substance called surfactant that helps their lungs remain expanded even when the baby breathes out.

Problems in development

The changes that a baby’s lungs undergo during birth require many complex processes. Problems with any of these steps can cause a newborn to have a breathing condition. For example:

• When a newborn does not produce enough surfactant, they can develop respiratory distress syndrome (RDS). This can either be due to premature birth or changes (mutations) in genes that control surfactant production.
• When a baby’s lungs do not reabsorb enough fluid during labor and delivery, they can develop transient tachypnea of the newborn (TTN).
• When blood cannot flow into the vessels of the lungs to get oxygen, a baby may have a condition called persistent pulmonary hypertension of the newborn (PPHN).

Other problems

Other things can happen in the womb, during birth, or soon after birth that can cause a newborn to have difficulty breathing.

• Infections: Bacteria or viruses can cause infections before or after birth that can lead to pneumonia or sepsis .
• Meconium aspiration: Meconium is the first stool that a fetus produces and sometimes it can get into the fluid that surrounds a baby (called amniotic fluid) before birth. If a baby inhales the fluid, called aspiration, it can get into the lungs. This can block the airway and cause lung inflammation , which can lead to breathing problems in a newborn. This is sometimes called “meconium aspiration syndrome.”
• Complications from treatments: Treatments for breathing conditions, especially if mechanical ventilation is needed, can cause air to leak out of the lungs and get stuck between the lungs and the chest wall. This is called a pneumothorax, or a collapsed lung.¹

There are certain factors that may raise the risk that your newborn will have a breathing condition:

• Premature delivery: This is the most common. Babies born several weeks before their due date usually have lungs that are not fully developed. This can cause problems with breathing.
• Problems with the baby’s heart or lung development include congenital heart or lung disorders.
• Diabetes in the mother: Uncontrolled diabetes before pregnancy or developing diabetes during pregnancy (called gestational diabetes) can raise the risk of the baby having respiratory distress syndrome when born.

The best way to prevent breathing conditions in newborns is to lower the risk of giving birth too early in pregnancy. Not smoking and not consuming alcohol, as well as having healthy eating habits, can lower the chance of premature birth.

Sometimes premature birth is due to another condition or circumstance that is outside of your control. If your provider thinks that your baby is at risk of being born too early, they can give you medicine called corticosteroids , which help your baby’s lungs mature and produce surfactant.

If your baby is born several weeks prematurely, there are still ways that doctors can prevent breathing conditions. Though continuous positive airway pressure (CPAP) is typically used as a treatment for breathing problems, it can also be used before symptoms begin to prevent breathing problems in newborns who are born early.