The earlier in the pregnancy a baby is born, the more likely that these breathing problems will occur. Many women who are likely to deliver prematurely have received steroid injections to try to help the baby’s lungs to work better after birth. Treatment after birth consists of two major forms of support. One is called CPAP (continuous positive airway pressure). This device consists of a mask or set of prongs extending a short distance into the nose, attached to an air source. A CPAP provides constant air pressure that is transmitted down into the baby’s lungs, helping them to become inflated and to stay inflated. This makes it easier for the baby to breathe independently. The length of time that a baby can require CPAP is extremely variable. It could be just a few hours or as long as several months.
If a baby requires more help than the CPAP, this would mean putting the baby onto a ventilator or breathing machine. In order to do this, a tube has to be inserted through the baby’s mouth down into the baby’s windpipe. The ventilator then works as a teammate with your baby’s lungs to improve the baby’s breathing status. Extra amounts of oxygen are often given through either the CPAP device or the ventilator. How long an individual baby will stay on a ventilator is extremely variable. It can be as short as a few hours or as long as several weeks. It is quite common for babies who have been on a ventilator to move to a CPAP as the next step toward recovery.
An additional breathing problem that premature babies have is called apnea. Apnea means the baby has stopped breathing completely. It occurs because the part of the brain that controls breathing is not fully developed in a preterm baby. Although this problem is extremely common, it is usually easily controlled. Like most of the problems of prematurity, the baby will outgrow this problem just by getting older. Treatments for apnea include the use of CPAP as well as caffeine. (Yes, it’s the same drug that is in coffee and cola drinks.) Caffeine stimulates the part of the brain that controls breathing to make the baby breathe more regularly. Caffeine therapy is safe and has been used for over 30 years in neonatal units.