Respiratory distress syndrome (RDS) is a breathing problem that affects newborns,
mostly those who are born more than 6 weeks early. The earlier
or more premature a baby is born, the more likely the baby will develop RDS.
Many babies with milder symptoms get better in 3–4 days. Those who are very premature
may take longer to recover.
What Are the Signs & Symptoms of Respiratory Distress Syndrome?
Within minutes or hours of being born, a baby with RDS will have breathing problems.
If untreated, these problems get worse over time.
Symptoms of RDS include:
noisy breathing or grunting
retractions (a tugging in of the muscles between the ribs, under the ribcage,
and at the neck) while trying to breathe
a blue tint in the lips, nail beds, and skin from lack of oxygen, called
What Happens in Respiratory Distress Syndrome?
RDS happens when a baby's lungs
don't make enough of a fatty substance called surfactant (ser-FAK-tent).
Surfactant is made in the last
few weeks of pregnancy. It helps tiny air sacs in the lungs called alveoli
(al-VEE-oh-lye) open more easily. These sacs fill with air when a baby breathes after
birth. Surfactant also helps keep the alveoli open when air leaves the lungs.
When a baby with RDS tries to breathe:
many of the alveoli cave in and can't open
oxygen can't get to the blood
carbon dioxide can't leave the body
If untreated, in time this can damage a baby's brain and other vital organs.
How Is Respiratory Distress Syndrome Diagnosed?
Health care providers will suspect RDS in a premature baby who has trouble breathing
and needs oxygen soon after birth. A chest
X-ray of the lungs can confirm the diagnosis.
How Is Respiratory Distress Syndrome Treated?
To help prevent respiratory distress syndrome, doctors can give steroid medicines
to pregnant women who are likely to deliver their babies early (before 37 weeks of
gestation). Steroids help the baby's lungs mature and make more surfactant before
the baby is born.
Doctors will give oxygen to a baby who has signs of RDS and breathing trouble.
If breathing problems continue, the baby may need continuous positive airway
pressure (CPAP). With CPAP:
The baby wears a mask or a
that's connected to a machine.
The machine sends a stream of air or oxygen into the lungs through the nose.
CPAP opens the alveoli, supplies oxygen, and prevents the alveoli from collapsing.
A baby who continues to have signs of respiratory distress or trouble maintaining
a good oxygen level may need more support with a breathing machine
Babies with RDS may need treatment with surfactant. Doctors give surfactant through
a breathing tube right into the lungs.
doctors who specialize in newborn care (neonatologists)
skilled nurses and neonatal nurse practitioners
respiratory therapists, who help with breathing machines
Many babies start to get better within 3 to 4 days, as their lungs start to make
surfactant on their own. They'll start to breathe easier, look comfortable, need less
oxygen, and can be weaned from the support of CPAP or a ventilator. Some babies —
especially very premature babies — need longer treatment until they can breathe on
What Else Should I Know?
Respiratory support with oxygen and a ventilator helps newborn babies with respiratory
distress. But long-term use can damage a premature baby's lungs. Some babies born
very early need oxygen support for a long time, leading to a condition called bronchopulmonary