One page summary: Respiratory distress syndrome in newborns

In two sentences

Respiratory distress syndrome happens when a baby's lungs do not yet make enough surfactant, the slippery substance that stops the tiny air sacs from collapsing at the end of each breath. ¹

It is mainly a condition of babies born early, and the risk rises the earlier the birth. Two treatments changed it completely: steroids given to the mother before birth, which speed up surfactant production, and surfactant given directly into the baby's lungs after birth. ²

The numbers, with their sources

• What surfactant does. It lowers surface tension inside the small air sacs so they stay open between breaths. Without it, the lungs partly collapse with every breath and each breath takes enormous effort ¹
• Who gets it. Mainly babies born preterm, with the risk rising the earlier the birth ¹
• The key prevention. Antenatal corticosteroids given to the mother before an expected preterm birth reduce respiratory distress syndrome and newborn death ²
• When steroids are given. Guidance sets out the gestational age window and the situations in which a course is recommended ³
• The main treatment. Breathing support, usually starting with CPAP, and surfactant given into the lungs where needed ¹
• The main long-term complication. Bronchopulmonary dysplasia, chronic lung disease in babies who needed prolonged breathing support ¹

What to do this week

1. Ask whether antenatal steroids were given, how many doses, and when.
2. Ask whether magnesium sulphate was given, if the birth was before 32 weeks.
3. Ask whether surfactant was given and how many doses.
4. Ask what the oxygen targets are and how the team decides to change settings.
5. Ask whether infection is being treated or excluded.
6. Ask about eye screening for ROP and when it starts.
7. Ask to be enrolled in developmental follow-up before discharge.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the neonatologist

• Were antenatal steroids given, and how long before delivery?
• Is this RDS, infection, or both?
• What support is my baby on, and what would it take to come down a step?
• Has surfactant been given?
• What are we watching for over the next few days?

For the obstetric team

• Why was my baby born early?
• Were steroids offered, and was there time for a full course?
• Was magnesium given for the baby's brain?
• What would you do differently in a future pregnancy?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Respiratory distress syndrome in newborns

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.