Hyaline membrane disease

Neonatal respiratory distress syndrome (NRDS) is a serious medical condition where a newborn baby's lungs cannot provide their body with enough oxygen.

NRDS is also known as hyaline membrane disease, infant respiratory distress syndrome or newborn respiratory distress syndrome.

Why it happens

NRDS most often occurs when there is not enough of a substance called surfactant in the lungs. This substance, made up of proteins and fats, helps keep the lungs inflated and prevents parts of the lung called air sacs from collapsing.

Your baby will normally begin to produce surfactant sometime between weeks 24 and 28 of pregnancy. Most babies will have produced enough surfactant to breathe normally by week 34. If your baby is born prematurely, they may not have enough surfactant in their lungs.

Occasionally, NRDS occurs in babies that are not born prematurely. This is usually due to a problem with the genes that play a role in lung development.

It's estimated that half of all babies born before 28 weeks of pregnancy will develop NRDS.

Signs and symptoms

The signs of NRDS are usually noticeable immediately after birth and get worse over the following few days. They can include:

• blue-coloured lips, fingers and toes
• rapid, shallow breathing
• flaring nostrils
• a grunting sound when breathing

As premature babies are usually born in hospital, most babies with NRDS are already in hospital when they develop these problems.

However, NRDS can also affect babies born at home. If you give birth outside hospital and notice the above symptoms in your child, call 999 immediately and ask for an ambulance.

Treating NRDS

Most babies with NRDS will need breathing help with extra oxygen and possibly some form of ventilator support. Babies needing ventilation can often be treated with a medication directly into the lungs called artificial surfactant, which helps restore normal lung function.

Some cases can be prevented or at least made less severe by treating the mother with a medication called betamethasone before birth.

Read more about treating neonatal respiratory distress syndrome.

Complications

In the majority of cases, NRDS can be successfully treated and deaths directly linked to NRDS are very rare in the UK.

However, in more severe cases there is a risk of further problems. These can include scarring to the lungs leading to longer term breathing problems. There is also a risk of brain damage, which may result in problems such as learning difficulties.

Read more about the possible complications of neonatal respiratory distress syndrome.