Hyaline membrane disease - Treating neonatal respiratory distress syndrome

Treatment of neonatal respiratory distress syndrome (NRDS) aims to manage the underlying cause of the condition while supporting breathing.

Treatment before birth

Treatment for neonatal respiratory distress syndrome (NRDS) sometimes begins before birth. If you are thought to be at a significant risk of giving birth before week 34 of pregnancy, you will usually be given two injections a day of a steroid medication called betamethasone a few days before the delivery is expected.

Betamethasone helps stimulate the development of the baby’s lungs. It's estimated that the use of betamethasone prevents NRDS occurring in a third of premature births.

Treatment after the birth

If betamethasone is not used, or if it is unsuccessful in preventing NRDS, it's likely that your baby will be transferred to a neonatal unit.

For mild symptoms your baby may only need extra oxygen, usually given into an incubator or by nasal tubes (cannula). If symptoms are more severe, your baby will be attached to a machine to either support or take over their breathing. Often these treatments are started immediately in the delivery room before transfer to the neonatal unit.

As NRDS is usually caused by the lack of a protective substance in the lungs called surfactant, your baby may be given a dose of artificial surfactant. This is usually delivered through a breathing tube to help restore normal lung function.

Evidence suggests that early treatment (within two hours of delivery) is more beneficial than if treatment is delayed.

Your baby will also be given fluids and nutrients through a tube connected to one of their veins.

Some babies with NRDS will only require help with breathing for a few days, although others – usually those who are born extremely prematurely – may need support for weeks or even months.

Premature babies often have multiple problems that keep them in hospital, but generally they are well enough to go home around their original expected delivery date. However, the exact length of time your baby will need to stay in hospital will largely depend on how early they were born.