Key Points

• Respiratory distress syndrome (RDS) is a breathing problem that sometimes affects babies born about 6 weeks or more before their due dates.
• Most infants who develop RDS show signs of breathing problems at birth or within the next few hours. If they're not given the right treatment, their brains and other organs may suffer from the lack of oxygen.
• RDS affects about 10 of every 100 premature infants in the United States, or about 40,000 babies, each year. Nearly all babies born before 28 weeks of pregnancy develop RDS. Full-term infants rarely get it.
• A lack of surfactant in a premature baby's lungs causes RDS. Surfactant is a liquid that coats the insides of a fetus' lungs and keeps them open so they can breathe in air after birth.
• Factors that can increase the chances your baby will develop RDS include if you have diabetes mellitus, cesarean delivery, stress during delivery, and infection. Some infants born at term develop RDS because they have abnormal genes for surfactant.
• Signs and symptoms of RDS at birth include rapid, shallow breathing; sharp pulling in of the chest below the ribs with each breath taken in; grunting sounds during exhalation; and flaring of the nostrils during breathing.
• Doctors usually begin treating RDS as soon as the baby is born. At the same time, they do several tests to rule out any other conditions that could be causing the baby's breathing problems. These include blood tests, chest x ray, and echocardiogram.
• The most important treatments for RDS are surfactant replacement therapy and breathing support. Other treatments include medicines, supportive therapy, and treatment for patent ductus arteriosus, a condition that affects some premature infants.
• Most infants who show signs of RDS are moved to a special intensive care unit in the hospital called a neonatal intensive care unit (NICU). There they receive around-the-clock treatment from a group of health care professionals who specialize in treating premature infants.
• Your baby also may need special care after leaving the NICU, including special hearing and eye exams, speech or physical therapy, and specialty care for other medical problems caused by premature birth.
• Thanks to recent medical advances, most babies with RDS who weigh more than 2 pounds at birth now survive and have no long-term health or development problems.