Respiratory Distress Syndrome

Respiratory distress syndrome is most common in premature newborn babies born before 28 weeks of pregnancy. RDS makes it difficult for the baby to breathe. Newborn babies affected with Respiratory Distress Syndrome are at a high risk of developing complications and require immediate medical attention.

Commonly Occurring Symptoms

Premature babies display symptoms of respiratory distress syndrome immediately after birth. There are some exceptions where symptoms may be delayed for several hours.

  • Bluish discolouration of skin and lips.
  • Difficulty in breathing. Visible signs of forced breathing with an unusual grunting sound.
  • Fast breathing. The rate of breathing is increased, leading to visible chest movements.
  • Flaring nostrils are a common sign as the baby struggles to gasp more air, allowing air into the lungs.
  • The child is sleepier than usual and difficult to wake. Observe the mood; he/she may be cranky or irritated due to difficulty in breathing.
  • Infants will alter their body positions if they have difficulty breathing. For example, leaning forward or tilting the head upwards.
  • Lower body temperature, cool and sweaty skin.

What Are the Causes of Respiratory Distress Syndrome?

Respiratory Distress Syndrome occurs in infants with underdeveloped lungs. Surfactant plays a crucial role in the development of respiratory distress syndrome. Surfactant is a foamy, slippery liquid substance that helps in keeping the lungs fully expanded to let air into the lungs thereby, allowing the baby to breathe. Lack of surfactant will cause the lungs to collapse and the newborn will have difficulty breathing. This leads to an inadequate supply of oxygen to the vital organs of the body like the brain and heart, resulting in tissue damage.

Infections, chronic illness, and blocked airways are some common causes in children.

When to Visit the Doctor?

Generally, respiratory distress syndrome is identified immediately after birth. But in exceptional cases, the symptoms are not seen for several hours, days, or months. Parents have to be alert for these symptoms if their baby is born before the due date. If difficulty in breathing or a blue discolouration is observed, the infant should be rushed to the hospital immediately for medical attention.

In the case of an emergency, do not panic. Follow these instructions.

  1. Stay calm and call the emergency services.
  2. Keep the baby in an upright position, usually in a sitting position.
  3. Measure the body's temperature.

Risk Factors Responsible for Respiratory Distress Syndrome:

Babies born earlier than the full-term pregnancy are at a higher risk of developing respiratory distress syndrome. The more premature the baby, the risk is higher. Other risk factors are:

  • Mother affected with diabetes. (Gestational diabetes)
  • Cesarean delivery. Pre-planned delivery before full term.
  • Multiple pregnancies. In the case of twins.
  • Young or teenage mothers. Generally, pre-term births are observed in this group of pregnant women.
  • Induced or rapid labour.


Various treatment modalities effectively resolve respiratory distress syndrome. The severity of RDS will determine the choice of treatment and the duration of treatment. Different types of treatments are available before birth and after birth.

a) Treatments Before birth:

Surfactant production starts in the 26th week of pregnancy. In cases where there is prior knowledge of pre-term birth. Steroid injections are given to the mother. A corticosteroid injection given a week after the baby is born will reduce the risk of RDS.

b) Treatments After birth:

These treatments are given after the baby is born.

  • Warm moist oxygen is administered via an incubator in mild cases of RDS. An incubator is a small mask over the face, covering the nose.
  • Nasal continuous positive airway pressure: This device is gently used to push oxygen/ air into the lungs. A continuous flow of oxygen prevents the lungs from collapsing, keeping the air sacs open.
  • Surfactant replacement therapy: additional surfactant is administered to ease and help with breathing. It is given via a breathing tube to replace and achieve an optimal level of surfactant required for essential functions. This therapy is used when the nCPAP machine fails to help the infant breathe and provide relief.
  • Mechanical ventilator: is a form of life support. It performs the function of breathing in patients who are incapable of doing so on their own. It is used in severe cases of Respiratory Distress Syndrome. It provides oxygen via a breathing tube that runs through the nose or mouth into the windpipe. 

Modern medicine is perfectly capable of managing RDS. We need to stay alert and informed about the various symptoms of RDS to avoid a severe situation. It is of utmost importance to visit a child specialist for expert advice.

Request an appointment at Apollo Cradle, Amritsar - Abadi Court Road. Call 1860-500-1066 to book an appointment.

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