In the mother’s womb, a baby receives all the oxygen it needs from the mother’s blood, which is passed to the baby’s blood through the placenta and along the umbilical cord. Once born, all babies have to get their own oxygen by breathing. This can be a particular problem for very premature babies.
There are two main reasons for this: firstly, the lungs may not be fully developed; secondly, the baby may be unwell and very weak.
Positive pressure ventilators
Conventional ventilation (positive pressure ventilators) blows oxygen-enriched air into the baby’s lungs through a tube that is passed through their mouth or nose. These ventilators inflate the lungs. The rate of breathing will be regularly adjusted to meet your baby’s current need. These sophisticated machines are designed to enable oxygenation (help oxygenate the blood) and to remove carbon dioxide (the by-product of breathing).
High frequency ventilator (oscillator)
A high frequency ventilator will puff small amounts of air into the lungs hundreds of times a minute. The baby’s chest appears to vibrate and although this may look alarming, this type of ventilation works extremely well for some lung conditions.
Gentle breathing support (CPAP)
Some babies need a little help with their breathing, but do not need a ventilator. They can be helped with Continuous Positive Airway Pressure, often called CPAP. This helps the baby breathe by having air flow through two fine tubes placed in the baby’s nostrils. This slightly raises the pressure and helps to keep the baby’s lungs inflated.
Back on the ventilator
The first time a baby is taken off a ventilator, he or she may breathe well for a while and then become tired. In this case, doctors will re-insert the ventilator tube and try again later. Gradually the periods off the ventilator should increase.
If your baby catches an infection or has some breathing difficulties, he or she might need to go back on the ventilator until the infection has cleared up.
Ventilators and chronic lung disease
Babies who need to be ventilated for long periods of time may get chronic lung disease, depending on the level of ventilation or oxygen they need, or if they develop a chest infection. Babies born before 34 weeks or who have a low birth weight (below 2 kg) are at risk, due to reduced amounts of surfactant production and underdeveloped lung tissue. Surfactant is a mixture of chemicals in the lungs that starts being produced at about 24 weeks but is not well developed before 36 weeks’ gestation.
If a baby has chronic lung disease, his or her lungs are stiffer and he or she has to work harder to get air into the lungs. The baby may also become more tired during feeds. Babies with chronic lung disease may need additional oxygen support for a while after they go home.