For Parents

Why is ventilation necessary?

There are a variety of reasons why some babies are unable to breathe without assistance at birth, particularly if they are preterm:

Lung immaturity: Some extremely preterm babies have not had sufficient time for their lungs to mature and this could mean that they struggle to breathe on their own. Sometimes mothers who are likely to deliver early are given steroids to encourage lung development in their unborn baby.

‘Apnoeic spells’: This is when a baby's breathing pattern is sporadic, which often happens in preterm babies where they have long pauses between breathing. Sometimes drugs can be given to reduce this but in severe cases ventilation will help.

Lack of Surfactant: Sometimes preterm babies may not have sufficient levels of an important chemical called Surfactant. Surfactant is an enzyme which is naturally produced in the body and which prevents the air sacs in the lung from collapsing when the baby exhales. Premature babies without enough Surfactant will breathe quicker and often make a grunting noise as they try to breathe properly. This is known as RDS or Respiratory Distress Syndrome.

Fluid in the lungs: Usually fluid that is in the lungs prior to birth is cleared before a baby is born. However if labour is short or premature or sometimes after a Caesarean section, this fluid still remains in the baby's lungs. In the severest cases the lungs can become infected and stiff, which means they don't work well and it is then difficult for the baby to breathe. The baby will then need ventilation to assist with breathing.

Meconium aspiration: This is a dark material that is found in the baby's digestive system prior to birth. Usually within 24 hours of birth, the baby passes bowel movements to expel the Meconium. However, if a baby is distressed before delivery they may pass meconium in the womb and this can sometimes be ingested by the baby and can partly block the airways.

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