If the mother's water breaks early or she goes into pre-term labor, the baby may begin to create surfactant early or drugs can be given to help start the production of surfactant before birth. "To determine if the baby has begun production of the substance, the mother's amniotic fluid will be tested," explains Dr. DiRenzo-Coffey. "If surfactant is not being produced, a drug called betamethasone may be given and an attempt to delay the birth will me made."

Most infants will recover from Respiratory Distress Syndrome within the first month after birth. "A newborn with RDS will be placed under special care immediately," says Dr. DiRenzo-Coffey. "Specialists will continuously monitor the baby's heart rate, breathing rate, and amount of oxygen in the skin."

Treatment may also include:

• Laboratory tests - Blood tests and an x-ray of the baby's chest will help to identify the cause of the breathing problems.
  
• IV fluids - Because baby is using all of his energy to breathe, an intravenous (IV) line is used to prevent dehydration. Once the lungs have improved, the baby can then drink milk.
  
• Antibiotics - The baby will be treated for infection with antibiotics. A blood culture will then be taken. If there is no sign of infection, the antibiotics will be stopped in 3 days.
  
• Oxygen - In order to maintain a level of oxygen within the normal range, the baby will be placed in a plastic hood where extra oxygen is blown. Test will be run to determine how much extra oxygen baby needs.

Depending on the baby's condition, other treatment may be necessary, including assisted breathing through a ventilator or other device and the administration of artificial surfactant.

"RDS will cause baby to be sick for approximately 3 days," says Dr. DiRenzo-Coffey. "Doctors will know the condition is improving when the amount of oxygen the baby requires starts to lessen. When a baby is using a ventilator, doctors will reduce the amount of oxygen administered until the baby can breathe on his or her own and the breathing tube can be removed."

Once baby no longer needs oxygen and can breathe at a normal rate, feedings can be started. "Those who are strong and mature enough to suck, can be breast- or bottle-fed," explains Dr. DiRenzo-Coffey. "However, those babies whose lungs are still recovering may be fed through a feeding tube that is passed through the mouth and into the stomach until they are strong enough to breast- or bottle-feed."

It is possible for short- or long-term problems to occur from RDS, although unlikely, says Dr. DiRenzo-Coffey. Complications may include:

• Pneumothorax - A short-term problem where the air sacs tear and air escapes outside the lungs. If the tear is small, no treatment is needed. If it is large, air will be drawn out with a needle or a tube. It can take anywhere from a few hours to a few days for an air sacs to heal itself.
  
• Chronic lung disease - A potentially long-term problem where babies with unusually severe lung disease or those born very premature receive a lot of oxygen and pressure from a ventilator which can scar the lungs. Most babies will grow new lung tissue to replace scarred tissue and will outgrow the problem within a few months. However, during the first few years of life, some children will have more bouts of wheezing or pneumonia along with a cold. As the child grows older, the problem will diminish.

"Parents should remember that it is not common for short- or long-term complications to result from RDS," says Dr. DiRenzo-Coffey, "and that almost all sufferers recovery completely and go on to live healthy, normal lives."

A graduate of Duke University of School of Medicine, Gina DiRenzo-Coffey, M.D., is Board Certified in Pediatrics. Dr. DiRenzo-Coffey practices at 2801 South 88th Street. For an appointment, call 391-7684.