Home > About your baby > Medical conditions > Respiratory conditions > Chronic lung disease (CLD) or bronchopulmonary dysplasia (BPD)

What is chronic lung disease (CLD)?

Chronic lung disease (CLD) – also known as bronchopulmonary dysplasia, or BPD – is a respiratory (breathing) condition. It is usually diagnosed in premature babies who need ongoing help and support with their breathing beyond 28 days of age after birth, or if they were born after 36 weeks gestation. CLD can also affect babies born at term, although this is less common. 

It is not common, but sadly, some babies die of CLD. We have more information about palliative care and bereavement, and links to some more sources of support further down this page. 
 

What causes CLD? 

CLD commonly affects babies born premature because their lungs are immature and may not have developed fully. If your baby has CLD, they may have had a condition called respiratory distress syndrome (RDS) shortly after they were born. Treatments used for RDS, including ventilation and oxygen use, can cause scarring to the lungs. If your baby has been put on a ventilator for a long time, they are at a higher risk of developing CLD.

Some babies born at term can develop long-term breathing difficulties. This usually happens in babies with underlying health conditions. You may hear doctors refer to this as CLD or long-term lung disease. If you are unsure, speak to staff on the neonatal unit for more information. 

What are the signs of CLD? 

Doctors may suspect CLD in your baby if: 

CLD is a condition that develops over time so your doctor may talk about the possibility of it before confirming a diagnosis. 

If your baby was born after 32 weeks gestation, or was born at term, doctors may diagnose CLD if your baby needs ongoing breathing support at 28 days after birth. 

What tests might my baby have?

Your baby may have some, or all, of the following tests to monitor their CLD: 

  • Chest X-ray: This can be used to diagnose CLD and understand how severe it is 

  • Pulse oximetry: This measures how much oxygen is in your baby’s blood (also called blood oxygen saturation) with a sensor placed on their finger, ear or toe 

  • Heart rate monitoring and breathing tests: These are measured using sensors that are placed on your baby’s skin 

  • Blood gas test: This is a blood test which measures your baby’s levels of oxygen, carbon dioxide and acid in the blood. Doctors will take blood from a heel prick sample. It can also be taken from a plastic tube that is placed in your baby’s tummy button, hand or foot. 

What treatment is available for CLD?

The treatment that your baby will have will depend on how severe the CLD is. Treatment that may be used include the following: 

Breathing (respiratory) support: oxygen therapy and CPAP 

Some babies will need to be given oxygen to help improve the low levels of oxygen in their blood. There are different ways of providing breathing support to babies: 

  • Conventional oxygen therapy

  • High-flow nasal oxygen therapy (including Optiflow and Vapotherm), where a warmed mix of oxygen and air is given

In these cases, oxygen is usually given through nasal cannulas, which are small soft tubes that are placed in your baby’s nostrils.  

Continuous positive airway pressure (often shortened to CPAP) is another type of respiratory support. It passes air with or without oxygen (depending on what your baby needs) through two thin tubes in your baby’s nose, or through a small mask that fits over their nose. CPAP slightly raises the pressure of the air and oxygen given, which helps keep your baby’s lungs inflated. This makes it easier for them to breathe.  

During oxygen support and CPAP, your baby breathes on their own. 

Mechanical ventilation 

Mechanical ventilators are machines that breathe for your baby. They blow air, with or without oxygen (depending on what your baby needs), into your baby’s lungs. This is done through a tube that is passed through your baby’s nose or mouth (called an endotracheal tube) into their trachea (windpipe). 

Medication 

Babies with CLD may have the following medications: 

  • Diuretics, which can help reduce extra fluid in the lungs 

  • Steroids, which can help reduce any inflammation in the lungs and help to improve lung function 

  • Nutritional support and careful fluid management

Feeding (nutritional) support 

Babies with CLD may not gain weight as quickly as babies without medical conditions. This is because they need more energy to breathe. 

To ensure that your baby continues to grow and develop, they may be fed through a tube passed into their nose or mouth to their stomach. This is called tube feeding. The mother or birthing parents’ breast milk provides the best nutrition for their baby, but formula or donor milk will be provided if expressing breast milk is not possible. 

Some babies may also need to be fed using nutrition that is given in a liquid form directly into their bloodstream intravenously (into a vein). This is called parenteral nutrition (PN). 

Dieticians will be involved to monitor your baby’s nutritional support and growth closely. The healthcare professional looking after your baby can talk to you about the benefits and risks of these treatments and medications.  

What happens if my baby has to go home on oxygen?

Some babies with CLD will be discharged from the neonatal unit on oxygen. This means their breathing will be supported by additional oxygen from a tank that is given to them through a tube in their nose. Many babies with CLD will no longer need home oxygen within a year.  

Health professional support and follow up will be arranged if your baby has to go home on oxygen. 

What are the short- and long-term effects of CLD?

You may be concerned about the effects of CLD on your baby. Most babies with CLD who don’t experience breathing difficulties after they have been discharged from hospital show steady improvement with their breathing.  

When a baby first comes home, ordinary coughs and colds may make them wheeze more than a baby without CLD. If your baby has been discharged from the unit but they are still on oxygen, they are at higher risk of viral infections and conditions that affect the lungs, such as bronchiolitis, flu or pneumonia. Your baby might need to go back into hospital to monitor their breathing or for more treatment.  

A small number of babies may need ongoing support with CPAP or a ventilator and move from the neonatal unit to paediatric wards (such as high-dependency or paediatric intensive care units) to continue treatment. Some children may require long-term breathing support at home, which is usually arranged with the paediatric respiratory team.

Some premature babies with CLD or babies who need support using a ventilator at birth are at risk of developing breathing conditions such as asthma as they get older. Asthma is a long-term condition that affects the airways carrying air in and out of the lungs. Asthma + Lung UK has more information about this. 

Some babies with CLD can develop high blood pressure in their lungs. This is called pulmonary hypertension and is where there is high pressure in the blood vessels that carry blood from the heart to the lungs. Asthma + Lung UK has more information about pulmonary hypertension in children. 

If you have any questions or concerns about the long-term effects of CLD, speak to your baby’s healthcare team. They are there to help and answer any questions you have.

What can I do to help my baby with CLD?

Take basic precautions against contagious illnesses 

We have information about ways you can help protect your baby against common infectious illnesses, particularly during the winter months. 

Don’t smoke and avoid smoky places 

It is important that neither you nor any other members of your household smoke in the home. This includes e-cigarettes and vapes. 

If your baby has been discharged from hospital on oxygen, it is important to be very careful around flammable substances and to keep cylinders away from heat sources. The NHS website has some more information about what to be aware of. 

Talk to the healthcare team about the nirsevimab injection 

RSV is a cold-like virus that can lead to critical illness in babies born premature or sick, and those with underlying medical conditions such as chronic lung disease. A single antibody injection called nirsevimab offers some protection from RSV infections for up to six months.

From late September 2025, the NHS started offering the nirsevimab injection to high-risk babies. This includes those under one year of age with moderate or severe chronic lung disease who remain on oxygen at the start of the RSV season (between October and March every year).  

If your baby is in the neonatal unit from September, staff will arrange for RSV immunisations to take place before your baby is discharged from hospital.   

If your baby is discharged from neonatal care from 1 March onwards and is eligible for the immunisation, you will be invited to attend an outpatient clinic for your baby to receive the nirsevimab injection. If you do not receive an invitation letter to a clinic and you believe your baby is eligible, contact their GP or local neonatal unit. 

Contact your baby’s GP about the flu vaccine

As babies with CLD may be more vulnerable to flu or flu-like illnesses, your GP may offer them the flu vaccine when they are home from the neonatal unit and over 6 months old.

Where can I get more help and support for CLD/BPD?

Having a baby with a respiratory condition such as CLD can be a stressful experience. Some parents worry about the long-term implications of CLD. We have information about how you might be feeling and the different types of support available. 

If you are unsure about any part of your baby’s diagnosis, treatment or care, the staff on the unit will help you in any way they can. It is okay to ask again if you need information repeated or made clearer. The team will understand and want to support you. 

We have included some links to charities and organisations who can provide more support.  Your unit may also be able to provide you with this information about local support groups and charities. 

If you need someone to talk to, you can also contact us on [email protected] or arrange a video call with one of our volunteers. You can also ask staff on the neonatal unit if local support groups and charities are available in your area. 

Other charities and organisations who can provide more support: 

  • Asthma + Lung UK provides support to anyone affected by a lung condition, through online and printed information, support groups, a web community, and a support line. 

  • NARA The Breathing Charity is a publicly funded charity that provides breathing monitoring equipment for children and babies who have respiratory problems.