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Why is my baby having trouble breathing?
Babies breathe to move air in and out of the body. The
lungs move oxygen from the air into the blood through tiny
sacs called alveoli. The body needs oxygen to stay alive.
Some babies are born with lungs that don’t work
well. One problem is called hypoxic respiratory
failure, or HRF. As a result, the baby is not
getting enough oxygen into the blood.

What causes HRF?
HRF can be caused by many things.
Examples are:
• Meconium aspiration – infant breathes
in a mixture of stool (meconium) and
amniotic fluid around the time of delivery
• Pneumonia – lung infection
• Sepsis – infection throughout the body
• Respiratory distress syndrome – baby’s
lungs don’t make enough surfactant.
This liquid helps keep the alveoli open
so that oxygen can be used
• Hernia in the diaphragm – hole in the
diaphragm, which is a muscle that helps
the lungs do their job
• PPHN (persistent pulmonary hypertension
of the newborn) – high blood pressure in
the lungs
• Prematurity – born before the baby’s
due date

How common is HRF?
HRF affects about 18 in 1000 babies born
in the United States.* It is more common in
babies who are born prematurely.

What treatment will my baby receive?
Treatment will vary based on the cause of HRF and how your
baby is doing. Possible treatments include:
• Extra oxygen – given by nasal cannula (nose tube) or mask:
– CPAP (continuous positive airway pressure) – a treatment
that uses mild pressurized air to keep the lungs open
– Mechanical ventilator (in more severe cases) – a
machine that helps your baby breathe using a tube
• Surfactant – a medicine that helps keep the alveoli open.
It is used for babies with respiratory distress syndrome,
one cause of HRF
• Inhaled or intravenous (IV) treatments to improve how the
lungs work
• Antibiotics – medicines that fight infections

How will I know how my baby is doing?
Your health care team will keep you up-to-date on your
baby. They have several ways to measure breathing and
lung health, including:
• Vital signs (heart rate, breathing rate, blood pressure,
and oxygen saturation) and lab tests
• Settings on the mechanical ventilator – level of
breathing support
• Oxygenation index – a formula that the health care team
uses to measure how well the baby’s lungs are working
What will happen next?
Many babies respond well to treatment for HRF. Each baby
is different. Talk to the health care team. They can answer
any questions you have about your baby

Glossary
Alveoli – tiny sacs in the lungs
that move oxygen from the air
into the blood
CPAP (continuous positive
airway pressure) – a treatment
that uses mild, pressurized air to
keep the lungs open
HRF (hypoxic respiratory failure)
– baby is not getting enough oxygen
Mechanical ventilator – a
machine that helps your baby
breathe by pushing air in and out
of the lungs
Oxygenation index – formula
the health care team uses to
measure how well the baby’s
lungs are working
Prematurity – born before the
baby’s due date
PPHN (persistent pulmonary
hypertension of the newborn) –
high blood pressure in the lungs
Surfactant – medicine that helps
keep the alveoli open so that
oxygen can be used
Vital signs – heart rate,
breathing rate, blood pressure,
and oxygen saturation

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