Introduction
This guide covers what chronic lung disease means for children, warning signs that need attention, treatment basics, and care options that support both medical needs and childhood development.
If you're ready to explore care options now, schedule a tour with our team.
If you're new to navigating medical complexity, our guide on what to do first when your child has a medical complexity is a helpful starting point.
What Is Chronic Lung Disease in Children?
Chronic lung disease (CLD) is a long-term breathing condition that requires ongoing medical care—most commonly affecting premature babies.
The most common type is bronchopulmonary dysplasia (BPD), which develops when premature lung tissue is damaged by the oxygen therapy or ventilators used in the NICU. About 10,000-15,000 newborns develop BPD in the U.S. each year, according to the American Lung Association.
Most children with CLD improve significantly as their lungs grow. About 80% of children with BPD no longer need oxygen by their first birthday.
Types of Chronic Lung Disease in Children
Five main types of chronic lung disease affect children:
- Bronchopulmonary Dysplasia (BPD): Lung damage in premature babies from oxygen and ventilation—the most common type, affecting about 40% of babies born before 28 weeks. Babies who experienced apnea of prematurity face higher risk.
- Chronic Respiratory Failure: Requires long-term ventilator support or tracheostomy.
- Restrictive Lung Diseases: Scarred lung tissue that limits full expansion.
- Severe Chronic Asthma: Persistent inflammation requiring daily medication.
- Secondary Lung Disease: Breathing problems from other conditions like cerebral palsy. Learn more about caring for children with cerebral palsy.
What Causes Chronic Lung Disease in Children?
Premature birth is the primary cause—babies born before lungs fully develop are at highest risk.
Life-saving NICU treatments can damage delicate lung tissue:
- High oxygen levels can injure developing air sacs
- Mechanical ventilation pressure can cause scarring
- Infections can lead to inflammation
The earlier a baby is born, the higher the risk. Babies born before 26 weeks have a 70-75% chance of developing CLD.
Other causes include genetic conditions like cystic fibrosis and complications during pregnancy.
Warning Signs of Respiratory Distress in Children
Recognizing breathing problems early helps you respond appropriately.
Common Signs to Watch For
- Rapid or labored breathing (faster than your child's baseline)
- Blue or pale color around lips, tongue, or nail beds
- Nostrils flaring with each breath
- Chest retractions (skin pulling between ribs)
- Wheezing or grunting sounds
- Tiring quickly during feeding or play
When to Call 911
Call 911 immediately for: blue/gray lips or face, severe chest retractions, breathing that stops or becomes extremely rapid, or if your child is unresponsive.
When to Call Your Doctor
Call the same day for: breathing faster than baseline, increased oxygen needs, wheezing that doesn't improve with treatment, fever with respiratory symptoms, or refusing to eat.
The American Academy of Pediatrics offers additional guidance on breathing emergencies.
How Is Chronic Lung Disease Diagnosed?
Doctors diagnose CLD through physical examination, chest X-rays, and oxygen assessments.
For premature babies, diagnosis typically happens when oxygen support is still needed beyond 28 days of life or 36 weeks corrected gestational age. The Cleveland Clinic provides detailed diagnostic criteria.
Treatment for Chronic Lung Disease in Children
Treatment focuses on supporting breathing while lungs heal and grow. Most children use multiple approaches together.
Common treatments include:
- Oxygen therapy: Many children need supplemental oxygen 12-20 hours daily via nasal cannula
- Nebulizer treatments: Deliver bronchodilators and corticosteroids directly to the lungs, typically 2-4 times daily
- Nutrition support: Good nutrition fuels lung healing—some children need high-calorie formula or G-tube feeding
- RSV prevention: Monthly Synagis injections during RSV season reduce severe infection risk by 55-78%
Your child's medical team will create a treatment plan specific to their needs.
Daily Care for Children with Chronic Lung Disease
Daily care typically includes oxygen monitoring, scheduled breathing treatments, medication administration, and equipment maintenance.
Many families manage care at home with support from their medical team. Others find that additional support—like home nursing or medical daycare—helps balance medical needs with work and family life.
Care Options for Children with Chronic Lung Disease
Children with CLD need expert respiratory management and opportunities for normal childhood experiences. Here's how the main options compare:
Traditional Daycare
Traditional daycares typically cannot accommodate children requiring oxygen, breathing treatments, or skilled nursing care. They lack the medical staff, equipment, and emergency protocols these children need.
Learn more about how medical daycare differs from traditional daycare.
Home Health Nursing
Private duty nurses provide skilled care at home. This offers one-on-one attention but doesn't provide socialization with peers—and nursing shortages can make consistent coverage challenging.
Learn about combining home nursing with medical daycare for complete care.
PPEC (Medical Daycare)
PPEC centers combine skilled nursing care with childhood development in one place.
What this means for respiratory care:
- Nurses with pediatric critical care experience monitor your child throughout the day
- Breathing treatments administered on schedule
- Staff-to-child ratios typically around 1:3
- Emergency response equipment and protocols on-site
What this means for your child:
- Play, learning, and socialization with peers
- Therapy services in one location (we provide some on-site and welcome your child's existing therapists)
- A chance to just be a kid while receiving expert medical support
What this means for your family:
- Up to 12 hours of daily care so parents can return to work or school
- Fully covered by Medicaid for eligible families—zero out-of-pocket cost
- Our team helps with paperwork and coordination
See what a typical day looks like at PPEC or read our complete guide to PPEC.
Long-Term Outlook for Children with Chronic Lung Disease
Most children with CLD improve significantly as they grow, and many outgrow their lung problems entirely.
- About 80% of children wean off oxygen by their first birthday
- Lungs continue developing through age 20, allowing healthy tissue to compensate
- With proper care, most children live full, active lives
Some children experience wheezing or reduced exercise tolerance into childhood. Regular follow-up with a pulmonologist helps track progress.
How Chronic Lung Disease Affects Development
Most children with CLD develop normally in cognitive and social-emotional areas.
Physical development and speech may need extra support due to the energy demands of breathing and effects of prolonged intubation. Therapies like PT, OT, and speech therapy help children reach milestones—and at PPEC, these can happen alongside medical care in one location.
The CDC's milestone tracker can help you monitor your child's progress.
Next Steps for Parents
Check eligibility: Our guide to PPEC eligibility requirements explains who qualifies—most children with CLD needing skilled nursing care meet criteria.
Understand coverage: PPEC is fully covered by Medicaid. Here's how to apply for Medicaid for PPEC services.
See it for yourself: The best way to know if PPEC fits your family is to visit.
Schedule a tour at a Spark Pediatrics center in Florida or Texas. Our team is happy to answer your questions and help you explore your options.