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Oxygen therapy - infants

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Oxygen is a gas that the cells in your body need to work properly. The air we breathe normally has 21% oxygen. A maximum of 100% oxygen can be given.

WHY IS OXYGEN USED?

Babies with heart or lung problems may need increased amounts of oxygen.

HOW IS OXYGEN DELIVERED?

There are several different ways to deliver oxygen to a baby. It depends on how much oxygen is needed and whether your baby requires a breathing machine.

An oxygen hood is used for babies who can breathe on their own but still need extra oxygen. A hood is a plastic dome or box with warm, moist oxygen inside. The hood is placed over the baby's head.

A thin, soft, plastic tube called a nasal cannula may be used instead. This tube has soft prongs that gently fit into your baby’s nose. Oxygen flows through the tube. The baby must be able to breathe without assistance in order to use this type of oxygen therapy.

Another alternative is a nasal CPAP system. CPAP stands for continuous positive airway pressure. A CPAP machine delivers oxygen through tubes with soft nasal prongs, but the air is under higher pressure, which helps the lungs better expand (inflate).

Finally, a breathing machine or ventilator may be needed to deliver increased oxygen to the baby. The oxygen flows through a tube placed down the baby's windpipe.

WHAT ARE THE RISKS OF OXYGEN?

Too much or too little oxygen can be harmful. If the cells in the body receive too little oxygen, energy production is decreased. With too little energy, cells may not work properly and may die. Your baby may not grow properly. There is risk for injury to many of the developing organs, including the brain and heart.

However, too much oxygen can also cause injury. Breathing too much oxygen can cause injury to the lung. Under certain conditions, too much oxygen in the blood may also lead to problems in the brain and eye. Your baby’s doctors and nurses try to balance how much oxygen is needed to minimize the risks of too little or too much oxygen. If you have other questions regarding the risks and benefits of oxygen in your baby you should discuss these with your doctor.

WHAT ARE THE RISKS OF OXYGEN DELIVERY SYSTEMS?

Infants receiving oxygen by hood may get cold if the temperature of the oxygen is not warm enough.

Sometimes a hood or nasal cannula cannot deliver enough oxygen to your baby. Most (but not all) nasal cannulas use cool, dry oxygen. At higher flow rates this can lead to irritation of the inner nose, such as cracked skin, bleeding, or mucous plugs in the nose. This can increase the risk for infection.

Similar problems can occur with nasal CPAP devices. Also, some CPAP devices use wide nasal prongs that can distort the nose.

Mechanical ventilators have a number of risks. Talk to your doctor about these risks.

Update Date: 11/27/2007

Updated by: Deirdre O'Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Childrens Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

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