What is Surfactant?Postpartum
So, who’s up for a biology lesson on the respiratory system in infants? No one? Before you hit the backspace button and go—boring— this topic is an important one! Those new parents who will experience the reality of premature birth need to understand why this substance is primary to the health of your little one. Prematurity affects one in ten babies in Canada and many of these preemies struggle with respiratory distress because their lungs are unprepared to process oxygen for their fragile systems. They lack surfactant.
Surfactant is a complex naturally occurring coating on the inside lining of the alveoli, the spongy air sacs in the lungs. This substance makes it easier for the alveoli to expand during breathing and from collapsing and sticking together when air leaves the lungs. Your baby begins to produce surfactant between weeks 24 and 28 gestation and by 35 weeks your baby will have produced enough naturally occurring surfactant not to need additional help with breathing at birth. But those babies born too soon, especially those born prior 30 weeks, will likely need surfactant replacement therapy.
The decision to use synthetic surfactant is based on your baby’s APGAR Score, blood oxygen levels, and the degree of distress with breathing. If your baby is working hard for each breath, giving extra surfactant, usually within the first 6 hours after birth, will even out the coating in the alveoli. Surfactant is given through the breathing, or endotracheal, tube that has been inserted into your infant’s lungs. This will keep your baby from becoming exhausted and makes breathing easier for them. Newborns who experience Respiratory Distress Syndrome will be given multiple doses of surfactant and this treatment will continue until their lungs are capable of making enough on their own.
Mothers who are high risk for premature birth are often given corticosteroids towards the end of their pregnancy to stimulate the baby’s lungs to produce surfactant sooner. Prematurity is more common in a diabetic mother, when carrying multiples, or where there is a history of premature birth previously. If you have warning signs of preterm labor and have a positive fetal fibronectin test, your healthcare provider may prescribe corticosteriods as well. There are several steps moms-to-be can do to reduce the risk of early birth, such as not smoking or drinking alcohol in pregnancy, eating a healthy diet, and getting good prenatal care. The only way to prevent lung issues in a preterm infant is to avoid a premature delivery. Unfortunately, sometimes no one can predict which pregnancy may end early and surfactant therapy becomes a reality.
We encourage you to learn more about our "What in the World" series. Please see our A to Z index for a whole host of pregnancy, postpartum, and parenting information and terminology.
Loree Siermachesky works as a multi-certified labour and postpartum doula, certified Lamaze childbirth educator, certified breastfeeding counselor, certified placenta encapsulation specialist and a certified car seat technician in Medicine Hat and Lethbridge. She has had the honour of attending over 1400 births in the last 20 years. She is well-known and greatly respected by the medical providers in Medicine Hat, Lethbridge, Brooks, Taber, and Calgary. She cares deeply for this profession and even more for her clientele, honoring them in whatever method of birth they choose, or helping them transition to new parenthood as they wish.