Babies born extremely early and weighing very little often develop serious lung problems called bronchopulmonary dysplasia (BPD). Doctors are seeing this problem happen more often, so researchers looked at all the best ways to prevent it. They found that there’s no single magic solution, but doctors can use many different proven strategies starting right after birth—including special breathing support, lung-coating medicines, careful fluid management, and good nutrition—to help these tiny babies develop healthier lungs and avoid long-term breathing problems.

The Quick Take

  • What they studied: What doctors can do right after birth to prevent serious lung disease in extremely premature babies
  • Who participated: This was a review of existing research about extremely low birth weight infants (babies weighing less than 1,000 grams or about 2.2 pounds at birth)
  • Key finding: No single treatment prevents lung disease in all at-risk premature babies, but using multiple proven strategies together—starting immediately after birth—significantly reduces the chances of developing this serious condition
  • What it means for you: If you have a baby born extremely early, doctors now have many evidence-based tools to protect your baby’s lungs. The best approach combines several strategies rather than relying on just one treatment. This gives premature babies the best chance at healthy lung development.

The Research Details

This was a review article, meaning researchers looked at and summarized all the best scientific evidence available about preventing lung disease in extremely premature babies. Instead of doing their own experiment, they examined what other doctors and scientists have already discovered and published. They looked at many different types of treatments and approaches that doctors use in the first days and weeks after these babies are born. The researchers organized all this information to help doctors understand which strategies work best and how to combine them effectively.

Review articles like this are important because they bring together all the scattered pieces of research into one clear picture. Instead of doctors having to read hundreds of individual studies, this review helps them understand the big picture of what actually works. This is especially important for premature babies because their lungs are very fragile and need careful, thoughtful care from the very beginning.

This review was published in a respected medical journal called Current Opinion in Pediatrics, which means it was checked by experts before publication. However, because this is a review of other studies rather than a new experiment, its strength depends on the quality of the studies it reviewed. The review appears to be comprehensive, covering many different approaches doctors use to help these babies.

What the Results Show

The researchers found that preventing lung disease in extremely premature babies requires a team approach rather than a single solution. They identified eight major strategies that doctors should consider: special breathing support techniques, medicines that coat the lungs (called surfactant), careful management of fluids going into the baby’s body, medicines to help the heart and lungs work together better, good nutrition, special vitamins and supplements, and careful timing of when to start breathing support. Each of these strategies has scientific evidence showing it can help, but they work best when used together as part of a complete plan. The review emphasizes that doctors need to start these strategies very early—even during pregnancy and immediately after birth—rather than waiting to see if problems develop.

The research also highlighted that different babies may need different combinations of these strategies. Some babies might benefit most from one approach while another baby needs a different mix. The review noted that the rate of lung disease in extremely premature babies appears to be increasing, which makes prevention strategies even more important. Additionally, the researchers found that managing other complications—like heart problems that sometimes occur in premature babies—is connected to preventing lung disease, showing how all these systems in a tiny baby’s body are connected.

This review builds on decades of research into premature baby care. While doctors have known about many of these individual strategies for years, this review shows that the most effective approach is combining multiple strategies rather than relying on just one. It also reflects a shift in thinking from simply treating problems after they develop to preventing them from happening in the first place. The finding that lung disease rates are increasing suggests that even with current knowledge, there’s still room for improvement in how these strategies are applied.

This review has some important limitations to understand. First, it doesn’t include new experimental data—it only summarizes what other studies have found. Second, the review doesn’t specify exactly how many studies were included or provide detailed statistics about how effective each strategy is. Third, because medical care varies widely around the world, some of these strategies may be more available in some hospitals than others. Finally, the review was published very recently (January 2026), so it may not include the very latest research findings.

The Bottom Line

If you have a baby born extremely early and weighing very little, work closely with your medical team to ensure they’re using multiple proven strategies to protect your baby’s lungs. These should include appropriate breathing support, lung-coating medicines when needed, careful fluid management, good nutrition, and other supportive care. Ask your doctors which specific strategies they’re using and why. The evidence strongly supports using this multi-strategy approach (high confidence), though individual results will vary depending on each baby’s unique situation.

This research is most relevant to parents of extremely premature babies (born before 28 weeks of pregnancy), doctors and nurses in neonatal intensive care units, and hospital administrators making decisions about premature baby care. If your baby was born at a normal weight or even moderately early, this research is less directly applicable, though some principles may still be helpful. If you’re pregnant and at risk for very early delivery, understanding these prevention strategies might help you have informed conversations with your doctors.

The benefits of these prevention strategies develop over weeks and months. Some strategies, like breathing support, help immediately. Others, like nutrition and supplements, work gradually to support healthy lung development. Most extremely premature babies spend 2-4 months in the hospital, during which these strategies are continuously applied. The real measure of success is whether the baby can breathe well on their own by the time they go home and continues to have healthy lungs in the months and years after discharge.

Want to Apply This Research?

  • If you’re a parent of a hospitalized premature baby, track which prevention strategies your baby is receiving (breathing support type, medications given, fluid intake, nutrition type) and any changes in your baby’s breathing or oxygen needs. Note dates and any improvements or concerns to discuss with your medical team.
  • For parents: Ask your medical team weekly about which lung-protection strategies are being used and request explanations you can understand. For healthcare providers: Use a checklist of evidence-based strategies to ensure a comprehensive approach is being used for each extremely premature baby in your care.
  • Track your baby’s oxygen requirements over time (how much oxygen support is needed), breathing patterns, feeding progress, and growth. These are all connected to lung health. Keep a simple log of hospital visits and any breathing-related concerns after discharge to share with your pediatrician during follow-up appointments.

This article summarizes research about preventing lung disease in extremely premature babies and is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have a premature baby or are at risk for early delivery, please consult with your healthcare provider or neonatal specialist for personalized medical advice. Treatment decisions should always be made in consultation with qualified medical professionals who can evaluate your specific situation. The strategies discussed in this research should only be implemented under proper medical supervision in appropriate healthcare settings.