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Developmental Care Practices for Infants with Grade 3 Bronchopulmonary Dysplasia While in the Neonatal Intensive Care

Bridget DiPrisco1, Kristin Brinker2, Matt Coyle3

  • 1Divison of Neonatology, Children's Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, CA.

The Journal of Pediatrics
|May 26, 2026
PubMed

Insights

Neurodevelopmental care for infants with severe bronchopulmonary dysplasia (BPD) varies with respiratory support. Infants requiring tracheostomies receive more developmental support, highlighting a need for standardized care practices.

Area of Science:

  • Neonatal medicine
  • Developmental pediatrics
  • Respiratory therapy

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting premature infants.
  • Grade 3 BPD represents a severe form requiring significant medical intervention.
  • Neurodevelopmental outcomes are crucial for infants with BPD.

Purpose of the Study:

  • To evaluate neurodevelopmental care practices for infants with grade 3 BPD.
  • To examine the relationship between developmental therapies, supportive equipment, and respiratory support.
  • To identify variations in care within neonatal intensive care units (NICUs).

Main Methods:

  • Cross-sectional study across 22 NICUs participating in the BPD Collaborative.
  • Data collected on respiratory support, therapies, and equipment for infants with grade 3 BPD.
  • Included infants who had never been discharged home, using medical records and nurse interviews.

Main Results:

  • 141 infants were included; 65.2% received invasive ventilation.
  • Respiratory support was significantly associated with physical and speech therapy frequency.
  • Infants with tracheostomies had more supportive equipment compared to those with endotracheal tubes or non-invasive support.

Conclusions:

  • Developmental support for infants with grade 3 BPD is inconsistent across institutions and dependent on respiratory support.
  • Infants with tracheostomies appear to have greater access to developmentally supportive activities.
  • Findings can inform benchmarking and guide future studies to standardize care and improve outcomes.
Abstract

Keywords:
neurodevelopmental impairmentoccupational therapyphysical therapyrespiratory supportspeech language therapytracheostomy

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