Conditions and Treatment

In our CRIB Program, we focus on caring for children born prematurely with bronchopulmonary dysplasia who may also have pulmonary hypertension or congenital heart disease.

  • Bronchopulmonary dysplasia (BPD) - a chronic lung disease that affects premature newborns who require a ventilator to breathe. Because these children’s lungs are very fragile, they can become damaged in the process.
  • Pulmonary hypertension (PH) - occurs when the blood vessels in the lungs either do not form correctly or become blocked or narrowed, resulting in high blood pressure in the lungs. If unrecognized, this can lead to failure of the right side of the heart. Pulmonary hypertension in newborns is a complication of prematurity and bronchopulmonary dysplasia. Studies suggest that 15% to 40% of infants with BPD develop PH. Therefore, our program includes regular screening of at-risk infants. Early diagnosis and treatment of pulmonary hypertension is important, as many children respond well to therapies. In many cases, when proper treatment is provided, pulmonary hypertension can resolve by the time the child reaches early childhood.
  • Congenital heart defects (CHD) - when a heart doesn’t form correctly in the womb. In our CRIB Program, we care for newborns with bronchopulmonary dysplasia who also may have congenital heart disease. We work with our greater cardiology and heart surgery team to cater to specific needs—for example, when a CRIB baby has a patent (open) ductus arteriosus (PDA), we work closely with our heart surgery team or our Preterm Patent PDA Closure Program team to determine if interventions are needed.

Our treatment approach

Because the heart and lungs are interconnected, when one is affected, so is the other. That’s why we bring multiple specialists together to monitor and manage these systems simultaneously, which includes detecting pulmonary hypertension as soon as possible. It takes many coordinated efforts from our joint team of heart, lung, and newborn specialists to optimize respiratory support, diagnose and treat pulmonary hypertension, and track patients’ growth and development.

Because every newborn’s journey is different, we take a personalized, adaptive, and research-driven approach to treating your child.

When the discharge moment is approaching for your child, we work together with your family to ensure a seamless transition from inpatient to outpatient care.

In the hospital

You can expect the following care steps while your newborn stays with us:

  • After delivery, your newborn will receive the highest level of care in our Level IV Neonatal Intensive Care Unit, where your child will receive respiratory support with careful weaning as they grow to help develop healthy lung tissue.
  • You will meet our CRIB Program team, who will support your baby’s heart and lungs to ensure healthy development. Our multispecialty care team will meet with you several times a month to review your baby’s progress.
  • Babies with BPD who are at high risk of pulmonary hypertension are screened with an echocardiogram and receive a detailed longitudinal heart and lung developmental care plan.
  • Your baby’s care team will also include dietitians, feeding and swallowing specialists, physical therapists, and dedicated social workers.
  • When other health needs arise, we collaborate with other pediatric specialists within Stanford Children’s to optimize your child’s whole-body health. For example, we may partner with our Betty Irene Moore Children’s Heart Center to provide extra subspecialty heart care for children with congenital heart disease.
  • Some infants with BPD need tracheostomies and long-term ventilators to grow and develop. When they improve and no longer require this high level of care, we transfer them to our Stanford Technology-Assisted Respiratory (STAR) Program. This program optimizes care and guides you in caring for your child.

In the outpatient CRIB clinic

When you visit our outpatient clinic with your child, you can expect the following:

  • Your child will be seen by the same neonatal nurse practitioner, pulmonologist, and cardiologist who were part of the team that cared for your child in the hospital.
  • Your child may also be seen by a dietitian, respiratory therapist, and social worker. For convenience, you see all providers together, at the same appointment.
  • Your doctor may order tests, which might include chest x-rays, echocardiograms, and lab tests.

Doctors and nurse practitioners within the CRIB Program will perform screenings regularly throughout early childhood. To make care more convenient, we provide telehealth visits for California families and in-person consultations at our Sunnyvale clinic location.

If you’re seeking an evaluation from our CRIB Program, please ask your child’s doctor for a referral.