Learn About Infantile Pneumothorax
Pneumothorax is when air or gas collects in the space inside the chest around the lungs. This may lead to lung collapse.
This article discusses pneumothorax in infants.
Pulmonary air leak; Pneumothorax - neonatal
A pneumothorax occurs when some of the tiny air sacs (alveoli) in a baby's lung become overinflated and burst. This causes air to leak into the space between the lung and chest wall (pleural space).
The most common cause of pneumothorax is respiratory distress syndrome. This is a condition that occurs in babies who are born too early (premature).
- The baby's lungs lack the slippery substance (surfactant) that helps them stay open (inflated). Therefore, the tiny air sacs are not able to expand as easily as normal.
- If the baby needs a breathing machine (mechanical ventilator), extra pressure on the baby's lungs, from the machine can sometimes burst the air sacs.
Meconium aspiration syndrome is another cause of pneumothorax in newborns.
- Before or during birth, the baby may breathe in their first bowel movement, called meconium. This may obstruct the airways and cause breathing problems.
Other causes include pneumonia (infection of the lung) or underdeveloped lung tissue.
Less commonly, otherwise healthy infants can develop an air leak when they take the first few breaths after birth. This occurs because of the pressure needed to expand the lungs for the first time. There may be genetic factors which contribute to this problem.
Many infants with pneumothorax do not have symptoms. When symptoms do occur, they can include:
- Bluish skin color (cyanosis)
- Fast breathing
- Flaring of the nostrils
- Grunting with breathing
- Irritability
- Restlessness
- Use of additional chest and abdominal muscles to aid breathing (retractions)
Babies without symptoms may not need treatment. The health care team will monitor your baby's breathing, heart rate, oxygen level, and skin color. Supplemental oxygen will be provided if needed.
If your baby is having symptoms, the provider will place a needle or a thin tube called a catheter into the baby's chest to remove the air that has leaked into the chest space.
Since treatment will also depend on the lung issues that led to the pneumothorax, it may last for days to weeks.
Johns Hopkins All Children's Hospital
Dr. Doshi specializes in neonatology at Johns Hopkins All Children’s. He sees patients at Sarasota Memorial Hospital, Sarasota Memorial – Venice and HCA Florida Brandon Hospital, through a collaboration with Johns Hopkins All Children’s. He joined the hospital staff in 2025. Dr. Doshi’s clinical and research interests focus on the long-term outcomes among extremely prematurely born patients by monitoring targeted oxygen saturation, nutritional support for optimal growth, and strategies to reduce bronchopulmonary dysplasia rates. He was previously a neonatologist at Golisano Children’s Hospital of Southwest Florida in Fort Myers. He earned his medical degree from Saurashtra University in Surendranagar, India. He completed a residency in pediatrics at Staten Island University Hospital, followed by a fellowship in neonatal-perinatal medicine at Cohen Children’s Medical Center. He also earned a Master of Public Health in epidemiology from Florida International University. He speaks English, Gujarati and Hindi. Dr. Doshi is rated as an Elite provider by MediFind in the treatment of Infantile Pneumothorax. His top areas of expertise are Infantile Pneumothorax, Bilirubin Encephalopathy, Transient Familial Hyperbilirubinemia, Gastroschisis, and Gastrostomy.
The Childrens Mercy Hospital
Shawn St. Peter is a Pediatric Surgeon and a General Surgeon in Overland Park, Kansas. Dr. St. Peter is rated as an Elite provider by MediFind in the treatment of Infantile Pneumothorax. His top areas of expertise are Appendicitis, Tracheoesophageal Fistula, Hernia, Appendectomy, and Gastrostomy. Dr. St. Peter is currently accepting new patients.
Matteo Bruschettini practices in Lund, Sweden. Mr. Bruschettini is rated as an Elite expert by MediFind in the treatment of Infantile Pneumothorax. His top areas of expertise are Infantile Pneumothorax, Infantile Apnea, Newborn Transient Tachypnea, and Intraventricular Hemorrhage of the Newborn.
Some air leaks will go away within a few days without treatment. Infants who have the air removed with a needle or catheter often do well after treatment if there are no other lung problems.
As air builds up in the chest, it can push the heart toward the other side of the chest. This puts pressure on both the lung that hasn't collapsed and the heart. This condition is called tension pneumothorax. It is a medical emergency because it can affect heart and lung function and be life-threatening.
A pneumothorax is often discovered shortly after birth. Contact your child's provider if your infant has symptoms of pneumothorax.
The providers in the newborn intensive care unit (NICU) should watch your infant carefully for signs of an air leak.
Summary: The primary aim of this research project is to determine if term neonates (37:0 to 41:6 weeks' gestational age) with mild respiratory distress can safely transition without continuous positive airway pressure (CPAP). The secondary aim is to determine the incidence of pneumothorax (PTX) for all term neonates assessed to have mild respiratory distress in the delivery room (DR).
Summary: The purpose of this study is to analyze the gastric fluid aspirated from the stomachs of neonates receiving routine post-delivery care to predict the need for prolonged respiratory support (\>6 hours of life).
Published Date: October 03, 2025
Published By: Mary Terrell, MD, NABBLM-C, IBCLC, Neonatologist, Cape Fear Valley Medical Center, Fayetteville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Crowley MA. Spectrum of neonatal respiratory disorders. In: Martin RJ, Fanaroff AA, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 67.
Haider SK, Vemana AP. Pneumothorax. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 461.