Cystic Fibrosis In Babies: Symptoms, Causes And Treatment

Treatment generally entails reducing the intensity of the symptoms and managing complications.

Medically reviewed by Dr. Ashraf Kasem, MS Dr. Ashraf Kasem Dr. Ashraf KasemMS facebook_icontwitter_iconyoutube_icon Specialty: Pediatrics and Neonatology Experience: 10 years
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Cystic Fibrosis In Babies

Cystic fibrosis in babies may result in frequent lung infections that affect their breathing ability over time and cause digestive problems. These health issues can be caused by the accumulation of sticky mucus in the lungs and digestive system (1) (2).

Cystic fibrosis is a progressive genetic disease caused by an inherited abnormality in the cells regulating salt, water, and mucus production (3). Males and females are equally affected by it (4).

Read on to learn about the causes, signs, diagnosis, and treatment of cystic fibrosis in babies.

Causes Of Cystic Fibrosis In Babies

Cystic fibrosis is a genetic disorder. It happens when the gene that makes a protein responsible for the influx (going in) and outflux (coming out) of sodium and chloride in the cells is faulty. The faulty gene leads to the thickening of the mucus that lines the airways and other organs. It also makes the secretions of the mucous membranes stickier (5).

The thick and sticky mucus is difficult for the body to clear. It ultimately increases the risk of infections and interferes with the healthy functions of organs, causing various symptoms indicative of cystic fibrosis.

How Does A Baby Get Cystic Fibrosis?

A baby develops cystic fibrosis because they inherit a faulty gene from their parents. The gene that causes cystic fibrosis is recessive. Therefore, for a child to get cystic fibrosis, both the parents need to be carriers of the faulty gene.If only one parent is a carrier, the child won’t get the disease but still may be a carrier (4).

If both the mother and the father carry one copy of the cystic fibrosis gene, but they do not have the disease themselves, their children may have a (6):

  • 25 percent chance of getting both defective copies and developing cystic fibrosis
  • 50 percent chance of inheriting one defective copy and being only a carrier
  • 25 percent chance of neither being a carrier nor having the disease

Approximately 30,000 people in the United States have cystic fibrosis. It is estimated that about 10 million people are carriers of the cystic fibrosis gene (4).

Signs And Symptoms Of Cystic Fibrosis In Babies

The signs and symptoms of cystic fibrosis usually begin to show within the first year of life. It affects different organs and systems, leading to various symptoms. General signs and symptoms could be evident to the parents, while most organ-specific symptoms are detectable during a medical examination.

General symptoms of cystic fibrosis (7):

  • Slow growth
  • Less weight gain
  • No stool in the first 24 to 48 hours of life

Respiratory symptoms of cystic fibrosis (6):

  • Chronic cough
  • More mucus in lungs and sinuses
  • Tiredness
  • Frequent lung infections
  • Recurrent wheezy chest
  • Frequent sinus infections
  • Coughing up blood
  • Heart enlargement
  • Nasal polyps
  • Symptoms of pneumonia (fever, increased coughing, shortness of breath, increased mucus, and loss of appetite)

Digestive symptoms of cystic fibrosis (6):

  • Belly pain from constipation
  • Increased gas, bloating, or a distended belly
  • Loss of appetite
  • Pale or clay-colored, foul-smelling, and mucus-rich stool that floats
  • Problems with the absorption of key nutrients, such as fats, proteins, and fat-soluble vitamins like A, D, E, and K, causing malnutrition

Diagnosis Of Cystic Fibrosis In Babies

Newborns are usually screened for cystic fibrosis. Most babies are diagnosed before the age of two years. In rare cases, the disease is not detected until the age of 18 years (7).

A blood sample is collected from the baby’s heel in the first few days of life. After the initial screening, if needed, the doctor tests the baby’s sweat to determine its salt content. A high level of salt (sodium and chloride) indicates cystic fibrosis (5) (8).

In most cases, cystic fibrosis is diagnosed in the initial screening process. However, in some babies, it is diagnosed following some other unexplained illness. In these babies, either a sweat test (as babies with cystic fibrosis have more salt in their sweat) or a genetic test is done. Genetic testing is done by collecting blood samples or an inner cheek swab (5).

Management Of Cystic Fibrosis

There is no cure for cystic fibrosis. The treatment plan depends on the symptoms’ severity and could change as per the baby’s age. The objective of the treatment is to reduce the intensity of symptoms, mitigate organ issues, manage complications, and facilitate healthy development.

A treatment plan for cystic fibrosis could consist of the following measures (9) (10).

  1. High-calorie diet: Some babies with cystic fibrosis need a high-calorie diet for healthy growth and development.
  1. Pancreatic enzymes: Babies with cystic fibrosis-related digestion issues may need to consume pancreatic enzymes before their meals. These pancreatic enzymes help digest the food, helping the baby attain optimum weight and growth.
  1. Vitamin supplementation: The disorder interferes with the absorption of various vitamins, including vitamins A, D, K and E Therefore, the doctor may prescribe vitamin supplements to ensure adequate nourishment and growth.
  1. Mucus thinners: Medicines, such as dornase alfa (Pulmozyme), help thin the mucus. Thin mucus is easier to cough and expel.
  1. Bronchodilators: Medicines, such as albuterol, help open the airways, aiding the lungs in clearing the mucus.
  1. Antibiotics: They are used to treat bacterial infections if any.
  1. Hypertonic saline: Inhaling hypertonic saline mist draws more water into the airways. The water helps in thinning the mucus. Hypertonic saline improves lung function with fewer pulmonary exacerbations.
  1. Airway clearance therapy (ACT): This therapy loosens the sticky mucus to make it easier to clear it through coughing. It will help the baby breathe easier. The doctor will decide the best option from the various techniques and treatments available under airway clearance therapy.

Frequently Asked Questions

1. What is the life expectancy of a baby with cystic fibrosis?

The average life expectancy of people affected by cystic fibrosis is around 44 years (7).

2. Do babies with cystic fibrosis poop a lot?

Yes, it is possible for some babies with cystic fibrosis to pass more stools than usual (11).

3. Do babies survive cystic fibrosis?

The survival rates of cystic fibrosis have improved in the past few years. Advanced treatments have helped manage the symptoms. Currently, around 50% of people diagnosed with the disease will live beyond the age of 40. However, children born with the condition may live longer due to prompt medical treatment available in today’s age (2).

4. Does cystic fibrosis show up on the X-ray?

An X-ray might predict cystic fibrosis. However, blood tests are the primary source of diagnosis. If the blood tests confirm the condition, an X-ray might be performed to study the severity of the lung changes (12).

Cystic fibrosis in babies is an inherited (genetic) disorder that causes mucus to become thick and sticky and affects various organs of the respiratory, digestive, and other systems. It generally makes the baby prone to respiratory infections and affects the absorption of several nutrients resulting in slowed growth. The condition may be managed with dietary modifications along with medications. Making sure you get genetically tested before pregnancy will help if you or your partner have a family history of the disorder.

Key Pointers

  • Cystic fibrosis is a genetic disorder that occurs due to a child inheriting a faulty gene from parents.
  • Slow growth, less weight gain, not passing poop for the initial 24 to 48 hours are some signs of cystic fibrosis in babies.
  • Most babies with cystic fibrosis reach their diagnosis before two years of age.
  • High-calorie diet and vitamin supplementation are some effective ways to manage this condition.

References

1. About Cystic Fibrosis; Cystic Fibrosis Foundation
2. Cystic fibrosis; NHS
3. Pediatric Cystic Fibrosis; Children’s National
4. Cystic Fibrosis Symptoms and Treatment; UPMC Children’s Hospital of Pittsburg
5. Cystic fibrosis; NHS
6. Cystic Fibrosis | Symptoms & Causes; Boston Children’s Hospital
7. Cystic fibrosis; U.S. National Library of Medicine
8. Cystic Fibrosis | Diagnosis & Treatments; Boston Children’s Hospital
9. Cystic Fibrosis And Your Baby; March Of Dimes
10. Cystic Fibrosis; Baby’s First Test
11. Cystic Fibrosis and the Digestive System; Stanford Children’s Health
11. Cystic Fibrosis; RadiologyInfo.org
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Dr. Ashraf Kasem
Dr. Ashraf KasemMS
Dr. Ashraf Kasem is a pediatric specialist with 10 years experience in pediatrics, neonatology and pediatric nutrition. Having a pediatrics practice in Mansoura, Egypt, he is an influencer in Egypt and Arabic countries with more than 500,000 followers on his Facebook page.

Read full bio of Dr. Ashraf Kasem
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