pnemothoraks and steroid administration

Dear Doctor. Thank you for your answer about my premature baby with pnemothoraks. Yes, she was switched to the lower pressure ventilation yesterday and so far her lungs managed to cope with it. Her meds are reduced, her frequency reduced lower each day, taking in her milk (my breastmilk - up to 9 ml today - increasing each day), she is aware of her surroundings, movement of limbs are good, color good - pinkish, she even tries to cough out the tube in her mouth as i know she hates it. She tends to fight back when the neo nurses ***** her mucus out from her mouth! My question is should we give her more time for her lungs to heal (breathe on her own)? How long do we need to wait till the neonatologist recommends steroids to be administered (i'm so scared of the side effects) if she doesnt respond by breathing on her own?

[Yao Sun, MD, PhD]

I cannot really comment on the specifics of the management of your baby (particularly in regards to the steroids) because the decision is so individualized.  Only the doctors actually taking care of your baby know all the specific information that's needed to make this decision.

You should feel free to ask for a family meeting with the neonatologist to discuss what the plans for you baby are now, and what the criteria would be for starting steroids.  (By the way, these steroids are anti-inflammatory steroids, not the steroids that athletes misuse.)  Please remember that the neonatologist will not recommend steroids unless he/she feels the benefits outweighs the risk.