New internal images of premature babies breathing for the first time, captured with the help of ultrasound, have scientists hopeful that they can reduce deaths and chronic disease rates.
It's the first time moving pictures of the moment have been recorded, with the vision showing how a baby's first breath pushes liquid from its lungs as it emerges from the womb.
At the moment, it takes several hours to determine the severity of a premature baby's lung problems because doctors have to measure oxygen levels and make clinical assessments.
The power of the new pictures may mean a more accurate diagnosis can be made within 20 minutes of birth.
"What we're hoping to do with ultrasound is see if we can make these decisions sooner and more closely after birth, and therefore initiate the right therapies sooner," Dr Douglas Blank, the study's lead researcher, said.
"Then the baby will have a better chance of surviving and surviving without significant lung damage," he said.
Scientists from the Royal Women's Hospital and Monash University performed ultrasounds on 115 full-term babies as they were born, with the very first breaths of 28 babies being captured.
They recorded the moment by placing tiny ultrasound paddles over their lungs.
"It was really kind of fun to watch these babies take their first breaths and see these dramatic changes on ultrasound," Dr Blank said.
"All of a sudden when the baby takes its first breath … [the picture] goes from a dark rectangular shape to being a more bright white rectangular-shape with horizontal flashes across it."
'They told me the risk of dying was very high'
Researchers have performed the ultrasounds on eight premature babies, including twins Marta and Sara Tartaglia.
Marta and Sara, who were born at 28 weeks and four days, are likely to stay in the Royal Women's Hospital's Newborn Intensive Care Unit for a few more months.
Sara, who was born smaller, weighed just 871 grams and needed ventilation for the first five days of her life.
Their mother, Concetta Tartaglia, said giving birth to premature babies was frightening.
"They told me the risk of dying was very high," Ms Tartaglia said.
"My big worry was the lungs."
She said she hoped the research would help other premature babies.
Reducing death and chronic lung disease
While most babies adjust to the outside world within 10 minutes, on average it takes up to four hours for all the liquid to be expelled from their lungs
Researchers will now see if that also applies for extremely premature babies born at less than 28 weeks gestation and weighing less than 1,100 grams.
"Those babies have a significant risk of dying or having significant lung damage, [as well as] chronic lung disease which can cause life-long problems including problems with development and learning," Dr Blank said.
Premature babies with severe breathing issues are given medication in addition to a breathing tube and a ventilator.
But that carries its own risks.
"The breathing machine can be damaging to their lungs and lead to problems down the track," Dr Blank said.
"So by being better able to decipher which treatment is appropriate for these premature babies, we might be able to further reduce the risk of death and chronic lung disease."
Researchers hope to film 50 premature babies for the study, which is due to be completed late next year.
The research has been published in Resuscitation and the BMJ's Archives of Disease in Childhood.
