Children’s Interstitial Lung Disease?

Children may have lung conditions at birth or develop them during childhood. Some children will have more unusual lung problems that fall under the umbrella term of Children’s Interstitial Lung Disease (ChILD).

What Is ChILD?

ChILD refers to a large group of rare lung conditions that can affect children from infancy up to adulthood.

“(ChILD) is a blanket term for this group of diseases. There are certain illnesses that tend to be seen mainly in very young children and some seen later in childhood,” says Geoffrey Kurland, MD, director, Pediatric Lung Transplant Program, UPMC Children’s Hospital of Pittsburgh.

While many of the ChILD conditions have similar symptoms, their age of onset and the severity of the lung disease vary greatly. They range from illnesses that are mild and resolve over time to those that are quite severe and can be life-threatening.

Adults also may have interstitial lung disease. However, those diseases are often quite different from many of the ChILD entities.

Researchers are still learning about the various known ChILD entities and discovering new ones. We still don’t know exactly how common many of these diseases are or how many children are affected by them.

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What Causes ChILD?

Several of the ChILD entities are genetic in origin. But for others, the cause remains unknown. Some of the ChILD entities are associated with other conditions, which may be factors in the development of lung disease.

According to the National Heart, Lung, and Blood Institute, potential causes and risk factors of ChILD include:

  • Genetics/family history.
  • Underdevelopment of lungs before birth.
  • Environmental factors, such as bacteria, fungi, chemicals, tobacco smoke, or pollution in the air.
  • Lifestyle factors, including illegal drug use.
  • Certain medicines, such as chemotherapy, radiation, immunosuppressing drugs, and more.
  • Other medical conditions, such as aspiration, autoimmune diseases, infections, lung cancer, and more.

ChILD Symptoms

Many conditions under ChILD have similar symptoms. However, severity may depend on the underlying condition or ChILD entity, the individual child, and other (often unknown) factors.

Typical symptoms include:

  • Shortness of breath or difficulty breathing.
  • Rapid breathing.
  • Retractions (pulling of the muscles between the ribs and in the neck when breathing).
  • Chronic coughing.
  • Frequent chest congestion.
  • Growth and development problems, or failure to thrive.
  • Recurrent bouts with other respiratory conditions, like pneumonia or bronchitis.
  • Bluish skin, lips, or nails.
  • Coughing up blood.
  • Overt wheezing.

There is no single test to diagnose ChILD. A pulmonologist can determine what tests to order based on your child’s symptoms.

Treatment of ChILD

Treatment for ChILD will depend on your child’s symptoms and their severity.

Some medications may work for certain conditions under ChILD. These may include tablet, liquid, inhaled, or intravenous medications.

If your child has trouble breathing, they may need oxygen support such as a respirator or oxygen therapy. Others may need treatment to relieve symptoms like chest congestion.

For the most severe cases of ChILD, a lung transplant may be necessary.

As more research is done, scientists are learning more about new potential treatments for some of the ChILD entities.

“There are new things being learned in this field, and it is especially exciting now because new entities are being discovered and novel forms of therapy are being developed,” Dr. Kurland says. “We still have much to learn.”

What Should I Do if My Child Has Interstitial Lung Disease?

If your child is suspected of having a ChILD entity, or if your child has long-standing pulmonary complaints, he or she should be seen and evaluated by a pediatric pulmonology specialist.

Your child should stay up to date on all vaccinations, including the influenza vaccine, pneumococcal vaccine, and COVID-19 vaccine (if eligible). You also should pay attention to environmental factors like air quality, both indoors and outdoors.

Because some children who have been diagnosed with ChILD have trouble growing and developing, ask your pediatrician if they need to consume more calories or take dietary supplements.

The Division of Pulmonary Medicine at UPMC Children’s Hospital of Pittsburgh provides consultation, diagnosis, and treatment for a wide range of pediatric respiratory conditions, including ChILD entities. To schedule an in-person or video visit appointment, call 412-692-5630.

Editor's Note: This article was originally published on , and was last reviewed on .

American Thoracic Society, What Is Interstitial Lung Disease in Children? Link

Asthma + Lung UK, What Is Children's Interstitial Lung Disease? Link

Children's Interstitial Lung Disease Foundation, What Is chILD? Link

National Heart, Lung, and Blood Institute, Childhood Interstitial Lung Disease. Link

About Pediatrics

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