Myth #3: “Most CLM babies can’t breathe at birth”
If you’ve just been diagnosed with a congenital lung malformation (CLM), it’s completely normal for your mind to jump straight to this fear: Will my baby breathe? We get it. We had this fear too.
Fact: Most babies with a CLM can breathe without support at birth.
In fact 90% of babies with CLMs are born asymptomatic, meaning they breathe on their own at birth without support. Most need no breathing support at all, while some will need only minimal help as they transition after delivery.
That said, a smaller subset of babies—about 10%—do need extra respiratory support at birth. The good news is that your care team can often predict who is more likely to need that support before delivery.
Why this myth sticks
Online, the stories that rise to the top are often the most intense: NICU stays, intubation, emergency interventions. Those experiences are real and important, but they’re not the most common outcome.
When you’re newly diagnosed, it’s easy to assume the high-risk scenarios are the default. But they aren’t.
What affects breathing at birth
Whether a baby struggles to breathe at birth usually depends on a few key factors your team is already watching:
Size of the lesion and how it changes over time
Whether it’s compressing normal lung tissue
Any shift in the heart/mediastinum
Signs of fluid buildup (hydrops), which is rare but more serious
This is why doctors track things like lesion measurements (and sometimes CVR) and do repeat ultrasounds: not to scare you, but to understand the trajectory and plan smartly.
What planning can look like (and why it’s reassuring)
If your baby appears low risk, you may be able to deliver normally with routine newborn care.
If your baby appears higher risk, your team may recommend delivering at a hospital with:
a NICU
neonatology present at delivery
access to pediatric surgery and pediatric specialists
That planning is not a sign that something is definitely wrong or will go wrong, it’s there to ensure immediate help is available if your baby needs it.
In rare, highest-risk situations, teams can plan specialized approaches at delivery. The point is: you and your team are not walking into birth unprepared.
The take-home message
Fearing that your baby won’t be able to breathe at birth is part of going through a CLM pregnancy. It’s hard and it’s a unique kind of anxiety other families don’t have to worry about. But for most CLM parents, their babies will be born asymptomatic. And even when babies do need support, there are ways to prepare for it.
If you’re feeling stuck on this fear, bring it straight to your care team and ask:
“Based on our scans, how likely is breathing support at birth?”
“Where do you recommend I deliver, and why?”
“Who will be in the room at delivery?”
“What’s the plan A / plan B if baby needs help?”
Other things that can help? Read some family stories to see what other families have gone through. Talk to a parent who has been through this before. Especially if you are anticipating a higher-risk delivery, it can help to chat to a CPAM mom who has been through that experience before.
We’re here. You don’t have to go through this alone.