This disorder can occur in premature newborns, or in full-term newborns who have certain risk factors.
Affected newborns breathe rapidly and may grunt when breathing out and may appear bluish or gray if they are not getting enough oxygen into their blood.
The diagnosis is based on breathing rate and difficulty and may be confirmed by a chest x-ray.
Some affected newborns need treatment with oxygen, and a few need assistance with breathing.
The characteristic feature of this disorder is that it is temporary (transient), and almost all affected newborns recover completely in 2 to 3 days.
(See also Overview of General Problems in Newborns Overview of General Problems in Newborns Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 9% of newborns need special care after birth due to prematurity, problems... read more .)
Tachypnea means rapid breathing. Transient tachypnea means temporary rapid breathing.
Before birth, the air sacs (alveoli) of the lungs are filled with fluid. Immediately after birth, the fluid must be cleared from the lungs so that the air sacs can fill with air and the newborn can breathe normally. Hormones released during labor cause the cells in the air sacs to begin absorbing fluid. Some of the fluid is squeezed out of the lungs by pressure on the chest during delivery. A majority of the fluid is rapidly reabsorbed directly by the cells lining the air sacs. If this fluid reabsorption does not occur rapidly, the air sacs continue to be partially filled with fluid and newborns may have difficulty breathing (respiratory distress).
Transient tachypnea of the newborn is more common among premature newborns Preterm (Premature) Newborns A preterm newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, preterm newborns have underdeveloped organs, which may not be ready to function outside of... read more (delivered before 37 weeks of gestation Gestational age Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 9% of newborns need special care after birth due to prematurity, problems... read more ) and full-term newborns (delivered between 37 weeks and 42 weeks of gestation) who have certain risk factors. For example, in full-term newborns, transient tachypnea is more common among those delivered via a cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more (C-section), especially one where the mother did not go into labor first. It is also more common among full-term newborns, particularly males, whose mother had diabetes Diabetes During Pregnancy For women who have diabetes before they become pregnant, the risks of complications during pregnancy depend on how long diabetes has been present and whether complications of diabetes, such... read more , asthma Asthma During Pregnancy The effect of pregnancy on asthma varies. Worsening of the disease is slightly more common than improvement, but most pregnant women do not have severe asthma attacks. (See also Asthma.) The... read more , or both during pregnancy.
Symptoms of Transient Tachypnea of Newborn
Newborns with transient tachypnea have trouble breathing almost immediately after birth. The most common symptom is rapid breathing (tachypnea).
Less frequent symptoms include retractions (pulling in of the chest muscles attached to the ribs and below the ribs during rapid breathing), flaring of the nostrils during breathing in, and grunting during breathing out.
Newborns may develop a bluish or gray discoloration of the skin and/or lips (cyanosis Cyanosis Cyanosis is a bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood. Cyanosis occurs when oxygen-depleted (deoxygenated) blood, which is bluish rather than... read more ) if the level of oxygen in the blood becomes low. In newborns of color, the skin may change to colors such as yellow-gray, gray, or white. These changes may be more easily seen in the mucous membranes lining the inside of the mouth, nose, and eyelids.
Diagnosis of Transient Tachypnea of Newborn
Breathing rate and difficulty
Chest x-ray
Blood tests and cultures as needed
Doctors suspect transient tachypnea in newborns who have rapid and difficult breathing shortly after birth.
Doctors do a chest x-ray and blood tests and blood cultures to rule out other disorders that cause similar symptoms, such as infection in the blood (sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have... read more ), pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more , or respiratory distress syndrome Respiratory Distress Syndrome in Newborns Respiratory distress syndrome is a lung disorder in premature newborns in which the air sacs in their lungs do not remain open because a substance that coats the air sacs called surfactant is... read more .
Treatment of Transient Tachypnea of Newborn
Oxygen
Sometimes other measures to assist breathing
Newborns sometimes are given oxygen through a two-pronged tube placed in the nostrils so that they breathe air that contains more oxygen than the air in the room does.
Rarely, some newborns may need continuous positive airway pressure Obstructive sleep apnea (CPAP—a technique allows newborns to breathe on their own while being given slightly pressurized oxygen or air given through prongs placed in the nostrils) and sometimes a ventilator Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get... read more (a machine that helps air get in and out of the lungs).
Prognosis for Transient Tachypnea of Newborn
Most newborns with transient tachypnea recover completely within 2 to 3 days without treatment or with a brief period of added oxygen.
Even with treatment, a very small number of infants develop high blood pressure in the lungs (persistent pulmonary hypertension Persistent Pulmonary Hypertension of the Newborn Persistent pulmonary hypertension of the newborn is a serious disorder in which the arteries to the lungs remain narrowed (constricted) after delivery, thus limiting the amount of blood flow... read more ) or collapsed lung (pneumothorax Pneumothorax in the Newborn Pneumothorax is a collection of air between the lung and the chest wall that develops when air leaks out of the lung. This disorder may develop in newborns who have lung disorders such as respiratory... read more ).