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Transient Tachypnea of the Newborn

(Rapid Breathing of the Newborn; Neonatal Wet Lung Syndrome)

By

Arcangela Lattari Balest

, MD, University of Pittsburgh, School of Medicine

Last full review/revision Jan 2020| Content last modified Jan 2020
Click here for the Professional Version
Topic Resources

Transient tachypnea of the newborn is temporary difficulty with breathing and often low blood oxygen levels due to excessive fluid in the lungs after birth.

  • 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 if they are not getting enough oxygen into their blood.

  • The diagnosis is based on breathing difficulty and may be confirmed by a chest x-ray.

  • The characteristic feature of this disorder is that it is temporary (transient), and almost all affected newborns recover completely in 2 to 3 days.

  • Some affected newborns need treatment with oxygen, and a few need assistance with breathing.

Tachypnea means rapid breathing. Transient tachypnea means temporary rapid breathing.

Transient tachypnea of the newborn is more common among premature newborns (delivered before 37 weeks of gestation) 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 after a cesarean delivery (C-section) and is especially likely to occur if the mother has not been in labor before a cesarean delivery (that is, a mother who has a scheduled caesarean delivery). It is also more common among full-term newborns whose mother had diabetes, asthma, or both during pregnancy.

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 a vaginal 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.

Symptoms

Newborns with transient tachypnea have trouble breathing (respiratory distress) 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 discoloration of the skin and/or lips (cyanosis) if the level of oxygen in the blood becomes low.

Diagnosis

  • Chest x-ray

  • Blood tests and cultures as needed

Other disorders may cause similar symptoms, such as infection in the blood (sepsis), pneumonia, or respiratory distress syndrome in premature newborns, so doctors do a chest x-ray and blood tests and blood cultures to rule out these disorders.

Prognosis

Most newborns who have transient tachypnea survive and do well. But even with treatment, a small number of infants develop high blood pressure in the lungs (persistent pulmonary hypertension) or collapsed lung (pneumothorax).

Treatment

  • Oxygen

  • Sometimes other measures to assist breathing

Most newborns with transient tachypnea recover completely within 2 to 3 days. Newborns sometimes need to be 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 (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 (a machine that helps air get in and out of the lungs).

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