Some newborns have very fast or labored breathing in the first few hours of life
because of a lung condition called transient tachypnea of the newborn (TTN). "Transient"
means it doesn't last long — usually, less than 24 hours. "Tachypnea" (tak-ip-NEE-uh)
means to breathe quickly.
Babies with transient tachypnea are closely watched in the hospital, and some might
need extra oxygen for a few days. Most babies make a full recovery. TTN usually does
not have any lasting effects on a child's growth or development.
What Causes Transient Tachypnea of the Newborn?
Before birth, a developing fetus does not use the lungs
to breathe — all oxygen comes from the blood vessels of the placenta. During this
time, the baby's lungs are filled with fluid.
As the baby's due date nears, the lungs begin to absorb the fluid. Some fluid also
may be squeezed out during birth as the baby passes through the birth canal. After
delivery, as a baby breathes for the first time, the lungs fill with air and more
fluid is pushed out. Any remaining fluid is then coughed out or slowly absorbed through
the bloodstream and lymphatic
system.
Babies with TTN have extra fluid in their lungs or the fluid leaves too slowly.
So they must breathe faster and harder to get enough oxygen into the lungs.
Who Gets Transient Tachypnea of the Newborn?
Transient tachypnea of the newborn is more common in:
babies born by rapid vaginal deliveries or C-sections
without labor. They don't go through the usual hormonal changes of labor, so don't
have time to absorb much fluid.
babies whose mothers have asthma or diabetes
What Are the Signs & Symptoms of Transient Tachypnea of the Newborn?
Symptoms of TTN include:
very fast, labored breathing of more than 60 breaths a minute
grunting sounds when the baby breathes out (exhales)
flaring nostrils or head bobbing
skin pulling in between the ribs or under the ribcage with each breath (known
as retractions)
bluish skin around the mouth and nose (called cyanosis)
How Is Transient Tachypnea of the Newborn Diagnosed?
Doctors usually diagnose transient tachypnea of the newborn in the first few hours
after a baby is born.
A doctor will examine the baby and also might order one or all of these tests:
Chest
X-ray. This safe and painless test uses a small amount of radiation to
take a picture of the chest. Doctors can see if the lungs have fluid in them.
Pulse
oximetry. This painless test measures how much oxygen is in the blood.
A small piece of tape with an oxygen sensor is placed around a baby's foot or hand,
then connected to a monitor.
How Is Transient Tachypnea of the Newborn Treated?
Babies with TTN are watched closely and may go to a neonatal
intensive care unit (NICU) or special care nursery. There, doctors check babies'
heart rates, breathing rates, and oxygen levels to make sure breathing slows down
and oxygen levels are normal.
Breathing Help
Some babies with TTN need extra oxygen. They get this through a small tube under
the nose called a .
A baby who gets extra oxygen but still struggles to breathe might need continuous
positive airway pressure (CPAP) to keep the lungs from collapsing. With CPAP,
a machine pushes a steady stream of pressurized air or oxygen through a nasal cannula
or mask. This helps keep the lungs open during breathing.
Nutrition
Good nutrition can be a problem when a baby is breathing so fast that he or she
can't suck, swallow, and breathe at the same time. If so,
(IV) fluids can keep the baby hydrated while preventing blood sugar from
dipping too low.
If your baby has TTN and you want to breastfeed, talk to your doctor or nurse about
pumping and
storing breast milk until your baby is ready to feed. Sometimes babies can get
breast milk or formula through a:
nasogastric (NG) tube: a small tube placed through the baby's nose that carries
food right to the stomach
orogastric (OG) tube: a small tube placed through the baby's mouth that carries
food right to the stomach
If your baby has one of these tubes, ask the doctor about providing breast milk
for your baby.
Symptoms of transient tachypnea usually get better within 24–72 hours. A baby can
go home when breathing is normal and he or she has been feeding well for at least
24 hours.
When Should I Call the Doctor?
Babies with TTN usually recover fully. Call your doctor right away if your baby:
