• Transient Tachypnea of Newborn

    (TTN; Wet Lungs; Type II Respiratory Distress Syndrome; Retained Fetal Lung Fluid; Transient RDS)

    Definition

    Transient tachypnea is a very fast breathing rate. It happens in newborns that have too much fluid in their lungs. The fluid limits the amount of oxygen these newborns pull into their lungs. As a result, the baby needs to breathe at a faster rate to get enough oxygen.
    Babies born with this condition usually recover within three days of birth. Transient tachypnea can be easily treated but will need care from a doctor.
    Respiratory System of an Infant
    factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Causes

    During pregnancy, a baby’s lungs are filled with fluid. Chemical signals just before birth will start to clear the fluid out of the lung. Then physical pressures during labor and birth will push more fluid out. After birth, the baby may also cough some of the fluid out of the lungs. The baby's first breaths should clear out any remaining fluid. Some newborns are not able to clear enough fluid from their lungs. The fluid blocks some oxygen from moving from the lungs to the blood. The low levels of oxygen causes transient tachypnea.
    Fluid might not clear from lungs quickly enough if :
    • The baby doesn’t respond well to the chemical signals during labor
    • Fluid isn’t squeezed out of the lungs in the birth canal

    Risk Factors

    Factors that may increase your baby’s chance of developing transient tachypnea include:

    Symptoms

    These symptoms may be caused by transient tachypnea or other health conditions. Talk to you doctor if your baby has any of these symptoms:
    • Rapid, labored breathing (over 60 breaths per minute)
    • Grunting or moaning sounds when exhaling
    • Flaring of the nostrils
    • Retractions—with each breath, the chest appears to sink in between the ribs or under the ribcage
    • Cyanosis—skin around the mouth and nose has a bluish tinge

    Diagnosis

    The doctor will look at your pregnancy and labor history. A physical exam of your baby will be done.
    Your doctor may order tests such as:
      Blood tests, such as:
      • Complete blood count—to look for signs of infection, such as pneumonia
      • Blood culture—to look for signs of infection caused by bacteria or other microorganisms
      • Blood gas determination—to check the oxygen level in the baby’s blood
    • Chest x-ray —an image of the lungs to check for causes of respiratory problems
    • Pulse-oximetry monitoring—an oxygen sensor is placed on the baby’s foot to determine how much oxygen is making it into the blood from the lungs
    Transient tachypnea may not be diagnosed until the symptoms go away. This may not be until three days after birth.

    Treatment

    Talk with your doctor about the best treatment plan for your baby. The main treatment for this condition is supportive care and close monitoring. This may include:
    • Supplemental oxygen—oxygen may be given through a mask, a tube that passes under the nose, or a tent. This extra oxygen will lower the workload on the lungs.
    • Continuous positive airway pressure (CPAP)—a tube is placed under the baby’s nose. The tube is attached to a breathing machine. The machine pushes a continuous flow of air or oxygen into the airways. This will help keep the airways open.
    • Antibiotics—intravenous (IV) antibiotics may be given until test results are back. The antibiotic will be stopped if the tests do not show an infection.
    • Supplemental feedings—it can be difficult for an baby to nurse when he/she has breathing problems. An IV line may be used to delivers fluids, glucose, and electrolytes.
    • Ventilator support—a ventilator may be used if a baby is really struggling to breath. This machine will help or take over breathing for the baby.
    A day or two after birth, the baby’s breathing should improve. By the third day of life, all symptoms of transient tachypnea should disappear.

    Prevention

    There are no guidelines for preventing transient tachypnea because the exact cause is not known. There are several things you can do to help give birth to a healthy baby:
    • Eat a healthful diet. Aim for a diet low in saturated fats and rich in whole grains, fruits, and vegetables.
    • Have regular prenatal check-ups.
    • Don’t smoke. If you smoke, quit.
    • Avoid drugs and alcohol.

    RESOURCES

    American Academy of Pediatrics http://www.healthychildren.org/

    March of Dimes http://www.modimes.org/

    CANADIAN RESOURCES

    Canadian Pediatrics Society http://www.cps.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    DynaMed Editorial Team. Transient tachypnea of neonate. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 9, 2012. Accessed July 25, 2012.

    Transient tachypnea of Newborn. Kids Health Nemours website. Available at: http://kidshealth.org/parent/medical/lungs/ttn.html . Accessed July 25, 2012.

    Lucille Packard Children’s Hospital. Transient tachypnea of the newborn. Lucille Packard Children’s Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/ttn.html . Accessed July 25, 2012.

    Revision Information

    • Reviewer: Michael Woods
    • Review Date: 09/2012
    • Update Date: 00/91/2012
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