TTN; Wet lungs - newborns; Retained fetal lung fluid; Transient RDS

Transient tachypnea is a respiratory disorder usually seen shortly after delivery in full- or near-term babies.

• Transient means it is short-lived (usually less than 24 hours).
• Tachypnea means rapid breathing (most normal newborns take 40-60 breaths per minute).

As the baby grows in the womb, the lungs make a special fluid. This fluid fills the developing baby's lungs and helps them grow. When the baby is born at term, chemicals released during labor tell the lungs to stop making this special fluid. The baby's lungs start removing or reabsorbing it.

The first few breaths your baby takes after delivery fill the lungs with air and help to clear most of the remaining lung fluid. Some of the fluid may also clear when the baby's chest is squeezed while passing through the birth canal.

Leftover fluid in the lungs causes the baby to breathe rapidly and make it harder for the baby to keep the small air sacs of the lungs open.

Transient tachypnea is more likely to occur in babies:

• Babies born before 38 weeks gestation
• Delivered by c-section
• Whose mothers have diabetes

Newborns with transient tachypnea have respiratory problems soon after birth, usually within 1 - 2 hours.

Symptoms include:

• Bluish skin color (cyanosis)
• Rapid, noisy breathing, such as grunting
• Flaring nostrils or movements between the ribs or breastbone known as retractions

The mother’s pregnancy and labor history are important to make the diagnosis.

Tests performed on the baby may include:

• Chest x-ray to rule out other causes of breathing problems
• Blood count and blood culture to rule out infection
• Continous monitoring of the baby's oxygen levels, breathing, and heart rate

Transient tachypnea is usually diagnosed after monitoring your baby for 1-2 days.

Your baby will be given oxygen as needed to maintain an adequate blood oxygen level. Your baby’s oxygen requirement will usually be highest within a few hours after birth and then begin to decrease. Most infants with transient tachypnea improve in less than 12-24 hours.

Very rapid breathing can cause the baby to feed ineffectively. Fluids and nutrients will be given through a vein until your baby improves. Your baby may also receive antibiotics until infection is ruled out. Rarely, babies with transient tachypnea may have persistent lung problems for as long as 1 week.

The condition usually goes away completely within 24 - 48 hours after delivery. Babies who have had transient tachypnea usually have no further problems associated with the condition, and do not need special care or follow-up other than their routine pediatrician visits.

Dudell GG, Stoll BJ. Respiratory Tract Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 101.