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

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.

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

Transient tachypnea is more likely to occur in babies who were:

• Born before 38 weeks gestation
• Delivered by C-section
• Born to a mother with diabetes

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

Symptoms include:

• Bluish skin color (cyanosis)
• Rapid breathing, which may occur with noises 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:

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

Transient tachypnea is usually diagnosed after the baby is monitored for 1 or 2 days.

Your baby will be given oxygen to keep the blood oxygen level stable. Your baby will usually need the most oxygen within a few hours after birth. Then the baby's oxygen needs will begin to decrease. Most infants with transient tachypnea improve in less than 12 - 24 hours.

Very rapid breathing can cause the baby to feed poorly. Fluids and nutrients will be given through a vein until your baby improves. Your baby may also receive antibiotics until the health care provider is sure there is no infection. Rarely, babies with transient tachypnea may have lung problems that last for as long as 1 week.

The condition usually goes away within 24 - 48 hours after delivery. Babies who have had transient tachypnea usually have no further problems from 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. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 95.