Transient Tachypnea of Newborn
(TTN; Wet Lungs; Type II Respiratory Distress Syndrome; Retained Fetal Lung Fluid; Transient RDS)
Pronounced: TRAN-see-ENT TAK-ip-NEE-ah
Definition
Transient tachypnea is a respiratory problem that occurs in 1% to 2% of newborns. It occurs when fluid does not leave the lungs as quickly as it should after birth. Babies born with this condition usually recover within three days of birth.
Transient tachypnea can be easily treated, but requires care from a doctor.
Respiratory System of an Infant
Causes
Before birth, a baby’s lungs are normally filled with amniotic fluid. During labor, chemical signals tell the lungs to start removing the fluid. When the baby passes through the birth canal, the chest is squeezed. That pressure may help clear some of the fluid from the lungs. After birth, the baby may also cough some of the fluid out. Once the baby starts to breathe, air fills the lungs and helps clear out any remaining fluid. 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
A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your child’s chance of developing transient tachypnea:
- Cesarean delivery
- Large baby
- Delayed cord clamping
- Rapid vaginal delivery
- Excess maternal fluid administration
- Sex: male
Symptoms
If your newborn experiences any of these symptoms do not assume it is due to transient tachypnea. These symptoms may be caused by other health conditions. Symptoms include:
- 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 has a bluish tinge around the mouth and nose
Diagnosis
The doctor will look at your pregnancy and labor history. He or she will also examine your baby and perform diagnostic tests.
Tests may include:
-
Blood tests, such as:
- Complete blood count—to look for signs of infection, such as pneumonia
- Blood culture—to look for signs of infection
- Blood gas determination—to check the oxygen level in the baby’s blood; may be repeated throughout the hospital stay
- Chest x-ray —a radiograph of the lungs used to check for causes of respiratory problems
- Pulse-oximetry monitoring—a piece of tape containing an oxygen sensor is placed on the baby’s foot. It is connected to a monitor that tells the doctor how well the lungs are working.
Often, transient tachypnea isn’t diagnosed until the symptoms go away, usually by three days after birth.
Treatment
Talk with your doctor about the best treatment plan for your child. Supportive care and close monitoring are the mainstays of treatment. Additional treatment options include the following:
- Supplemental oxygen—the baby receives extra oxygen through a mask or nasal prongs.
- Continuous positive airway pressure (CPAP)—a tube is placed in the baby’s nose. A breathing machine pushes a continuous flow of air or oxygen into the airways to keep them open.
- Antibiotics—intravenous (IV) antibiotics may be given to the baby until test results show that he or she doesn’t have an infection.
- Supplemental feedings—when struggling to breathe, it can be difficult for an infant to nurse. In such a case, an IV line that delivers fluids, glucose, and electrolytes is utilized.
- Ventilator support—in rare cases, a machine is used to help the baby breathe.
A day or two after birth, the child’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. But there are several things you can do to help ensure you will give birth to a healthy baby:
- Eat a healthful diet, one that is low in saturated fat 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:
Lucille Packard Children’s Hospital
http://www.lpch.org
Milton S. Hershey Medical Center, Penn State
http://www.hmc.psu.edu
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca
Sick Kids (The Hospital for Sick Children)
http://www.sickkids.ca
References:
Finberg L, Kleinman RE. Saunders Manual of Pediatric Practice . 2nd Ed. Philadelphia PA: Saunders; 2002.
RM Kleigman, RE Behrman, HB Jenson, BF Stanton. Nelson Textbook of Pediatrics . 18th Edition. Eds. Saunders Publishers, Philadelphia PA, 2007.
Taussig LM, Landau LI. Pediatric Respiratory Medicine . St. Louis, MO: Mosby; 1999.
Transient tachypnea–newborn. The National Library of Medicine and the National Institutes of Health Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/007233.htm . Accessed September 12, 2005.
Transient tachypnea of the newborn. Lucille Packard Children’s Hospital website. Available at:
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrnewborn/ttn.html
. Accessed September 12, 2005.
Transient tachypnea of the newborn. Penn State Children’s Hospital website. Available at:
http://www.hmc.psu.edu/childrens/healthinfo/t/ttn.htm
. Accessed September 12, 2005.
Transient tachypnea of the newborn. University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/pa/pa_ttn_hhg.htm . Accessed September 12, 2005.
Last reviewed November 2008 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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