Tachypnea of the Newborn
A newborn with transient tachypnea (TTN) has extra fluid in his lungs
which causes him to, breathe rapidly (more than 60 times a minute), pull
in his chest wall with each breath (retractions , and occasionally have a
bluish tinge around his lips (cyanosis), which indicates a need for extra
oxygen. This rapid breathing begins shortly after birth and the baby's breathing
rate usually becomes normal within 24 to 48 hours.
A baby's lungs are normally filled with fluid while she is inside
the mother. After birth, the baby takes her first breath and the lungs fill
with air, replacing the fluid. The baby's blood absorbs the lung fluid, or
she coughs the fluid out. The absorption process usually takes several hours.
For unknown reason, some babies have extra fluid or absorb the fluid too
slowly. The fluid makes the lungs stiff, causing the baby to breathe faster
and harder than normal. As the fluid is absorbed, it becomes easier to breathe
and the baby's breathing rate becomes normal.
The process of labor and vaginal birth squeezes the baby's chest wall
and prepares the lungs for the first breath. Babies born by cesarean section
(C-section) without labor or babies born after fast labors are more likely
to have TTN.
Any newborn with a breath problem is usually taken to a special care
nursery for observation and They are usually attached to a monitor, which
continuously records their heart rate, respiratory (breathing) rate and oxygen
At this point in time, the pediatrician does not know the cause of
the breathing problem. Therefore, blood tests may be done ( a complete blood
count (CBC) and blood culture) to look for infection, a chest x-ray to determine
if the baby has pneumonia or a congenital abnormality that is causing the
rapid respiration, and a blood gas test to see if the baby needs more
Most babies with Transient Tachypnea of the Newborn do not need extra
oxygen. Occasionally, a baby will need a little oxygen for a short period
of time. The most reliable signs that the lung fluid is leaving the
lungs are that the baby needs less oxygen and the breathing rate comes down
to normal in 24 to 48 hours.
Since a baby with transient tachypnea of the newborn is often breathing
over 80 times per minute, they can not coordinate sucking, swallowing and
breathing at the same time. Therefore, an IV is often inserted to prevent
dehydration and keep the baby's blood sugar level normal. Once respirations
return to normal or near normal levels, the baby will be allowed to nurse
or receive formula, depending on the mother's preference.
Every newborn with breathing problems is suspected of having an infection
because the difference between pneumonia or a
blood infection caused by the beta streptococcus (sepsis) and TTN cannot
be detected in the early stages. For this reason many infant's are given
intravenous (IV) antibiotics after blood has been drawn for tests. The medication
is continued , usually for 48 t0 72 hours) until the results of the blood
tests confirm that there is no infection.
Babies who have TTN recover completely within 24 to 72 hours after
birth and have no long-lasting side effects.
Adapted from an article written
by Patricia Bromberger, M.D., neonatologist, Kaiser Permamente, San Diego,
CA Copyright 1999 Clinical Reference Systems