Transient Tachypnea of the Newborn

Transient tachypena of the newborn, or TNN, is a relatively rare respiratory condition, affecting roughly one percent of births. The condition requires treatment, but the prognosis for recovery is excellent, when given proper care. Most babies make complete recoveries with no lingering problems afterward.

Breathing is a considerable concern in baby health issues.Before birth, babies receive nutrition and oxygen through the placenta. Their lungs are literally filled with fluid while they are in the womb. The liquid needs to be expelled or absorbed in order for proper breathing to occur.

The Medline Plus Medical Encyclopedia offers information about transient tachypena of the newborn including other terms used in reference to this infant respiratory problem. Terms include:

• Wet lungs
• TNN
• Retained fetal lung fluid
• Transient RDS

The pressure from vaginal birth typically pushes some of the fluid out of the lungs. The baby also experiences hormonal shifts that help them absorb fluids into the body and away from the lungs during labor and delivery. Any remaining liquid is absorbed in the bloodstream or gradually expelled with coughing.

Some babies have difficulty getting rid of extra liquid in their lungs. This makes breathing and proper oxygen processing through the lungs troublesome. Some conditions may increase the risk of transient tachypnea.

• Cesarean section can increase the risks of developing this respiratory condition in newborns. The baby does not travel through the birth canal so the fluids are not pushed out of the lungs during the delivery, and the babies do not have the same hormonal changes as those who undergo vaginal births.

• Premature or small babies may have difficulty expelling the excess liquid. Their lungs may not be fully developed.

• Fast vaginal births can also lead to excess fluid in the lungs because the baby has a shorter duration of pressure during delivery. She may also have fewer hormonal changes as well, making absorption into the blood stream and tissues difficult.

The symptoms are readily apparent, but they can be confused with other conditions including pneumonia. Telltale signs of transient tachypna in babies include:

• Difficulty breathing
• Rapid breaths
• Stomach retracting significantly with each breath
• Bobbing head
• Flaring nostrils
• Blue color around the nose and mouth

The symptoms require more than mere observation in order for proper diagnosis. This is especially true considering how similar the symptoms of TTN are to other respiratory problems in newborns. Detection is crucial to protect infant breathing and is necessary to ensure full recovery.

A physician must diagnose the newborn respiratory problem. Diagnosis is complicated because other breathing conditions have similar symptoms. An X-ray of the chest can detect fluid in the lungs.

Doctors may use some of the following approaches in addition to observations to monitor the condition.

• Oxygen sensors set in tape can be placed on the baby's hand or foot. The sensor is connected to a monitor that tests the oxygen levels in the body, allowing physicians to see how well the lungs are working.

• A complete blood count (CBC) test can check oxygen levels in the blood.

• Physicians monitor the baby’s breathing and heart rates.

• Nursing and feeding may also be monitored.

The baby may have difficulty getting enough nutrition as breathing and suckling simultaneously may be impossible if breaths are too rapid and laborious.

Babies may require little more than close monitoring in order to recover from transient tachypnea, but other medical interventions may be necessary. Physicians may implement some of the following treatment approaches:

• Less severe
  • Plastic oxygen hood, known as a “headbox”
  • Oxygen mask
  • Oxygen nose tube
• More severe
  • CPAP, continuous positive airway pressure using a nose tube and an air machine
  • IV fluids for nutrition and hydration
• Most severe
  • Ventilator
  • Testing for other medical problems

The prognosis is typically excellent for newborns with transient tachypnea in most cases. Proper care and monitoring ensures a full recovery within 72 hours; some recovering in as little as one day.

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