Transient Tachypnea of the Newborn (TTN)

What Is Transient Tachypnea of the Newborn?

Some newborns have very fast or labored breathing in the first few hours of life because of a lung condition called transient tachypnea of the newborn (TTN). "Transient" means it doesn't last long — usually, less than 24 hours. "Tachypnea" (tak-ip-NEE-uh) means to breathe quickly.

Babies with transient tachypnea are closely watched in the hospital, and some might need extra oxygen for a few days. Most babies make a full recovery. TTN usually does not have any lasting effects on a child's growth or development.

What Causes Transient Tachypnea of the Newborn?

Before birth, a developing fetus does not use the lungs to breathe — all oxygen comes from the blood vessels of the placenta. During this time, the baby's lungs are filled with fluid.

As the baby's due date nears, the lungs begin to absorb the fluid. Some fluid also may be squeezed out during birth as the baby passes through the birth canal. After delivery, as a baby breathes for the first time, the lungs fill with air and more fluid is pushed out. Any remaining fluid is then coughed out or slowly absorbed through the bloodstream and lymphatic system.

Babies with TTN have extra fluid in their lungs because it failed to clear as expected. So they must breathe faster and harder to get enough oxygen.

Who Gets Transient Tachypnea of the Newborn?

Transient tachypnea of the newborn is more common in:

• premature babies because their lungs are not fully developed
• babies born by rapid vaginal deliveries or C-sections without labor. They don't go through the usual hormonal changes of labor, so don't have time to absorb much lung fluid.
• babies whose mothers have diabetes

What Are the Signs & Symptoms of Transient Tachypnea of the Newborn?

Symptoms of TTN include:

• very fast, labored breathing of more than 60 breaths a minute
• grunting sounds when the baby breathes out (exhales)
• flaring nostrils or head bobbing
• skin pulling in between the ribs or under the ribcage with each breath (known as retractions)
• bluish skin around the mouth and nose (called cyanosis)

How Is Transient Tachypnea of the Newborn Diagnosed?

Doctors usually diagnose transient tachypnea of the newborn in the first few hours after a baby is born.

A doctor will examine the baby and also might order one or all of these tests:

• Chest X-ray. This safe and painless test uses a small amount of radiation to take a picture of the chest. Doctors can see if the lungs have fluid in them and also can check the heart and surrounding structures.
• Pulse oximetry. This painless test measures how much oxygen is in the blood. A small piece of tape with an oxygen sensor is placed around a baby's foot or hand, then connected to a monitor.
• Complete blood count (CBC). This blood test checks for signs of infection.

How Is Transient Tachypnea of the Newborn Treated?

Babies with TTN are watched closely and may go to a neonatal intensive care unit (NICU) or special care nursery. There, doctors check babies' heart rates, breathing rates, and oxygen levels to make sure breathing slows down and oxygen levels are normal. 

Breathing Help

Some babies with TTN need extra oxygen. They get this through a small tube under the nose called a nasal cannula .

A baby who gets extra oxygen but still struggles to breathe might need continuous positive airway pressure (CPAP) to keep the lungs from collapsing. With CPAP, a machine pushes a steady stream of pressurized air or oxygen through the nose with a nasal cannula or mask. This helps keep the lungs open during breathing.

Nutrition

Good nutrition can be a problem when a baby is breathing so fast that he or she can't suck, swallow, and breathe at the same time. If so, intravenous (IV) fluids can keep the baby hydrated while preventing blood sugar from dipping too low (hypoglycemia).

If your baby has TTN and you want to breastfeed, talk to your doctor or nurse about pumping and storing breast milk until your baby is ready to feed. Sometimes babies can get breast milk or formula through a:

• nasogastric (NG) tube: a small tube placed through the baby's nose that carries food right to the stomach
• orogastric (OG) tube: a small tube placed through the baby's mouth that carries food right to the stomach

If your baby has one of these tubes, ask the doctor about providing breast milk for your baby.

Symptoms of transient tachypnea usually get better within 24–72 hours. A baby can go home when breathing is normal and he or she has been feeding well for at least 24 hours.

When Should I Call the Doctor?

Babies with TTN usually recover fully. Call your doctor right away if your baby:

• has trouble breathing
• breathes rapidly
• is not feeding well
• has skin that looks blue around the mouth