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Transient Tachypnea of the Newborn

(Rapid Breathing of the Newborn; Neonatal Wet Lung Syndrome)

By

Arcangela Lattari Balest

, MD, University of Pittsburgh, School of Medicine

Last full review/revision Jul 2021| Content last modified Jul 2021
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Topic Resources

Transient tachypnea of the newborn is temporary difficulty with breathing and often low blood oxygen levels due to excessive fluid in the lungs after birth.

  • This disorder can occur in premature newborns, or in full-term newborns who have certain risk factors.

  • Affected newborns breathe rapidly and may grunt when breathing out and may appear bluish if they are not getting enough oxygen into their blood.

  • The diagnosis is based on breathing difficulty and may be confirmed by a chest x-ray.

  • The characteristic feature of this disorder is that it is temporary (transient), and almost all affected newborns recover completely in 2 to 3 days.

  • Some affected newborns need treatment with oxygen, and a few need assistance with breathing.

Tachypnea means rapid breathing. Transient tachypnea means temporary rapid breathing.

Transient tachypnea of the newborn is more common among premature newborns Premature Newborn A premature newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, premature newborns have underdeveloped organs, which may not be ready to function outside... read more (delivered before 37 weeks of gestation Gestational age Problems in newborns may develop Before birth while the fetus is growing During labor and delivery After birth About 10% of newborns need special care after birth due to prematurity, problems... read more ) and full-term newborns (delivered between 37 weeks and 42 weeks of gestation) who have certain risk factors. For example, in full-term newborns, transient tachypnea is more common after a cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more Cesarean Delivery (C-section) and is especially likely to occur if the mother has not been in labor before a cesarean delivery (that is, a mother who has a scheduled caesarean delivery). It is also more common among full-term newborns whose mother had diabetes Diabetes During Pregnancy For women who have diabetes before they become pregnant, the risks of complications during pregnancy depend on how long diabetes has been present and whether complications of diabetes, such... read more , asthma Asthma During Pregnancy The effect of pregnancy on asthma varies. Worsening of the disease is slightly more common than improvement, but most pregnant women do not have severe asthma attacks. (See also Asthma.) The... read more , or both during pregnancy.

Before birth, the air sacs (alveoli) of the lungs are filled with fluid. Immediately after birth, the fluid must be cleared from the lungs so that the air sacs can fill with air and the newborn can breathe normally. Hormones released during labor cause the cells in the air sacs to begin absorbing fluid. Some of the fluid is squeezed out of the lungs by pressure on the chest during a vaginal delivery. A majority of the fluid is rapidly reabsorbed directly by the cells lining the air sacs. If this fluid reabsorption does not occur rapidly, the air sacs continue to be partially filled with fluid and newborns may have difficulty breathing.

Symptoms

Newborns with transient tachypnea have trouble breathing (respiratory distress) almost immediately after birth. The most common symptom is rapid breathing (tachypnea).

Less frequent symptoms include retractions (pulling in of the chest muscles attached to the ribs and below the ribs during rapid breathing), flaring of the nostrils during breathing in, and grunting during breathing out. Newborns may develop a bluish discoloration of the skin and/or lips (cyanosis Cyanosis Cyanosis is a bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood. Cyanosis occurs when oxygen-depleted (deoxygenated) blood, which is bluish rather than... read more ) if the level of oxygen in the blood becomes low.

Diagnosis

Prognosis

Treatment

  • Oxygen

  • Sometimes other measures to assist breathing

Most newborns with transient tachypnea recover completely within 2 to 3 days. Newborns sometimes need to be given oxygen through a two-pronged tube placed in the nostrils so that they breathe air that contains more oxygen than the air in the room does.

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An important part of normal development is an infant’s growing attachment to its parents. As this bond strengthens, the infant may express fear or anxiety when the parents leave. This “separation anxiety” typically begins at around 8 months of age and resolves at around 24 months of age. Which of the following is the normal and expected infant behavior in reaction to a parent leaving the room during the time period of separation anxiety?
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