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Transient tachypnea of the newborn

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Transient tachypnea of the newborn (TTN) is a self-limiting condition that affects newborns around the world. Tachypnea is observed within first few hours of life up to a day or two.

What is Tachypnea?

Tachypnea is a condition where one observes rapid breathing. Normally, an adult takes in 12 to 20 breaths per minute when at rest. When the rate of breath increases to more than 20 breaths per minute, it indicates tachypnea. One should note, children have higher breathing rates when at normal, which becomes steady by the time they reach 18 years of age.

What Causes Tachypnea?

Tachypnea can occur due to pathological or physiological causes. It could occur after one undergoes vigorous exercise or women in labor. It could also occur in cases of cellular injury, hypoxia or as a symptom of carbon monoxide poisoning. Tachypnea may also occur in people with lung cancer, severe anemia, anxiety or other lung diseases like COPD.

What is Transient Tachypnea of the Newborn (TTN)?

Transient tachypnea of the newborn (TTN) is a mild respiratory condition of newborns that last for2 to 3 days after birth. It is a temporary fast breathing rate condition in newborns. Babies with this condition require medical care as it is easily treatable. TTN occurs in about 1 to 2% of newborns.

Pathophysiology of Transient Tachypnea of the Newborn?

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The baby’s lungs are filled with fluid within the mother’s womb. The oxygen is supplied to the baby through the placenta. During a normal labor, that is, vaginal birth, the chest wall gets squeezed. This allows the fluid from the lungs to be squeezed out. After birth, the baby takes those important first breaths that helps fill the lungs with air and allows any remaining fluid to be pushed out. Any fluid that remains gets coughed out or is absorbed into the lymphatic system or bloodstream.

However, when the extra fluid is not cleared in the lungs or is cleared too slowly, it causes problems breathing. The baby cannot inhale oxygen properly and when the baby starts breathing faster and tries harder to get more oxygen. Thus, leading to transient tachypnea of the newborn.

Causes ofTransient Tachypnea of the Newborn

Transient tachypnea is also called as wet lung disease or retained fetal fluid. It can occur in preemies as their lungs have not fully developed. It could also occur in full-term babies. The newborns who are at higher risk of developing TTN include:

  • Babies delivered through C-section as their chest is not squeezed like babies who are delivered through the vagina
  • Babies who are born to mother’s with gestational diabetes or diabetes
  • Babies who are born to mother’s with asthma
  • Babies who are small at birth

Symptoms of Transient Tachypnea of the Newborn

The problems with breathing will be observed soon after birth, that is, within an hour or 2. These breathing problems include:

  • Rapid, noisy breathing that sounds like a grunt or moan
  • The baby uses extra muscles to breathe that is, flaring of the nostrils
  • Movement between the ribs is observed called as retractions
  • Bluish tinge around the mouth and nose (cyanosis)

Other than these breathing problems, the baby will seem normal and healthy.

Diagnosis of Transient Tachypnea of the Newborn

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Diagnosis is based on a chest X-ray as the condition is similar to pneumonia or persistent pulmonary hypertension. Along with an X ray, the doctor will carry out a pulse-oximetery monitoring to check the amount of oxygen level in blood an a complete blood count to check for any infection.

Treatment for Transient Tachypnea of the Newborn

The baby will be shifted to the neonatal ICU or special care nursery (SCN). Here, a pulse-oximeter and a cardiac monitor will be attached to the baby to check for the heart rate, breathing rate as well as the amount of oxygen in the blood.

Babies showing signs of cyanosis will be given extra oxygen. If no cyanosis observed, extra oxygen is not required. The baby will be kept on IV fluids as it will be difficult for the baby to suckle the mother or drink from a bottle. This will prevent dehydration and keep blood sugar levels normal. IV antibiotics will be given as every baby with breathing problems is suspected to have an infection.

How Long Does Transient Tachypnea of the Newborn Last?

Babies completely recover from TTN within 48 to 72 hours. Usually, it just takes 1 to 2 days for the baby to recover.

Transient tachypnea of the newborn is a common condition that is easily treatable. It will leave no long-lasting side effects to the baby’s growth and development.

Written by: Saptakee sengupta
Date last updated: March 29, 2015

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