Transient tachypnea of the newborn (TTN) is a short-lived condition of fast breathing that affects newborn babies. Though rapid breathing in a newborn looks alarming, TTN is not often dangerous. But your doctor will want to make sure your baby doesn't have some other, more dangerous cause of rapid breathing.
Babies with rapid breathing need careful evaluation. Thankfully, TTN is easily detected and treated in a hospital. But you should stay alert to your baby's breathing if you deliver at home or at a birthing center so you can notice any changes.
What Are the Symptoms of TTN?
Tachypnea means fast breathing. As the name suggests, a newborn with this condition breathes more quickly than normal for a limited time.
A newborn normally breathes 30–60 times each minute. If a baby breathes more than 60 times in a minute, it's considered tachypnea.
Along with rapid breathing, your newborn may also appear to have difficulty breathing. They may grunt while they breathe. Their nostrils may flare with each breath. The spaces between the ribs may move in and out with their breathing. You may also notice a blue tone to the skin around their mouth and nose (cyanosis).
The muscles of the chest wall and nostrils are considered supplemental breathing muscles. This means they're not strictly necessary for breathing. If you notice your baby using these muscles, they may be having difficulty breathing. Check in with your pediatrician so they can make sure your baby doesn't have a dangerous illness.
Transient Tachypnea of the Newborn Causes
While in the womb, babies get their oxygen from the placenta. They don't use their lungs because they're filled with fluid. As birth nears, their lungs start absorbing the fluid. Some is squeezed out when passing through the birth canal. As the baby cries and breathes after birth, the lungs fill with air. The remaining fluid is pushed out, coughed out, or absorbed.
This fluid is necessary for the development of the lungs. But it must be removed for a baby to breathe effectively. Around the time of their birth, this fluid is absorbed by the blood vessels, lymph vessels, and lung epithelial cells. If the fluid remains in the lungs, oxygen from your baby's inhaled air will have trouble reaching the blood to oxygenate it. This can cause breathing difficulties and fast breathing.
Some babies are more likely to develop TTN, including:
- Babies born early (premature) — their lungs have not had time to fully develop
- Babies born early by planned cesarean section — without the usual hormonal changes that happen during labor, they may not have absorbed the lung fluid
- Babies whose birthing parent has asthma or diabetes
Several other conditions can cause rapid breathing in a newborn. Most of them are dangerous conditions with the potential to cause severe disease. Your physician will keep these in mind as they treat your child:
- Respiratory distress syndrome, also known as hyaline membrane disease
- Meconium aspiration syndrome
- Pneumothorax, or a collapsed lung
- Persistent pulmonary hypertension of the newborn
- Delayed transition
- Rare causes — choanal atresia, diaphragmatic hernia, tracheoesophageal fistula, congenital heart disease, nervous system disease, metabolic disease, and hypoglycemia
Transient Tachypnea of the Newborn Treatment
Before starting treatment, your pediatrician will want to order some tests, such as the following:
- Complete blood count. This test can tell the doctor if your baby has an infection.
- Blood culture. This test is used to pinpoint any bacteria present in your baby's bloodstream.
- Chest X-ray. This will show any fluid in your baby's lungs. If your baby has respiratory distress syndrome or pneumonia, the x-ray can detect them.
- Pulse oximetry. This test uses a non-invasive device to measure the concentration of oxygen in your baby's blood. It's painless and can be used over an extended period to determine whether your baby's getting better or worse.
- Arterial blood gas test. This test can provide more information about the oxygen, carbon dioxide, and acid–base balance in your baby's blood.
If oxygen saturation is low, they'll give your baby oxygen to help them breathe.
Some babies find it difficult to breathe even with oxygen. A device called a continuous airway positive pressure (CPAP) machine may be used to help them. This prevents the alveoli in the lungs from collapsing.
If your baby is breathing very fast, you may have trouble feeding them. Your physician may give them intravenous fluids for hydration and nutrition. Another option is pumping your breast milk so it can be given to your baby through a tube placed in their stomach.
If there's any suspicion of bacterial infection, your physician will order antibiotics. They can be stopped later if the test results don't show an infection.
How Long Can TTN Last?
Transient tachypnea of the newborn usually starts within 2 hours of birth. Their need for oxygen will be high for a few hours after birth and should then decrease. Most babies with TTN get better in 12–24 hours, although it can persist for 72 hours or longer. TTN is likely to last longer in babies who had very high breathing rates immediately after birth.
Your baby will likely recover completely from TTN 24 hours after delivery, and recovery is usually complete. There are no further problems, and no other care or treatment is needed. TTN does not have long-term effects on a child's growth or development.
Transient tachypnea of the newborn is the most common cause of breathing difficulty in babies. It usually gets better with simple treatment. But treatment on time is crucial. Without treatment, transient tachypnea of the newborn can sometimes progress to respiratory failure.
You should be alert to your child's breathing rate and pattern. If you see them breathing fast or struggling to breathe, inform the hospital staff immediately. It's important to start treatment quickly and make sure no serious diseases are present. Babies who recover don't have long-term lung problems or other disorders.