Transient Tachypnea of Newborn- Causes, Symptoms, Diagnosis, and Management

What Is Transient Tachypnea?

Transient tachypnea is seen in newborns during the first few hours after delivery. Transient means short span, and tachypnea means shortness of breathing, hence the symptoms of this condition. It is a benign condition that is short-lived and sometimes caused by delays in clearing the fluid of the lungs at the time of birth. The symptoms related to this state usually resolve in three days in newborns. Almost ten percent of infants are born between 33 and 34 weeks, five percent between 35 and 36 weeks, and almost one percent are born full term. This type of respiratory condition is usually seen in early or late-term babies and is commonly in about one to two percent of all newborn babies.

What Are the Causes of Transient Tachypnea in Newborns?

Before birth, the lungs of the infants have fluid inside. This fluid is absorbed as hormone changes occur during intrauterine life and is further absorbed through the birth canal during birth. In the end, as the baby starts breathing, the left-out fluid gets absorbed on its own in case a baby is born with fluid in the lungs. On the other hand, if the fluid is not absorbed and there is too much fluid left in the lungs, the baby has difficulty taking oxygen into the lungs. Due to this, babies normally breathe faster and harder to take in oxygen, which causes breathlessness or shortness of breath. The normal breathing rate of a newborn is 40 to 40 times per minute (newborn rapid breathing).

Who Is at Risk for Transient Tachypnea of Newborns?

Transient tachypnea is usually seen in full-term babies. However, there are other situations where a baby can have this condition, such as babies born with cesarean delivery (c-section). In this situation, the baby does not undergo any type of hormonal change as a baby born with vaginal delivery would have. Due to no hormonal changes, fluid absorption in the lungs is delayed. This causes respiratory complications. Moreover, if the mother has asthma (inflamed, swollen, and narrowed airways) and diabetes (high blood sugar), there are more possibilities that a child will be born with this condition, too.

What Are the Signs and Symptoms of Transient Tachypnea in Newborns?

There are multiple symptoms associated with transient tachypnea in newborns. However, every newborn can experience different symptoms, such as:

• The breathing rate of more than 60 breaths per minute.

• Flaring of the nostrils.

• Pulled-in ribs.

• Grunting sound.

• Cyanosis or the bluish discoloration of skin due to decreasing blood oxygen levels. It is the symptom often seen with conditions like tachypnea.

• Tachycardia is a condition where the heart rate increases by over 100 beats per minute. However, a high heart rate is not the only sign of health complications. For instance, even exercise or emotional stress can also cause this condition.

How to Diagnose Transient Tachypnea of Newborns?

There are multiple options to diagnose this condition, such as:

• A mother’s labor history plays an essential part in diagnosing the condition. So, doctors should lead with this question.

• In severe conditions, doctors may recommend a chest X-ray to determine the condition's cause. The X-ray also shows signs of hyperinflation (air trapped in the lungs when breathing out), prominent perihilar vascular markings, edema (fluid leakage through tiny blood vessels), or fluid accumulation in the fissure.

• A blood count is to rule out any infections associated with transient tachypnea.

• A blood culture is needed to check if there is an infectious condition related to this.

• ABG (arterial blood gas) analysis is also used to determine hypoxia (low oxygen level in the blood) or hypocapnia (decrease in the carbon dioxide level) due to tachypnea.

• Echocardiography is an ultrasound of the heart that rules out congenital cardiac defects in newborns. It evaluates the heart's activity and values regarding pumping blood.

How to Treat Transient Tachypnea in Newborns?

Although transient tachypnea can resolve on its own, there are a few options available for the treatment of this condition, such as:

• Doctors might recommend giving oxygen to maintain a newborn's regular pulse. This can be done with the help of a small tube under the nose called a nasal cannula.

• A pulse oximeter or blood gas monitor can estimate saturated blood oxygen levels.

• Also, blood tests can be done regularly to monitor oxygen and carbon dioxide levels in the blood.

• During the first few hours after birth, newborns require high oxygen, which can decrease with time.

• Most transient tachypnea resolves within 24 hours after birth.

• Continuous positive airway pressure (CPAP) is recommended for newborns. It is a mechanical ventilation system that provides continuous airflow or oxygen and prevents the possibility of lung collapse by keeping the lung passages open until breathing becomes normal again.

• If an infant has severe irregular breathing, doctors recommend stopping the feeding until it gets normal.

• It is very difficult to feed a baby during this condition due to the fear of choking on the food. It is very difficult for a baby to suck, swallow, or even breathe. For this time, intravenous nutrition is given to keep the baby hydrated. This can also prevent the blood sugar from dropping too low and create other complications.

• In this condition, doctors do not recommend breastfeeding; milk can be pumped and stored until the baby’s breathing is normal again. During this time, infants can get milk or formula through other options such as:

  • Nasogastric Tube: This tube placed through the baby's nose brings food directly to the stomach.

  • Orogastric Tube: A small tube placed into the baby’s mouth carries food to the stomach.

• In some cases, doctors recommend tube feeding due to a high respiration rate and fear of food aspiration.

• Until doctors rule out an infection associated with this condition, they may also prescribe antibiotics.

• It is very unlikely for a newborn to have this lung condition for more than a week.

Conclusion:

Transient tachypnea generally resolves itself within a day. Moreover, if a baby has this condition at the time of birth, there is very little to no chance that it will have the same condition again. Only routine follow-up visits after birth can be sufficient to maintain their health.