When my son was born, he was having problems breathing, and he was taken to the nursery for observation. I was very worried and the nurses were vague about answering my questions. They called it newborn respiratory distress and said that if it cleared up it is very common. About 4 hours later it had cleared up enough that he could stay in my room. Can you explain what this was; what causes it; and how to prevent it?
I am so glad you asked this question because this scenario happens quite a bit, and it can be awfully frightening to new parents. The medical term for the episode you describe above is called Benign Transient Tachypnea of the Newborn. Translated, it means a newborn baby who breathes fast for a short amount of time and is not sick. This is a good example of how we doctors can come up with fancy descriptive names when we have little idea of what is causing the problem. However, the reason we pay so much attention to this otherwise benign condition is that it mimics what occurs when a newborn has a life-threatening illness.
Luckily, life-threatening bacterial infections (such as Group B Strep) in newborn babies are not tremendously common. However, one of the first signs that an infant is seriously ill is breathing fast. The baby with serious infection may initially seem to be active, apparently breastfeeding ok, looking alright, but breathing fast. Obviously, the baby will do best if he is treated earlier than later, so any newborn baby that is breathing abnormally fast is usually carefully observed in the nursery for any other signs of infection. This often poses difficulty in communication between the healthcare team and the parents. While the team wants to keep the parents well informed of concerns about the baby, they are often hesitant to give distressing news about the baby breathing fast when there is a possibility of it clearing up within a matter of hours.
So, what causes Transient Tachypnea of the Newborn? Well, as I alluded to at the beginning, we really don't know exactly. The most common thought is that the infant breathes fast due to having some retained amniotic fluid in its lungs, and it takes time for this fluid to get absorbed. However, this has not held up well to scientific scrutiny. Others have pointed fingers at the heart and lungs. Within the first few minutes of life, a significant number of changes occur in how the lungs and heart work. Researchers have looked to see if these changes take longer in some children causing a short period of breathing fast. Again, there is not a lot of evidence to support these theories either.
There are a few things we do know about transient tachypnea of the newborn. It seems to occur more often in males, in babies whose mothers had long labor, and those who had C-sections after there was failure to progress in labor. The breathing fast occurs almost immediately after birth and may last up to about 24 hours. This diagnosis is usually what is typically called a "diagnosis of exclusion." What this means is that when all other more serious conditions have been confidently ruled out, the diagnosis of transient tachypnea of the newborn is given. To rule it out, observation of the baby may be all that is needed. However, in more confusing instances such as when there are other signs of possible infection, more extensive testing may be required.
I'm sure it was a frightening time for you waiting to find out how your son was doing, but I am happy to hear all turned out well for him. It is not often that the symptoms of a harmless condition and a life-threatening infection look so similar, but this is one of them. Hopefully, the future will bring better ways to positively diagnose this condition so that we don't do unnecessary testing and cause unnecessary stress to parents.
Good luck to you.
