Key takeaways: Transient tachypnea of the newborn (TTN) is fast breathing caused by fluid that hasn’t cleared from the lungs. It’s more common after cesarean birth without labor and in early term babies. It usually improves within 24 to 72 hours with supportive care.
Before birth, a baby’s lungs are filled with fluid. During labor and birth, hormonal changes and the squeeze of the birth canal help clear this fluid, and babies absorb the rest after birth. When fluid clears more slowly, a baby may breathe fast. This is called transient tachypnea of the newborn (TTN).
Who Gets TTN?
TTN is one of the most common causes of breathing problems in term and near-term newborns. Risk factors include:
- Cesarean birth, especially without labor.
- Birth before 39 weeks.
- Birthing parent with diabetes or asthma.
- Fast labor.
- Male sex and large size, in some studies.
Signs
Usually within the first hours after birth:
- Fast breathing (more than 60 breaths per minute).
- Grunting.
- Nostril flaring.
- Pulling in at the ribs (retractions).
- Sometimes a bluish color or need for extra oxygen.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. My book starts in the first hours after birth and walks you through every newborn check and the weeks that follow.
Diagnosis
Doctors diagnose TTN based on symptoms, timing, and sometimes a chest X-ray. They also consider other causes, such as infection, pneumonia, respiratory distress syndrome, or heart problems, and may run tests.
Treatment
TTN is treated with supportive care while the lungs clear the fluid:
- Monitoring of breathing and oxygen levels.
- Extra oxygen or breathing support (such as CPAP) if needed.
- Temporarily pausing oral feeds if breathing is very fast, with IV fluids or tube feeds instead.
- Sometimes antibiotics until infection is ruled out.
Most babies improve within 24 to 72 hours.
Feeding
Babies with fast breathing may not be able to feed safely by mouth at first. If you plan to breastfeed, start hand expression or pumping early and ask about skin-to-skin once your baby is stable.
Outlook
TTN usually resolves completely. Some studies suggest a possible association with wheezing later in childhood, but most babies have no lasting problems.
Prevention
Avoiding elective delivery before 39 weeks, when there’s no medical reason, reduces the risk of TTN and other breathing problems.
The Bottom Line
TTN is temporary fast breathing from retained lung fluid. It usually clears in 1 to 3 days with supportive care. Ask your care team about feeding and skin-to-skin as soon as your baby is stable.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
- Early Term Babies: Why the Last Weeks of Pregnancy Matter
- Late Preterm Babies: Why Babies Born at 34 to 36 Weeks Need Extra Care
- Your Newborn’s First 24 Hours: What Happens in the Hospital, Hour by Hour
- Newborn Hiccups, Sneezes, and Grunts: What’s Normal
Sources
- Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol. 2006;30(1):34-43.
- Tita AT, Landon MB, Spong CY, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009;360(2):111-120.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 765: Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities. Obstet Gynecol. 2019;133(2):e156-e163.
- Hermansen CL, Mahajan A. Newborn respiratory distress. Am Fam Physician. 2015;92(11):994-1002.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
