Transient Tachypnea of the Newborn/TTN/wet lung is a great nuisance to
breast-feeding mothers as it causes infants and mothers to be separated in
the first few hours or days of life.  Many cases of TTN may be preventable
by avoiding elective C-section before 39 weeks (as per American College of
Obs/Gyne recommendations).

TTN is probably the commonest reason for admission of a "term" infant to
NICU.  It is just what it says: (a) transient, lasting several hours and
occasionally a day or two, and (b) associated with persistent tachypnea and
mild respiratory distress, often with a respiratory rate greater than 60-70
per minute.  TTN is often indistinguishable from pneumonia and many infants
who remain breathless for more than 4-6 hours end up on iv antibiotics in
addition to oxygen therapy.  Occasionally term infants become very sick and
require ventilatory support.  Fortunately improvement is spontaneous and
recovery is almost always complete.  Most babies simply require oxygen,
warmth and minimal handling.

The cause of TTN is uncertain but theories abound from a poorly "squeezed"
chest to delayed lymphatic drainage of the lung.  It is probably associated
with a mild form of surfactant deficiency (usually found in the more severe
form as Respiratory Distress Syndrome in premature infants).  TTN is also
associated with elective C-section (not always!).  The important lesson
regarding C-section is that if you're not in labor you may not be full-term
and therefore your baby may be surfactant deficient.  It is therefore
really important that elective C-sections only be done after 39 weeks
unless some medical reason exists to do them earlier (and risk delivering
an infant with respiratory distress).

Interfering with nature always has its price!

Khalid Aziz
Memorial University of Newfoundland