A newborn may have difficulty breathing after birth. The most common of these are transient respiratory distress in the preterm infant and RDS, or neonatal respiratory distress in the premature infant.
Transient respiratory distress in the newborn
Transient respiratory distress (tachypnea, adaptation disorder) is a common physiological problem in the newborn. During the fetal period, the lungs are full of amniotic fluid and after birth, during the first breaths, the amniotic fluid is removed from the pleura and replaced by air. In some cases, this transition is deficient and excess fluid is left in the lungs. We can also talk about adaptation disorder. The condition is transient and usually resolves by the age of 2-3 days. Risk factors for transient tachypnea include planned caesarean delivery, a large infant, maternal diabetes and asthma, twin pregnancy and male sex. Nasal overpressure or high-flow mustache (Optiflow) plus supplemental oxygen is used to treat such breathing difficulties. Severe breathing difficulties may require respiratory therapy.
Generally, respiratory distress syndrome (RDS) is a problem in premature infants, but sometimes a slightly premature or even full-term child may develop RDS. RDS is caused by a lack of a surfactant that lowers lung surface tension. Usually, a slightly premature child with RDS will be treated with overpressure and, if necessary, supplemental oxygen. If oxygen demand is increased, the surfactant may be administered to the trachea either by pressurization with a thin catheter or via the inhalation tube in ventilator therapy.
Respiratory arrest or apneas
The regulation of breathing in a premature infant in the brain’s respiratory center may initially be immature and the child may have respiratory pauses or apnea. If necessary to stimulate the respiratory center, treatment with caffeine is initiated.