Respiratory distress is a common presentation of disease in the newborn infant. The term is used to describe a constellation of easily observable physical signs, including rapid breathing (more than 60 breaths per minute), cyanosis, retractions (sucking in of the skin between the ribs, under the ribs, or above the sternum with each breath), flaring of the nostrils, and a grunting sound on expiration. Many clinical causes exist for these signs, and their presence is an indication that further observation or investigation is necessary.

It is important to note, however, that tachypnea may only be a normal or transient condition in the newborn. Babies may breathe rapidly during the first few hours after birth. This phenomenon is related to the clearing of lung fluid from the airways and the cardiopulmonary adjustment to extrauterine life. Tachypnea also may be associated with transient conditions such as hypothermia. Isolated tachypnea, which is not associated with cyanosis, may be managed by observation only during the first few hours of life. If the tachypnea persists or is associated with other evidence of respiratory distress, further investigation is indicated. This analysis usually includes a radiograph of the chest and determination of arterial blood gas levels or of blood oxygen saturation.

The causes of respiratory distress in the newborn include the following: