Summary
Differentials
Common
- Transient tachypnea of the newborn
- Respiratory distress syndrome (RDS)
- Aspiration pneumonia
- Pneumothorax
- Polycythemia
- Transposition of great arteries
- Tetralogy of Fallot
- Pulmonary atresia
- Persistent pulmonary hypertension of the newborn
- Pneumonia
- Pulmonary edema
- Congenital diaphragmatic hernia
- Congenital pulmonary airway malformation (CPAM; formerly known as congenital cystic adenomatoid malformation [CCAM])
- Upper airway obstruction
- Asphyxia
- Methemoglobinemia (met-Hb)
- Hypoglycemia
- Neonatal sepsis
Uncommon
- Total anomalous pulmonary venous return
- Hypoplastic left heart syndrome or single ventricle physiology states
- Tricuspid atresia
- Truncus arteriosus
- Pulmonary hemorrhage
- Pulmonary hypoplasia
- Congenital lobar emphysema
- Pulmonary lymphangiectasia
- Tracheoesophageal fistula (TEF)/esophageal atresia (EA)
- Pleural effusion
- Arteriovenous malformation
Contributors
Authors
Mohan Pammi, MD, PhD, MRCPCH
Professor
Division of Neonatology and Department of Pediatrics
Baylor College of Medicine
Houston, TX
Disclosures
MP received payment for a talk on neonatal COVID-19 in the NICU for Goldline Learning in 2021.
Acknowledgements
Dr Mohan Pammi would like to gratefully acknowledge Dr AnnaMarie Arias-Shah, Dr Robin H. Steinhorn and Dr Ponthenkandath Sasidharan, the previous contributors to this topic.
Disclosures
AA-S and PS declare that they have no competing interests. RHS is Associate Editor for Journal of Pediatrics. The University of California has received honoraria for Dr Steinhorn from Scientific Therapeutics Information Inc, through Mallinckrodt.
Peer reviewers
Rama Bhat, MD
Professor of Pediatrics
Department of Pediatrics
Medical Center
University of Illinois
Chicago, IL
Disclosures
RB declares that he has no competing interests.
Utpala G. Das, MD
Assistant Professor Pediatrics/Neonatology
Medical College of Wisconsin
Milwaukee, WI
Disclosures
UGD declares that she has no competing interests.
Russell Peek, BSc (Hons), MBChB (Hons), MRCPCH
Consultant Paediatrician
Neonatal Unit
Gloucestershire Royal Hospital
Gloucester
UK
Disclosures
RP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Sasidharan P. An approach to diagnosis and management of cyanosis and tachypnea in term infants. Pediatr Clin N Am. 2004 Aug;51(4):999-1021. Abstract
National Institute for Health and Care Excellence. Specialist neonatal respiratory care for babies born preterm. Apr 2019 [internet publication].Full text
Lee HC, Strand ML, Finan E, et al. Part 5: Neonatal resuscitation: 2025 American Heart Association and American Academy of Pediatrics guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2025 Oct 21;152(16_suppl_2):S385-423.Full text Abstract
Sweet DG, Carnielli VP, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome: 2022 update. Neonatology. 2023;120(1):3-23.Full text Abstract
Plana MN, Zamora J, Suresh G, et al. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev. 2018 Mar 1;3(3):CD011912.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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