Diagnosing TRALI in neonates can be challenging due to overlapping symptoms with other neonatal disorders such as Respiratory Distress Syndrome (RDS) and neonatal pneumonia. Key diagnostic criteria include acute onset of respiratory distress within 6 hours of a blood transfusion, hypoxemia, and bilateral infiltrates on chest radiography. It is crucial for healthcare providers to differentiate TRALI from other causes of respiratory distress to provide appropriate treatment.