Neonatal Resuscitation

A baby has been immersed in utero in amniotic fluid for 9 months. The baby needs to transition from getting oxygen via the placenta into getting oxygen via the lungs: breathing.
The baby’s initial breaths are important to help expel fluid from the lungs and create a positive pressure.

Most babies handle this transition with ease, and even come out kicking and screaming! Others are quiet and calm, breathing effortlessly as they assess this new place, and bond with their mother.

However, in a small percentage of babies, even ones born physiologically at home, this transition can need a little help in some babies, and is a crucial moment.

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It is important to know the times when baby is more likely to need resuscitation, such as after being born with extended crowning, breech, or with shoulder dystocia.

And it is incredibly important to know how to assess baby so you can start immediately helping them, no matter the circumstances of their birth.

"Just as a newborn’s efforts at ventilation are key to a successful transition after birth, the most important part of newborn resuscitation is effective ventilation." Lisa M Hainstock, Pedsinreview

Please ignore the outdated and antiquated advice in the Emergency Childbirth Hand book (don’t bend your baby like that!) and instead research proper Neonatal Resuscitation techniques and programs (like NRP).

Please note: NRP is very different to infant CPR or pediatric guidelines. One is for neonatal resuscitation - usually babies that have never breathed before, and the other is for infants who are older and need resuscitating for a different post birth reason. Both have their benefits, but infant CPR is not recommended immediately after birth.

Calmly stimulate the baby by rubbing its back and talking to it. You can gently suction baby's mouth with yours to remove any excessive fluid. Then, to inflate the lungs and promote breathing, give gentle breaths.

For more information on the correct way, and further measures that may be needed, you can research neonatal resuscitation and infant CPR.

Karen Strange has some free videos on Youtube. Start with this one, and her website

https://karenstrange.com/ 

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Jessica, a freebirth friendly midwife, has also put together on YouTube a neonatal basics video and accompanying PDF.

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Further reading:

https://midwifethinking.com/2016/04/13/the-placenta-essential-resuscitation-equipment/

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991653/