Neonatal resuscitation involves clearing the baby’s airways, warming them, providing oxygen, intubating, performing CPR, and administering medications. Premature birth or reduced oxygen supply during delivery may require resuscitation. The first stage is clearing the airways, followed by drying and warming the baby. If necessary, oxygen is provided, and if the baby’s heart rate is low, CPR is performed. Medications may be given if resuscitation is still unsuccessful.
Neonatal resuscitation is done after delivery to help the baby start breathing. It may include measures such as clearing the baby’s airways, warming the baby, providing oxygen, intubating the baby, performing neonatal CPR, administering medications, or any combination of these procedures. The type of neonatal resuscitation varies, although most babies need airway clearance soon after birth. Studies indicate that resuscitation of a newborn, beyond the point of clearing its airways, is required in 10% of all births. The most common reasons are premature birth or a reduction in the baby’s oxygen supply during labor and delivery.
Inside the uterus, a fetus’s lungs fill with amniotic fluid. In most cases, this fluid is cleared during labor, allowing the baby to breathe on its own soon after birth. To aid this process, the first stage of neonatal resuscitation is performed. The most common reasons are premature birth or a reduction in the baby’s oxygen supply during labor and delivery. The birthing doctor usually clears the baby’s nose and throat of fluid with a bulb syringe, thus opening the baby’s airways so that he can breathe. If your baby is still struggling, the doctor will often rub his back vigorously or slap his feet to get him jerking and breathing for the first time. When these measures fail, the next stages of neonatal resuscitation begin.
Before neonatal resuscitation can continue, the newborn must be dried and placed under heat lamps to help maintain his or her temperature. Babies are typically born without the ability to regulate their temperature; getting too cold can stress your baby’s body, making it even harder to breathe. If the baby is still having trouble breathing after this step, a breather typically supplies the baby with oxygen. If the baby is too small or the bag vent does not work, intubation may be needed.
If, after at least 30 seconds, there are no signs of improvement and the baby’s heart rate is 60 beats per minute or less, neonatal CPR is performed. This is usually done with two fingers, placed slightly below the chest, delivering 90 compressions per minute. During this time, the baby is still getting oxygen.
In some cases, these stages of newborn resuscitation are still unsuccessful. At this point, medications may be given to help the baby breathe or to increase the heart rate. Adrenaline is generally considered to be the most effective and safest means of improving a child’s heart function. Under certain circumstances, naloxone hydrochloride, sodium bicarbonate, and volume expanders may be used to aid in neonatal resuscitation, although research on the effectiveness of these drugs is varied.
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