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All of your baby’s body systems must learn to work together in a completely new way after birth. Before birth, the placenta provides your baby’s oxygen and nutrition, and it also removes carbon dioxide from the blood. When your baby is born, the heart and lungs must quickly adapt to do this work themselves. Most babies make the transition smoothly, but for some babies, more intervention is necessary to change from relying on the placenta to breathing on their own. This intervention is called neonatal resuscitation.
Immediately after birth, personnel trained in neonatal resuscitation will evaluate your baby. If your baby shows signs of needing help switching to using the lungs to breathe, the team will begin neonatal resuscitation. During resuscitation, an Apgar score will be done twice. This score will show how well your baby is making this transition to breathing with the lungs.
If your baby is healthy and breathing well, he or she will be placed in your arms as quickly as possible.
Doctors at Riley at IU Health perform the Apgar test one minute after birth. This test checks for:
The checks are repeated twice; once at one minute after birth and once at five minutes after birth. However, your baby will be monitored closely for the first five minutes after birth. If at any time there is concern about your baby’s breathing, some immediate steps are taken, including:
If these immediate steps do not improve your baby’s condition, ventilation, chest compressions or other emergency measures may be necessary while your baby is still in the delivery room.
Babies who require some intermediate resuscitation may stay briefly in the neonatal intensive care unit (NICU) for more monitoring before being returned to the same room as their mothers. Babies born by cesarean section (C-section) may be more likely to need neonatal resuscitation and monitoring since it can be harder for them to clear mucus from their airways.
Babies who need more involved resuscitation or added treatments will often stay in the NICU where they can receive more advanced treatments and have more involved testing. Highly trained NICU team members will monitor your baby around the clock so they can immediately provide care if your baby’s condition changes.
Sometimes the need for neonatal resuscitation is a surprise. However, if a prenatal screening test or genetic test shows your baby has a congenital diaphragmatic hernia, abdominal wall defects, an open neural tube defect like myelomeningocele or a genetic condition like Down syndrome, the need for neonatal resuscitation may be likely. Your baby may also require neonatal resuscitation if a premature birth is expected.