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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.
What to Expect
What to Expect
Doctors at Riley at IU Health perform the Apgar test one minute after birth. This test checks for:
- Heartbeat
- Normal activity and muscle tone
- Irritability
- Appearance and normal skin color showing good blood circulation
- Respiration or breathing
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:
- Using suction to clear the airway passages, including the nose, mouth and possibly the windpipe
- Warming your baby
- Massaging or stroking the skin to stimulate crying
- Drying your baby
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.
Key Points to Remember
Key Points to Remember
- Neonatal resuscitation occurs when babies need extra help making the transition from relying on the placenta to breathing on their own.
- The Apgar measures how well your baby is transitioning from using the placenta to breathing on their own.
- Neonatal resuscitation may start with simple steps, like warming your baby, and then go to more complicated steps, like ventilation or chest compressions, depending on your baby’s condition.
- Neonatal resuscitation starts in the delivery room and may continue in the NICU depending on the baby’s condition.
- You may know in advance that your baby will require neonatal resuscitation if a known birth defect or health concern is found during pregnancy.