Wednesday, February 23, 2011

Clearing A Newborn's Airway

Often babies are born with mucous clogging their mouth and airway. This hinders their breathing. A bulb syringe can be used to clear the passage. A bulb syringe is not the only way to clear the passages though. The method of "suck and spit" does the job, too. The following video beautifully exemplifies this.

Routine suctioning of babies is not necessary, or beneficial, however. California Midwife Ronnie Falcao writes the following on her Neonatal Resuscitation page:

I just wipe the baby off. And if you put her/him head down you can SEE the junk run out of his/her nose and mouth -- the natural mechanism is for the baby to drain and "spit" and THEN breathe, so i want to encourage it to happen that way.... (I "suspect" that suctioning -with a bulb- might make a baby try to breathe before it's cleared)....

How do I know whether to suction? The sign I use is real simple -- I gently touch the baby when just the head is out. If he purses his lips and looks like he's "trying to spit: then I figure all the reflexes are there and I'm not going to need to suction....

I finally figured out that suctioning and stimulation are great first steps in a baby who is a slow starter, but that a baby who clearly getting it together on his or her own doesn't need me to suction.... the baby seems to be quite capable of dealing with secretions on its own, and thus the suctioning is being done to make me feel better rather than because it is necessary. Now I wait, unless meconium is present. Then I suction on the perineum and afterwards, of course. But this in not the normal scenario.

From Henci Goer:

Routine suctioning is worse than useless; it's harmful. Evidence suggests that suctioned babies take longer to achieve normal oxygenation levels. Linda Smith has written about the adverse effects of suctioning on initiating breastfeeding. Suctioning c-sectioned babies isn't even logical. The problem is fluid in their lungs. Suctioning the nasopharynx isn't going to do a thing about that. Finally, it is now believed that meconium aspiration results largely from events occurring in pregnancy. Thanks to randomized controlled trials of suctioning for meconium, the sole remaining accepted indication is meconium staining and a nonvigorous baby--

Also from Ronnie Falcao:

Other important aspects to helping a baby breathe are:

  1. head extended with a straight neck so the airway is free (the tray provides a good surface for this if needed)
  2. mucus/meconium out of the airways
  3. head draining on mom's belly if needed after breathing established. Nursing helps bring up mucus as does crying.
  4. keep the baby warm and dry by changing blankets.
  5. homeopathics can help with resuscitation if you think of it. Carbo veg for a blue baby (also fetal distress-not enough oxygen via the placenta. Aconite for fear or fright, with a white baby, traumatic delivery. Laurocerasus for wet lungs, face blue, difficult breathing.

1 comment:

Pregnancy Miracle said...

I have read this first time such that these types of things are also done. May be the mid wife’s have more experience of doing that. And they know more then us.