Most babies breathe without help immediately after birth and should have a good cry by one minute after delivery. Drying the baby well helps to stimulate breathing. These babies do not need their mouth, nose and throat suctioned and smacking babies to start breathing is no longer acceptable.
About ten percent of babies do not breathe well and need some help from the delivery staff. This is called resuscitation. Usually they are given bag and mask ventilation using room air. A small plastic face mask it placed firmly over the baby’s nose and mouth while a bag is squeezed to push air into the baby’s lungs. This expands the lungs and usually results in the baby making gasps as breathing starts. The aim is to get the baby breathing by a minute after delivery. Giving oxygen is usually not needed and may even have dangers.
With good breathing efforts the baby will become pink, the heart rate will increase and the baby will become active. These clinical signs are measured in the Apgar score which records the baby’s condition at 1 minute after birth. The score is named after an American, Dr Virginia Apgar who first described the method of assessing newborn babies in 1953. A normal score is seven or more out of a possible total of ten. Most babies born in a health facility will be given an Apgar score.
Babies who breathe well after some help at birth usually grow and develop normally. Failure to start breathing quickly may result in brain damage or even death. Therefore it is very important that someone with the knowledge and equipment to resuscitate babies is present at every delivery.