Summary

In this study session, you have learned that:

1. The most important signs of asphyxiation in newborns at delivery are: difficulty breathing, gasping or no breathing; abnormal heart beat; poor muscle tone (floppy limbs); lack of movement; bluish skin colour (cyanosis), and being stained with meconium.
2. Assessment of the degree of asphyxia should be done in the first 5 seconds after the birth, at the same time as commencing basic newborn care (e.g. drying the baby, keeping it warm, tying and cutting the cord, etc).
3. Swift action is necessary to begin resuscitating a baby who is not breathing well, after you have suctioned its mouth and then its nose.
4. Check that the baby is alive (listen for an apical heartbeat); that the heart rate is above 60 beats/minute (begin heart massage before resuscitation if the heart rate is less than 60 beats/minute); and that the baby is not stained with meconium, which must be suctioned out before resuscitation can begin.
5. Position the baby with its neck extended to open the airways; place a correctly fitting ventilation mask over the baby’s mouth and nose, and begin ventilating at a rate of about 40 breaths per minute.
6. Watch for signs of improvement: e.g. pinkish colour, movement, ability to breathe unaided, etc. Refer urgently if this has not been achieved after 30 minutes of ventilation.
7. Remember to conduct all the activities of essential newborn care, including cord care, giving a vitamin K injection and tetracycline eye ointment, establishing early and exclusive breastfeeding, and ensuring that anti-HIV medication is given to prevent mother-to-child-transmission.