You may also see the baby begin to move a little bit, beginning to flex its limbs and look less floppy. You would expect to see the baby’s skin colour change from bluish or very pale, to a healthier pinkish colour. What other change would you expect to see in the baby while you are ventilating it, if the resuscitation is going well? Also look again at the three photos of newborns with different level of asphyxia (Figures 7.1, 7.2 and 7.5). Most babies who are not breathing can be saved if resuscitated correctly and quickly.įrom Table 7.1, you can learn how to assess a newborn’s degree of asphyxia. If a baby does not breathe soon after birth, it may get brain damage or die. A baby who is not breathing at all after birth, or who is only gasping for breath, or who is breathing less than 30 breaths per minute needs help immediately. A severely asphyxiated baby may not breathe at all, there may be no movement of its limbs (arms and legs), and the skin colour may be deeply blue or deeply white. Within no more than 5 seconds after the birth, you should make a very rapid assessment to find out whether the baby is alive or dead, and (if it is alive) to assess whether it has any degree of asphyxia. ![]() Moderate to severely asphyxiated babies usually require intensive resuscitation, so the next thing you have to learn is how to grade asphyxia in a newborn. Cyanosis is a bluish discolouration of the lips and skin, which occurs when there is insufficient oxygen in the blood (Figure 7.2). ![]() You may also need to resuscitate any baby that is severely anaemic due to blood loss during labour and delivery, or that continues to be cyanotic despite established breathing. Therefore, the purpose of neonatal resuscitation is to help the newborn to establish spontaneous breathing and facilitate oxygen delivery to its organs and tissues – particularly the brain, which is very quickly damaged by oxygen shortage. The baby who cannot breathe cannot establish independent life outside the mother. However, neonatal asphyxia is mainly due to failure of the newborn to breathe after birth, or its heart fails to pump enough blood to the lungs for gas exchange, or it has low haemoglobin levels (anaemia) so it cannot deliver enough oxygen around the body. Gas exchange is when oxygen from the inhaled air is absorbed into the blood as it passes through the lungs, and waste carbon dioxide is released from the blood into the air that is breathed out This study session is unusual in that much of it is taught through diagrams. short of oxygen due to breathing problems), and the correct action that you should take. You will learn how to distinguish between a healthy baby and one that is moderately or severely asphyxiated (i.e. However, in this study session our focus is on newborns who are not breathing well, and what you need to do in order to resuscitate them and get them breathing normally. You will learn them in much greater detail in the Module on Postnatal Care and the steps will be covered again in the Module on Integrated Management of Newborn and Childhood Illness. Of course, most babies breathe spontaneously as soon as they are born and all you need to do is follow the steps of basic newborn care, which were briefly outlined in Study Session 5 of this Module. ![]() Within a few seconds you have to be able to identify the general danger signs in a newborn that tell you to intervene quickly to protect it from developing serious complications, or even dying, because it is not able to get enough oxygen into its body. ![]() The moment when a baby is born is also the time when the birth attendant has to make a very rapid assessment of the condition of the newborn to decide whether it needs helping to breathe.
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