We asked a question on our Facebook page last week about what you wanted to learn from our most recent lecture series here in Uganda.The topic chosen was neonatal resuscitation. This is what our infield blogger April Parsons learned from the conference.
Neonatal resuscitation refers to helping babies breathe, specifically right after they are born.
They go through a massive transition; from being inside the mother and relying on her, to being completely independent.
To a greater or lesser extent some babies will be able to breathe just by rubbing them down and giving them some stimulation. Others will need you to breathe for them for the first couple of minutes.
Proper stimulation is essentially warming the baby and drying the baby – a cold baby doesn’t breathe. After a brief rubdown and towel drying the baby should start breathing on his own. If that doesn’t work then you go right into breathing for the baby with bag-and-mask ventilation. In order to do this properly, you should tilt the shoulders and adjust the head to reposition the airway to insure the chest rises with each ventilation. It’s also necessary to finesse as strength is not always key and could potentially hurt the baby.
Every time the mother goes through a contraction it shuts off blood supply to the baby for that minute. The longer the labor the longer the baby has went without the oxygen in the blood so any physical stress from the mother means there is a higher likelihood that the baby will need help breathing.
However, It usually won’t take long for the baby to start breathing on its own. How long you continue the bag-and-mask breathing is decided on a case-by-case basis. You could go for as long as 20 minutes if there is a good heart rate.
When a baby is born through a caesarean section in the US a pediatrician is almost always available. Accompanying them are also very experienced nurses that come in and do the newborn resuscitation.
Here in East Africa it is quite different and there is typically only the doctor and a nurse. Also, more often than not, the nurse won’t attend years of school, but will go through an on-the-job training at the hospital or health center in which they work.
Through conferences, like the one put on by KHI, the nurses are better equipped to handle newborn babies in East Africa!