Initial newborn assessment, routine care, and cord clamping
THE CONTEXT
Three observations at birth determine whether the newborn receives routine care with the mother or requires initial resuscitation steps.
Three initial questions
•
Assess whether the newborn is term, has good muscle tone, and is breathing or actively crying. Flexed posture and active movements indicate good tone.
•
If all three answers are yes, the newborn remains with the mother for routine care.
•
If any answer is no, the newborn needs at least some resuscitation. Cut the cord and perform the initial steps.
Routine care
•
Provide warmth through skin-to-skin contact on the mother's abdomen and chest.
•
Position the newborn and clear the airway if required by wiping the mouth and nose with a clean cloth. Routine suction is unnecessary.
•
Dry the newborn with a warm, dry cloth, remove wet linen, and cover the baby.
•
Continue evaluating vital parameters and help the mother breastfeed to facilitate transition to the extrauterine environment.
Cord clamping
•
Delay cord clamping for 30–60 seconds in both term and preterm newborns who do not require resuscitation.
•
The source states that evidence is insufficient to recommend delayed cord clamping when resuscitation is needed. In these newborns, clamp and cut the cord immediately and initiate resuscitation without delay.