What Your Ob Will Do To Take Care Of Your Baby Right After Birth

This post might also be entitled 'back to the future baby care." After we guide the baby from the mom's body as obstetricians we are right there to take care of the baby. We do a quick visual assessment, we remove loops of cord from the neck and body of the baby if we have to, we are then there to make sure the baby begins to breathe, get warm, get immediate contact with mom's skin, and have a good heart rate and act vigorous. We have also been taught to get those first bubbly secretions out with DeLee suction device from the baby's mouth, we are told to perform a rapid clamping of the umbilical cord, and to use 100% oxygen when oxygen is necessary for the baby to get going right after birth. The obstetrical text book written by Dr. Fedrick Irving in 1932 they recommended pretty much the opposite of everything we have been doing for a few decades: Dr. Irving said hold the babe upside down  (think Saturday Morning Post Pictures of the friendly Obstetrician!), and urged us to delay umbilical cord clamping. And now in a reversal of advice of today, and back to the advice of yesterday, a new study that says routinely suctioned babies who were studied at 2 and 6 minutes had worse oxygen scores than those in whom suctioning was avoided if not needed. Remember, as with other areas of medicineIf you delay clamping the cord you get an extra 25 ml of blood for each kg of the baby. Actually milking the blood towards the baby helps to get a few extra drops of blood into the baby as well.  But these babies are likely to have more bilirubin even with bilirubin no suctioning is necessary. So I guess we still have a bit or sorting to do, but it is most likely that mother nature may know best in these cases and if the baby is born with just a bit of mouth fluid, it's ok to just let baby clear that fluid on her own!


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