Stop Suctioning the Airway of a Baby at Birth
Evidence based clinical guidelines recommend NOT suctioning a baby’s airways unless they are unresponsive, floppy and require resuscitation. And even then only to do so using a laryngoscope so that you can see what you are doing.It is normal for a baby to work fluid out through birth and as he transitions over to using his lungs to breathe. It is not natural or normal for a baby to have a pointy bulb syringe gag him in the throat in the first minute of his new life in this world. In theory, your doctor or midwife is trying to clear your baby's airway so that the baby does not breathe amniotic fluid and mucous in. It used to be thought that suctioning should clear everything out so your baby can breathe better. But studies have shown that this suctioning can actually cause your baby to receive less oxygen than is optimal. Suctioning at birth: Source
- Does not reduce the risk of MAS
- Can cause the baby to gasp (inhale deeply which is exactly what you are wanting to avoid with meconium stained liquor) (Roggensack et al. 2009)
- Can lower the baby’s heart rate for up to 20 minutes (vagal bradycardia) (Waltman 2004).
- Can interfere with the initiation of breastfeeding (Killion 2000)
- Can cause tissue trauma (Davies & MacDonald 2008).
- Can produce bradycardia
- Can cause laryngospasm
- Can cause cardiac dysrhythmias
- Can cause edema
- Can cause trauma to mucous membranes
- Can cause tachycardia
- Can cause emotional distress
- Can cause bronchospasm
- Can cause cardiac arrest
Latest ResearchThe latest research now shows that babies who have their faces wiped (mimicking the licking that mammals do after birthing) have a clinical outcome that is exactly the same as those who are suctioned. This is very exciting, as wiping the face has zero side effects or risks!
What about suctioning when there is meconium?Meconium is the sticky black bowel movement that your baby will pass in his first days after he is born. Sometimes babies pass it in utero during labor, or sometimes as they are being born. We have already shared how this is a completely normal process. Many doctors routinely suction the baby's mouth and nose only when there is meconium stained amniotic fluid present. A baby aspirating (breathing in) meconium can cause Meconium Aspiration Syndrome (MAS). Suctioning the baby's mouth and nose to reduce the amount of meconium has been believed to help prevent this; however, ALL current research shows there is absolutely no difference in outcomes between (vigorous) babies suctioned and those left alone. If suctioning did work for these situations, then there would be almost no cases of MAS once routine suctioning became the norm in care. That isn't the case though.
Why are babies still being suctioned?
It’s as if we thought that despite many millions of years of evolution, human beings were not capable of surviving unless someone sucked out their upper airways after birth.Additional Resources: http://midwifemelissamarks.com/evidence-based-midwifery-the-case-against-newborn-suctioning/ https://neonatalresearch.org/2013/06/17/we-can-stop-routine-suctioning-at-birth/ http://www2.aap.org/nrp/docs/iu/2013_fallwinter_iu.pdf http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830145/