When the baby is fully delivered, lay it along your arm. Grasp the baby like a football with one of the baby’s arms and one of its shoulders between your fingers. Hold the baby carefully and remember that babies are very slippery. Follow this procedure:

a. Cleaning the Baby’s Nose and Mouth. Using sterile gauze, wipe away any blood and mucus from the baby’s nose and mouth.

b. Suctioning the Baby’s Nose and Mouth. Then, suction the baby’s nose and mouth with a rubber bulb aspirator in this manner:

(1) Squeeze the bulb before inserting the tip.

(2) Place the tip in the baby’s mouth or nostrils and release the bulb slowly.

(3) Expel the contents of the bulb into a waste container, repeating the suctioning as needed.

c. The Baby’s Breathing.

(1) If the baby does not breathe spontaneously, stimulate him by rubbing his back gently or by slapping the soles of his feet. If there is no response, start moutt-tomouth or mouth-to-nose resuscitation.

CAUTION: NEVER use mechanical resuscitation devices on a newborn.

Editor’s Note: The warning about mechanical resuscitation devices applies to adult devices. Trained individuals in a hospital setting frequently use a newborn-specific bag, mask, flowmeter and 100% oxygen source to help in resuscitation efforts. These tools are rarely available outside of a hospital setting.

(2) If spontaneous breathing begins, administer oxygen by mask for a few minutes. Do this until the baby’s color is pink.

(3) If the baby still does not start to breathe and the precordial pulse is absent, begin CPR, keeping the baby wrapped in a blanket as much as possible.

d. Tying the Umbilical Cord. If the baby has been delivered normally and is breathing well, follow this procedure:

(1) Tie or clamp the cord about eight inches from the infant’s navel, using two ties (or clamps) placed two inches apart.

(2) Cut the cord between the two ties, handling the cord gently because it tears easily.

(3) Examine the cut ends of the cord to be sure there is no bleeding. If one of the cut ends is bleeding, tie or clamp the end proximally to the previous tie, or you can clamp the cord and reexamine it.

e. Making the Baby Safe and Comfortable. Wrap the baby in a sterile blanket. Be sure to keep the baby warm at all times.