Suction Techniques For Newborns: How Long Should You Go?

how long suction for a newborn

Suctioning has been a standard procedure for newborns for decades, especially for those born via C-section, who may have trouble clearing lung fluid and mucus. However, evidence suggests that routine suctioning may be unnecessary and potentially harmful. While suctioning can effectively clear a newborn's airway, it can also stimulate the vagus nerve, leading to bradycardia and apnea. As such, the World Health Organization advises against routine bulb suctioning unless the baby shows clear signs of respiratory distress or has aspirated meconium.

Characteristics Values
When to suction a newborn When a baby shows clear signs that suctioning is appropriate, such as increased oxygen needs, bradycardia and apnea, audible breathing, gasping or wheezing, and visible secretions or obvious difficulty clearing the airway.
How long to suction for 10 seconds or less.
How often to suction Limit suctioning to no more than four times a day to avoid irritating the nose.

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Suctioning is only necessary for newborns with respiratory distress or low Apgar scores

Suctioning is a procedure that can be used to clear a newborn's airway of fluids and mucus, making it easier for them to breathe. While it has been a standard practice for decades, the World Health Organization now advises against routine bulb suctioning of newborns. This is because the procedure can have serious consequences, and evidence suggests that it may be unnecessary for healthy newborns.

Routine suctioning is only recommended against when the baby is born through clear amniotic fluid and begins breathing on their own shortly after birth. However, suctioning is still necessary and beneficial for newborns with respiratory distress, low Apgar scores, or those struggling with the transition from fetus to newborn.

The Apgar score is a quick evaluation that a baby receives immediately after birth to determine if they need immediate medical care. The test measures a baby's appearance, pulse, grimace, activity, and respiration. A score of 7 or above is considered good, while a score of 4-6 is moderately abnormal, and a score of 3 or below is concerning and indicates a need for increased intervention. Low Apgar scores may be caused by a high-risk pregnancy, difficult labor or delivery, C-section births, or fluid in the baby's airway.

If a newborn is displaying signs of respiratory distress, such as increased oxygen needs, bradycardia, apnea, audible breathing, gasping, or wheezing, suctioning may be necessary to clear their airway. It is important to monitor the baby's vital signs before and after suctioning and to minimize the length of suctioning to 10 seconds or less to reduce the risk of complications.

In conclusion, while routine suctioning of newborns is no longer recommended, it is still a necessary procedure for those with respiratory distress or low Apgar scores to ensure their airways are clear and they are able to breathe effectively.

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The World Health Organization advises against routine suctioning of newborns

The World Health Organization (WHO) advises against routinely suctioning newborns in the minutes following birth. This is a break from the decades-old standard of care for newborns. The shift away from this practice is supported by evidence and an increasing number of hospitals.

The WHO recommends that if a baby is born through clear amniotic fluid and begins breathing on their own soon after birth, suctioning should be avoided. However, if the baby shows signs of respiratory distress, such as increased CO2 levels, bradycardia, apnea, audible breathing, gasping, or wheezing, suctioning should not be delayed. In such cases, the faster the suctioning is performed, the greater the likelihood of the newborn's survival.

Suctioning should only be performed when there are clear indications and should be limited to 10 seconds or less to minimize the risk to the newborn. It is important to monitor the baby's vital signs before and after the procedure and to be mindful of the differences in their airway compared to adults.

Additionally, it is recommended to keep the mother and infant together whenever possible. Skin-to-skin contact between the mother and baby can improve health outcomes, reduce stress, and help the newborn better regulate their body temperature during the transition from fetus to newborn.

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Suctioning should only be performed when clear indications are shown, such as increased oxygen needs or audible gasping

Suctioning a newborn is a standard procedure to remove fluids from the nose and mouth, helping them breathe, suck, and eat. However, it should only be performed when clear indications are shown that suctioning is necessary.

Firstly, if a baby is born through clear amniotic fluid and begins breathing on their own shortly after birth, do not suction. In such cases, suctioning is unnecessary, and the World Health Organization advises against it. Instead, simply wiping the baby's mouth and nose with a towel can clear excess secretions and stimulate respiration.

Suctioning should be performed only when a neonate shows clear signs that suctioning is appropriate. These signs include:

  • Increased oxygen needs: If the baby is struggling to breathe and requires additional oxygen, suctioning may be necessary to clear any blockages.
  • Bradycardia and apnea: Suctioning can help stimulate breathing by removing any fluids or mucus obstructing the airways.
  • Audible breathing, gasping, or wheezing: If the baby is making audible sounds of distress while breathing, such as gasping or wheezing, suctioning can help clear their airways.
  • Visible secretions or obvious difficulty clearing the airway: In cases where there are visible signs of mucus or fluid in the baby's nose or mouth, or if they are having difficulty clearing their airways, suctioning can provide relief.

It is important to weigh the risks and benefits of suctioning and to monitor the baby's vital signs before and after the procedure. Airway trauma, hypoxia, infection, and increased intracranial pressure are potential risks of suctioning, especially for neonates. Therefore, it is crucial to only perform suctioning when clear indications are shown and to prioritize alternative methods, such as wiping with a towel, whenever possible.

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Suctioning should be kept to 10 seconds or less to minimise risk

Suctioning a newborn is a standard procedure to remove fluids from a baby's nose and mouth. It is typically done when a baby is born through meconium-stained amniotic fluid or is experiencing respiratory distress. While suctioning can be life-saving in these situations, it is important to keep the procedure as brief as possible to minimise risk.

Suctioning should be kept to 10 seconds or less to reduce the potential for adverse effects. This is because the procedure can stimulate the vagus nerve, leading to bradycardia and lower Apgar scores. Additionally, a newborn's airways are fragile and easily damaged, so longer procedures may increase the risk of airway trauma.

To ensure the procedure is as safe as possible, it is recommended to hyperoxygenate the neonate before and after suctioning. This helps to minimise the risk of hypoxia. It is also important to monitor the baby's vital signs before and after the procedure, as well as to choose smaller equipment that is appropriately sized for their smaller, more narrow airways.

If the first pass of suctioning does not fully clear the airway, it is important to reoxygenate the neonate before attempting a second pass. This two-step process ensures that the baby's oxygen levels remain stable throughout the procedure.

By keeping the suctioning procedure brief and following the appropriate safety protocols, healthcare providers can effectively clear a newborn's airway while minimising the potential risks associated with the procedure.

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Suctioning a newborn's nose with a bulb syringe: squeeze the air out of the bulb, place the tip into a nostril, then let go to pull mucus out

Suctioning a newborn's nose is only necessary when the baby shows signs of respiratory distress, such as increased oxygen needs, bradycardia, apnea, audible gasping or wheezing, and visible secretions. If the baby is breathing normally and there are no signs of distress, suctioning is not required.

When using a bulb syringe to suction a newborn's nose, follow these steps:

  • Squeeze the air out of the bulb: Start by squeezing the bulb of the syringe to remove the air from it. This step creates a vacuum, which will help in suctioning the mucus.
  • Place the tip into a nostril: With the bulb squeezed, gently insert the tip of the syringe into one of the baby's nostrils. Ensure you only insert it about 1/4 to 1/2 inch into the nostril.
  • Let go of the bulb to pull out the mucus: Once the tip is in place, slowly release the bulb. This action will create suction, pulling the mucus out of the baby's nose and into the bulb.
  • Squeeze the bulb to empty it: After removing the syringe from the nostril, quickly squeeze the bulb into a tissue to expel the mucus. Ensure you do this over a tissue or sink to avoid any mess.
  • Repeat for the other nostril: If needed, repeat the process for the other nostril to ensure thorough suctioning.

It is important to note that you should limit suctioning to no more than four times a day to avoid irritating the baby's nose. Additionally, always clean the bulb syringe with warm, soapy water after each use to prevent the risk of infection.

Frequently asked questions

Limit suctioning to no more than 4 times each day to avoid irritating the nose. Minimize the length of suctioning to 10 seconds or less.

If your newborn's mucus is too thick to suction, you can thin it with saline or prescribed respiratory drops.

Do this before feeding them, but only if they seem congested. If done after feeding, suctioning may cause vomiting.

You can use a bulb syringe.

Airway trauma, hypoxia, infection, and increased intracranial pressure are especially dangerous to neonates, so weigh the risks and benefits and know the baby’s health history before proceeding.

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