Hesperian Health Guides
Newborn Babies and Breastfeeding
Contents
Care Just After Birth
In the first hour after birth, you can help the survival and long-term health of a baby:
- Make sure she is breathing well.
- Keep her warm and dry, skin-to-skin with her mother.
- Help her start breastfeeding.
Is the baby breathing well?
As the baby is being born, and as you are drying her and putting her to her mother’s breast, check to see if she is breathing well. When you act quickly, you can usually save a baby who is not breathing.
 Strong legs and arms
Good color Breathing well, or crying |
 Limp, floppy
Dark red or purple, or turning blue, pale, or gray Struggling to breathe, or no signs of breathing or crying |
| This baby looks healthy. | This baby needs help fast. |
If the baby is limp, blue, or not breathing
Do not hit the baby.
- Clear mucus from the baby’s mouth by gently wiping it with your finger wrapped in a clean piece of cloth. Or use a bulb syringe or suction trap to get the mucus out of the mouth, then the nose.
- Rub firmly up and down the baby's back. Use a towel or clean cloth to warm and dry her at the same time. Rub across the bottom of her feet too. This should stimulate her enough that she should take a good, strong breath.
If the baby still does not breathe, or stops breathing, you must give rescue breathing.
Rescue breathing
- Lay the baby on a firm surface: a table or the floor. Keep a cloth under her and partially cover her so she stays warm.
- Lift the baby’s chin just a little, so her chin is tilted slightly up, toward the ceiling. It can help to put a small rolled-up cloth under her shoulders. This keeps her throat open for breathing.
- Open your mouth wide. Seal your lips over the baby's mouth and nose.
- Puff air into the baby. Use only small breaths. Give one small, quick puff of air every 1 or 2 seconds. Be careful not to blow too hard, or you can damage the baby’s tiny lungs.
After each puff, wait a moment for the baby to breathe out.
1 and…
Breathe.
If air does not seem to go in, stop. Lift the baby’s chin to be sure it is facing straight up and the throat is open. Then try again.If the baby starts to cry, or breathes at least 30 breaths each minute on her own, she is OK for now. Put her on her mother’s chest, and keep her warm. She will probably be fine. But watch closely for the next few hours. Is the baby a good color? Is she breathing easily? If the baby becomes blue around the body or mouth, or struggles to breathe, get help.
If after 20 minutes of rescue breathing, the baby does not begin to breathe on her own, she will probably die. Stay close to the family in this time of grief. They will need your attention and care.
 |
 |
|
The baby should face straight up, like this. |
Not like this. |
 Cover the circled area with your mouth. |
You can use a bag and mask instead of your own mouth. |
Keep the baby warm – on the mother's skin
with the mother.
The best place for a new baby is on her mother.
A new baby must be kept warm and dry. The mother’s own body heat will warm the baby. Do not take the baby away from the mother to examine or bathe it. The baby does not need a bath right away – and a bath can make the baby dangerously cold. There is no reason to separate the mother and baby – unless you must give rescue breathing.
- Dry the baby as you are putting her on her mother's skin.
- Warm the baby by putting her, naked, against her mother's bare chest. Then cover the two of them with a blanket or cloth. Quickly replace wet blankets with dry ones because wet cloth will chill the baby.
If the mother must be sent to the hospital, or for some reason cannot hold her baby right away, the father or another family member can hold the baby skin-to-skin.
Start breastfeeding
Babies tend to fall asleep within about an hour of birth. The baby should breastfeed before falling asleep. So if she does not nurse right away, try squeezing a few drops of the mother’s first milk onto her lips to get her interested. Or tickle the baby's cheek with the mother's nipple. Nothing ensures a baby’s health like breastfeeding. See more on breastfeeding and the importance of giving the first milk, called colostrum.
Early babies and small babies
A baby born early or small needs more attention.
- Early means born before 8½ months of pregnancy.
- Small means less than 2.5 kilos (5½ pounds).
Or just look at the baby: does it seem very small or thin?
These babies may need more help to start breastfeeding and to keep warm. They can more easily get infections and other health problems.
Keep the baby skin-to-skin, and wearing a hat to stay warm. Wake the baby to breastfeed once every 2 hours until she is strong and getting fat. If she has trouble breastfeeding, give her a little breast milk in a small cup or spoon. Women can learn how to remove milk by hand for cup feeding.