Neonatal Resuscitation

Publication Date: November 16, 2023
Last Updated: January 19, 2024

Top 10 Take-Home Messages for Neonatal Resuscitation

  1. For term and late preterm newborn infants ≥34 weeks’ gestation who do not require resuscita-tion, delayed cord clamping (≥30 seconds) can be beneficial compared with early cord clamping (<30 seconds).
  2. For term and late preterm newborn infants ≥34 weeks’ gestation who do not require resuscitation, intact cord milking is not known to be beneficial com-pared with delayed cord clamping (≥30 seconds).
  3. For nonvigorous term and late preterm newborn infants (35–42 weeks’ gestation), intact cord milking may be reasonable compared with early cord clamp-ing (<30 seconds).
  4. For preterm newborn infants <34 weeks’ gesta-tion who do not require resuscitation, delaying cord clamping (≥30 seconds) can be beneficial com-pared with early cord clamping (<30 seconds).
  5. For preterm newborn infants between 28 and 34 weeks’ gestation who do not require resuscitation and in whom delayed cord clamping cannot be per-formed, intact cord milking may be reasonable.
  6. For preterm newborn infants <28 weeks’ gesta-tion, intact cord milking is not recommended.
  7. Effective positive-pressure ventilation is the priority in newborn infants who need support after birth.
  8. Using a T-piece resuscitator to deliver positive-pressure ventilation is preferred to the use of a self-inflating bag.
  9. Because both T-piece resuscitators and flow-inflating bags require a compressed gas source to function, a self-inflating bag should be available as a backup in the event of compressed gas failure when using either of these devices.
  10. Use of a supraglottic airway may be considered as the primary interface to administer positive- pressure ventilation instead of a face mask for new-born infants delivered at ≥34 0/7 weeks’ gestation.

Term/Late Preterm Newborn Umbilical Cord Management

For term and late preterm newborn infants ≥34 weeks’ gestation who do not require resuscitation, delayed cord clamping (DCC) (≥30 seconds) can be beneficial when compared to early cord clamping (<30 seconds). (IIa, B-R)
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Overview

Title

Neonatal Resuscitation

Authoring Organizations

American Academy of Pediatrics

American Heart Association