Help with suctioning neonate after delivery please!

sahm02 · Nov 29, 2009

Have you taken an NRP class that would really help with your questions. Deep Suction is with a catheter, usually an 8FR but it really depends on the size of the baby.. bulb suction is standard on any neonate at delivery.

beachmom · Nov 29, 2009

Bulb suction is standard, the mouth then the nose. We only deep suction if there is a reason. If baby is really moist, mostly we bulb suction often and get baby crying. Sometimes we deep suction to the top of the trachea, like if we are inserting an ET tube.

If we did PPV for awhile or CPAP or if baby is really spitty from swallowing amniotic fluid, we suction the stomach. Before inserting it, you measure the feeding tube from the mouth to the ear to the stomach. It usually is 22 cm or so. Then pass the tube and suction with a syringe. If you get a lot of air, empty the syringe and suck some more. I have seen the stomach emptied with wall suction, but that seems a bit harsh and harder to control. Whenever I have passed the tube, I have never once ended up in the lungs. The tube always ends up in the esophagus.

HOpe this helps.

NurseNora, BSN, RN · Nov 30, 2009

Remember that around the world, there are more babies born (and surviving) with no suction at all. It's not often a baby needs more than the bulb syringe. Positioning and encouraging crying is usually the only thing needed.

NRP and STABLE both discuss which size to use for what size baby. I'd advise those classes as soon as possible. It's likely that your department has the books for each wherever it keeps it's educational supplies. Check there.

Until then, be very wary of using a suction tube too soon after delivery. You'll Vagel the baby's heart rate down and cause more problems than you solve.

Talk with the other nurses you work with, talk with the nursery nurses. You have lots of resources immediatly available to you.

CEG · Nov 30, 2009

The hospital where I worked as an L & D nurse delee'd each and every baby. Totally unnecesary and probably harmful in a lot of cases. Now that I am a CNM I don't even bulb suction unless there is some reason. Just wipe the baby's face and let them work out anything that needs to be worked out. I try not to mess with things. And imagine if someone stuck that bulb syringe up your nose- not comfy!

Stardust 1 · Nov 27, 2014

I work at deliveries for > 30 years. I follow NRP. NRP recommends bulb suctioning ONLY. With an infant at delivery transitioning their circulation, putting anything in the back of their throat can cause a vagal (slowing of heart beat and respirations - increased heart rate and respirations are important for adequate pressures to allow for the sophisticated circulatory transitional changes). If a vagal occurs from suctioning, this can cause the infant to have their transition from intrauterine to extrauterine circulation interrupted and then the infant will/can end up being admitted to the NICU. This is unnecessary and heartbreaking for the parents. I find the main problem is no one actually reads/studies the NRP book and CD at the back of the book (case studies) and they just do what the instructor says who also hasn't read the book.

klone, MSN, RN · Nov 27, 2014

Zombie thread!

Editorial Team / Admin · Nov 27, 2014

Please note that thread is >5 yr old and standard practices change.

cayenne06, MSN, CNM · Nov 30, 2014

lol, I am so glad this thread is old! I was ready to get all up in arms that everyone was still doing routine bulb suction!

Don't suction neonates unless there is a clear indication. It is actively harmful to do so.

Elvish, BSN, DNP, RN, NP · Dec 2, 2014

I can think of maybe one time in the last 6 months that I bulb suctioned a baby. We just don't do it anymore, though the docs still hand us the bulb off the delivery table like we're going to use it. Stim and wipe their faces, put them on mom to splint the chest and let the fluid work its way out. Easy peasy. If a kid needs deep suction, I call NICU to come eval. I'm not doing it.