How do you clear a newborn's airway?

[kythe, LPN]

Hello everyone! I've been an LPN in LTC for 6 years now and though I've been trained as a doula, I have never worked in L&D. So I have a question for all of you more experienced people. :)

I was recently in an online discussion with some people over the issue of clearing a newborn's airway. Someone asked why doctors hold babies by the ankles and spank them. Most people replied that it is the best way to drain fluid from the lungs and clear their airway.

I wrote what I *thought* was a rationale I remembered from nursing school, but I was completely torn apart over it. I thought this hasn't been a common practice since the 1950's and 1960's because dangling babies causes whiplash and spinal problems since they need to be supported. Also, spanking their bottom doesn't stimulate the lungs - it only surprises the baby.

The lungs aren't empty sacs that fill with air, or water to be drained by simply being tipped over. The alveoli look more like broccoli branches, and the best way to clear them is through vigorous rubbing on the chest and back, and oral suctioning. And this is all I've seen at the hospital births I attended during nursing school.

But it seems the practice of holding a baby upside down and spanking it is still common.

What are your experiences?

[bagladyrn, RN]

Not sure where you are getting the idea this is a common practice. 25+ yrs. of OB at multiple (many) facilities and I've never seen this done (Outside of old black and white movies!)

[OB-nurse2013, BSN, RN]

I've never seen this done or heard of it being done. Even from the older, more experienced nurses on my unit.

[klone, MSN, RN]

I think that practice was done, like, 50 years ago. I have NEVER seen a doc do that. I've just heard about it in stories of "isn't that crazy they used to do that??"

[klone, MSN, RN]

And in answer to the question posed in the title, you clear the infant's airway by first, letting them cry spontaneously. If they're not, or there's a lot of gunk, you use a bulb syringe to suction out the nose and mouth cavity. If there is meconium and the infant is not crying, then they will use a meconium trap and deep suction with a small tube that actually goes down the trachea.

[klone, MSN, RN]

Hey, I tried PMing you but it said your box is full. :)

[kythe, LPN]

Ok, I tried to clean out my pm's - something I think I haven't done since joining the site years ago.

Maybe I should stop second-guessing myself based on what random people on the internet say. I should probably hang out here more, I would get a better education.

[DalekRN]

I'd sue if someone held my newborn by the ankles and spanked them... Can't believe that was ever common practice.... o.O

[Elvish, BSN, DNP, RN, NP]

Yeah, no spanking at my place either.

[NicuGal, MSN, RN]

Almost 30 years and never seen that except on TV!