We can stop routine suctioning at birth!

I never understood why it was thought to be so important, (indeed by some essential) to stick some sort of suctioning device into the babies mouth, usually right back to the posterior pharyngeal wall, and suck out amniotic fluid. It was as if we thought that despite many millions of years of evolution, human beings were not capable of surviving unless someone sucked out their upper airways after birth. Most mammals do not have access to suction devices at birth, yet surprisingly most of them survive regardless. Fortunately Wally Carlo’s team (does he ever sleep?) have just shown that babies who only have their face wiped (which I guess is analogous to the facial licking that a lot of mammals do) have a clinical outcome that is just as good as babies who get induced vagal stimulation oropharyngeal suctioning by caregivers. We already know that routine suctioning increases bradycardia, now we know that it doesn’t have any routine advantages. Let’s stop. Kelleher J, Bhat R, Salas AA, Addis D, Mills EC, Mallick H, et al. Oronasopharyngeal suction versus wiping of the mouth and nose at birth: a randomised equivalency trial. The Lancet. 2013(0). Of note the current recommendations from several bodies have already abandoned routine suctioning in infants born at term with clear amniotic fluid, but that recommendation was based on very little data, this new trial gives a lot more force to that recommendation. I think we can move from not recommending routine suctioning, to recommending against it.

About keithbarrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
This entry was posted in Neonatal Research and tagged , . Bookmark the permalink.

3 Responses to We can stop routine suctioning at birth!

  1. MOBianchi says:

    What about mec stainned secretion and vigorous newborn, wouldn’t be the same? If the baby does not need help, just stop “helping” then.

  2. You may be right, I also think we need to rethink the standard definition of ‘vigorous’. If the baby is breathing with a good heart rate, does it matter if they are a bit hypotonic? They will soon get their tone back, if you leave them alone and stop stimulating bradycardias.

  3. Pingback: Suctioning the Airway of a Baby at Birth: Outdated and Possibly Dangerous | Blog - My Baby's Heartbeat Bear

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