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Wiping Is as Effective as Suctioning in the Delivery Room

August 20, 2013

Wiping Is as Effective as Suctioning in the Delivery Room

  1. Robin Steinhorn, MD

In low-risk newborns, wiping the nose and mouth is as effective as bulb suctioning to clear the oropharynx of secretions.

  1. Robin Steinhorn, MD

The current Neonatal Resuscitation Program (NRP) guidelines indicate that nasal or oral suctioning of healthy neonates is not required after delivery and that these interventions should be reserved for infants with obvious obstruction to spontaneous breathing. In addition, small trials have shown that suctioning of the mouth and nose is not necessarily a benign practice and can lead to complications such as bradycardia and apnea.

In a randomized study involving 506 low-risk neonates, investigators at the University of Alabama compared routine wiping versus suctioning with a bulb syringe in the delivery room. Infants with depressed muscle tone or respiration or meconium-stained amniotic fluid were excluded.

The primary endpoint of respiratory rate at 24 hours after birth was equivalent between the wipe and suction groups (51 and 50 breaths per minute, respectively). Secondary outcomes of Apgar score, need for advanced resuscitation, and tachypnea were also similar between the two groups. A nonsignificant trend toward higher admission rates to the neonatal intensive care unit was noted in the wipe group (18% vs. 12%; P=0.07).

Comment

These findings confirm the Neonatal Resuscitation Program guideline stating that routine wiping of the nose and mouth is as effective as bulb suctioning to clear the oropharynx of secretions in the delivery room. In this study, infants were low risk; most were already vigorous and may not have required suctioning or wiping to initiate breathing. Wiping avoids the risks for bradycardia and injury from more invasive suctioning and can be easily used in resource-limited settings.

Dr. Steinhorn is Professor and Chair of Pediatrics, University of California Davis Medical Center, Sacramento.

Citation(s):

Reader Comments (1)

Kojo Ahor-Essel MD,DCH,MGCP Physician, Pediatrics/Adolescent Medicine, Sunyani,Ghana

It is interesting to know this but how was the wiping carried out? Can it be described?

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