Care of the premature infant immediately after birth

At birth, the premature infant is immediately:

• Moved onto a nearby bed with an overhead radiant heater.
• Dried off to prevent chilling (hypothermia).
• Assessed for heart rate, breathing, and color, which determine the initial medical interventions required.

If the infant is having trouble breathing:

• The airway may be cleared (suctioned).
• The lungs may be expanded using a bag and mask, which blows air into the lungs.
• Oxygen may be blown over the infant's face, given by face mask, or in severe cases, given through a tube in the throat (intubation).
• An umbilical catheter may be inserted into the umbilical cord stump to provide fluids and/or medications intravenously.

If the infant has no pulse, the heart may be stimulated with:

• Chest compressions (gently pressing on the infant's chest).
• Medication, if 30 seconds of compressions are not effective. If medication and compressions do not successfully stimulate a viable heart rate after 15 to 20 minutes, resuscitation is stopped.

As soon as heart rate and breathing are stable, the infant is moved to the neonatal intensive care unit (NICU).