I have been following this "suction" thread with much interest and would
like to broaden the picture that many of you have.  I have also been
following the line of discussion on RN background for IBCLC and would like
to bring a point from that discussion to this one  - that is that the
background we bring to the situation likely influences what we see in that
situation.

I'm just finishing up a very busy month as a resident in Newborn
Nursery.(Must have been a cold March last year) As the NBN resident my job
includes examining and admitting all the newborn nursery babies as well as
going to uncomplicated c-section deliveries and regular full term gestation
vaginal births where they feel some minor resuscitation may be needed.

To attend these deliveries I had to be trained/pass an  exam and practical
demonstration on Neonatal Resuscitation.  It is set up by the American
Academy of Pediatrics and the American Heart Association.  If any of you
have taken ACLS [Advanced Cardiac Life Support] or PALS [Pediatric Advanced
Life Support] it is similar to that but deals with the initial
resuscitation of a newborn.

It deals with ABC's [airway breathing circulation] and the mechanical and
medical means necessary to support infants who for one reason  or another
are not breathing or don't have adequate cardiac circulation.  It also
deals with the proper resuscitation of a baby who has passed meconium at
some point prior to delivery. Meconium is that tarry sticky dark first
bowel movement that babies have.  If and infant has been "stressed" before
birth it can cause relaxation of the anal sphincter and meconium flows into
the amniotic fluid.  Babies do "breathe" amniotic fluid in utero and a
distressed baby may have "gasping" respirations.

As a part of the "A for Airway" in a Non-Meconium baby, the guidelines are
to use a bulb syringe  or mechanical suction to suction the mouth first
then the nose.  What ever is in the mouth can be aspirated into the lungs
when the baby first begins to breathe.  There is no mention of suctioning
out the stomach when there is no meconium present.

Continued with Part 2
Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications