NRP instructor here.

No routine suctioning at the perineum, only suction when required,  
only suction for meconium if the baby is not vigorous.  Before these  
changes, we used to set up suction to be used at the perineum, this is  
no longer done.  I no longer work in LDR but when I did work there the  
surgeon had suction set up for the baby to use at delivery of the  
babies  head at cesarean.  The nurse who took the baby to the warmer  
did not use suction until the baby was under the warmer, then it was  
used as needed (usually more than needed).  I am not sure what is  
happening now.

When I was doing midwifery training in the UK, the person who took the  
baby from the surgeon, used delee suction, we didn't have separate  
suction set up for the doctor to use.  It wasn't all that pleasant to  
use and I suspect that with universal precautions, delee suction could  
pose some risk and should only be used when other alternatives are not  
available.

If you need more info, please email me.

Cordelia Merritt RN BSN IBCLC

The reason for the change is that there is no good evidence that  
routine suction is helpful and that it can be harmful.
On Aug 26, 2009, at 9:00 PM, LACTNET automatic digest system wrote:

> Date:    Wed, 26 Aug 2009 22:25:57 -0500
> From:    laurie wheeler <[log in to unmask]>
> Subject: delee suctioning
>
> Perhaps look into the evidence-based neonatal resuscitation program  
> (NRP)
> which is updated periodically. Perhaps you have an NRP instructor in  
> your
> facility or region. You might even be able to contact one or more of  
> the
> national board members (if they have a board or some governing body of
> sorts), especially another pediatrician, which might pull more  
> weight with
> your new doctor. NRP I believe teaches to clear the airway by  
> suctioning
> with a bulb or even just wiping secretions if needed, and to NOT  
> suction
> vigourous babies, even with meconium. The last time I took it the  
> instructor
> promoted immediate skin to skin contact, and assessment of the baby  
> on the
> mother, unless baby was in trouble.
> Laurie Wheeler RN MN IBCLC
> Mississippi USA


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