I know it's been a while since we talked about this, but I wanted to
address the question that came up about whether or not NRP has relevance
outside of the delivery room. I haven't worked in L&D for years, but I've
continued to keep up my certification since I transitioned to lactation in
1999.  I want to be prepared if a baby becomes unresponsive after birth.

The NRP book reads that "the physiologic principles and the steps you
should take to restore vital signs during the newborn period (first month
after birth) remain the same (p 7-21).  Some examples of babies who require
[NRP] beyond the immediate newborn period are a baby who develops apnea in
the nursery and a 2-week-old baby with sepsis who presents to the doctor's
office in shock.  (Hopefully moms wouldn't bring a baby that sick to an
outpatient lactation visit, but it could happen).

The next page goes on to describe a healthy newborn who breastfeeds
immediately after birth, and becomes apenic and unresponsive at 20 hours of
age.

Those of us who are eligible to be certified in NRP can assist in
resuscitation through temperature control and clearing the airway (at least
a bulb syringe) and ventilation with an ambu bag.  It was suggested that
basic CPR would be adequate, but the compressions for a neonate (first
month after birth) are 3 compressions to 1 (ventilation), but they are 5:1
in CPR.  If we used CPR, then our compressions wouldn't be performed at an
adequate rate.

Thanks for listening.

Joyce, RN, IBCLC

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