Questions?
It can be overwhelming to hear that your baby needs oxygen therapy after birth. As a nurse who cares for newborns at delivery, I have heard the worry, the questions, and the sadness from parents who don’t understand what is happening to their baby.
Oxygen therapy does not always mean something went wrong, but some parents may later learn their baby’s breathing problems were connected to a birth injury or delivery complication.
I want to bring some clarity and understanding to why a baby would need oxygen immediately after birth, describe the equipment used for this therapy, and help you understand what the nurses are monitoring.
Our on-staff nurses can listen to your concerns and help explain your baby’s oxygen therapy after delivery.
Why Your Baby Might Need Oxygen and Breathing Support
A baby may need oxygen therapy after birth if they are not breathing well enough on their own or their oxygen levels are too low.
During pregnancy, the placenta supplies the baby with oxygenated blood. After a baby is born, their crying helps to open up their lungs and transition to independent breathing for adequate oxygenation.
However, there are many reasons that can cause a newborn to not receive enough oxygen on their own, resulting in the need for supplemental oxygen to be given to them.
- Block in the airway: If a baby passes their first stool before delivery, they have the risk of inhaling meconium into their lungs, causing respiratory distress.
- Fluid in the lungs: Often following a C-section, because the baby does not go through a natural squeezing exiting the birth canal, there can be temporary respiratory issues due to excess fluid in the lungs.
- Infection: Respiratory distress symptoms, such as breathing too fast or working too hard to breathe, are often one of the first signs of an infection.
- Low oxygen during labor: Problems with the placenta or maternal complications during labor, like bleeding, can cause the baby to receive less blood or oxygen before birth, leading to fetal distress.
- Premature birth: Babies born before 37 weeks gestation have a risk of low oxygen levels because of underdeveloped lungs. The earlier the birth, the less surfactant a baby will have. Surfactant is a substance that keeps the lungs open and prevents them from collapsing. Premature babies also have an underdeveloped brain that helps to regulate breathing, while also having weaker muscles.
Not every baby will need the same type of oxygen support. Some babies only need a small amount of oxygen, while others need more breathing support right away after delivery.
Oxygen Therapy Delivery Devices Used After Birth
After a baby is born, the nurses will assess what oxygen therapy delivery method your baby will need. If the breathing complications are expected from the mother’s history, such as a known brain anomaly or prematurity, the doctor may be prepared to intubate the baby after delivery.
This means that they are anticipating the baby not being developed enough to breathe on their own, so they will place a breathing tube in their airway to provide breaths and pressure for adequate oxygenation.
Oxygen Mask
In most situations, the nurse will initially provide oxygen through a mask that goes over the baby’s nose and mouth. This mask also provides pressure to help keep the lungs open.
Some babies may be breathing on their own but need support bringing up their oxygen levels right after birth, so they may just need the mask to temporarily supply oxygen to help them transition from birth to life.
Nasal Cannula
If continued oxygen is needed to keep the baby’s levels stable, a nasal cannula (tube with two short prongs that go into the nose) is used.
Breathing Tube and Ventilator
If your baby is born and is not breathing independently or is not taking enough breaths, the nurse will give the baby breaths through the mask. Sometimes a baby will begin breathing on their own after some support is given.
However, if the nurse needs to give your baby breaths for more than just a temporary period right after birth, the doctor will place a breathing tube for prolonged support.
For these babies, they will be transferred to the NICU for a mechanical ventilator to give breaths to the baby instead of the nurse delivering them by hand.
What the Nurses Are Monitoring for Oxygen Therapy
After a baby is born, the nurse will quickly examine the baby to see if they need any breathing support. Nurses are watching how the baby looks, breathes, moves, and responds right after delivery.
1. Initial Signs After Birth
Babies who do not need oxygen support have strong cries in the first minute of life, good tone or muscle contraction, a strong heart rate above 100 beats per minute, and responsive reflexes. They transition from a blue skin tone to a pink skin color by five minutes of life.
Babies who do need oxygen support may not cry, have slow breathing, or have a weak cry. More signs that a baby needs breathing support include weak muscle tone, a slow heart rate, weak or absent reflexes, and an unchanging dusky, blue skin tone.
A baby’s Apgar score helps nurses and doctors check breathing, heart rate, muscle tone, reflexes, and skin color right after birth.
2. Response to Oxygen Therapy for Babies
A nurse is monitoring the baby for these signs consistently while there are signs of distress. In most cases, if a baby is being well oxygenated with proper breathing support, the baby’s heart rate and oxygen levels should increase and stabilize. The nurse will see good chest movement, and the skin color will become pinker.
A baby showing signs of distress may need oxygen, closer monitoring, or additional breathing support after delivery.
3. Weaning or Continued Support
If the baby stabilizes, the nurse will wean the baby off or pause respiratory support to see if the baby’s breathing and oxygen levels remain stable.
If so, the baby is okay to be free from oxygen therapy, but will remain closely monitored for changes. If not, oxygen therapy will need to be continued until the baby can breathe independently and hold their good oxygen levels.
If the baby is transferred to a NICU for breathing support, the weaning and monitoring process is slower and more involved.
Get Birth Injury Legal Help
It can be scary and overwhelming watching your baby need breathing support. Sometimes the nurses have an idea of what is causing the distress, and other times, more tests need to be done to confirm what is happening.
A chest X-ray should be ordered for any babies needing continued oxygen therapy after delivery. The doctor might also order labs to help give insight into the infant’s health, such as screening for low blood sugar levels and infection. The goal is to see your baby healed, healthy, and able to go home without complications!
But what do you do if you feel like the doctors and team that were meant to help your baby, heal their distress, and prevent harm, in fact did the opposite? It is heartbreaking to feel like your baby’s distress could have been prevented with proper care before, during, or after birth.
This should never occur, and you deserve answers and justice for you and your child. If you feel like your child was diagnosed with a birth injury that could have been prevented, reach out to our team today. Taking legal action can help you provide for your child’s future.
Call us right now at (800) 914-1562 or fill out our case review form to see how we can help you get the care and support your child deserves.
