Fig. 88.—Birth of the head immediately followed by external rotation.
Fig. 89.—Wiping mucus from baby’s mouth with gauze wrapped about little finger.
Immediate Care of the Child. After the baby has been brought safely into the world, it is of greatest possible importance to make sure that it begins its separate existence by crying lustily, in order fully to expand its lungs. This provides for oxygenation of its blood, which has taken place, until now, through the placental circulation. In many cases the baby cries satisfactorily without aid, but not infrequently must be stimulated to do so. In all instances the first step is to clear the air passages of the mucus lodged in the mouth and throat, by some one of the many approved methods. One is by means of a piece of wet sterile gauze wrapped about the little finger, and wiped gently about in the back part of the baby’s mouth (Fig. [89]), though many doctors object to this procedure for fear of abrading the very delicate mucous membrane, no matter how lightly it is done. They prefer to hold the baby by its feet, with the head hanging down and the neck sharply curved backward, when by gravity the mucus will drop out of the mouth; or, holding the baby by the feet, to run the thumb and forefinger along the neck on either side of the trachea, toward the mouth, and force out the mucus in that way. If the baby does not cry well after the mucus is removed, it may usually be stimulated to do so if held by the feet, head downward, and the back gently rubbed (Fig. [90]) or the face stroked or the buttocks spanked two or three times. When holding the baby in this position the nurse should slip one finger between the ankles and grasp them firmly.
Fig. 90.—Stroking baby’s back to stimulate respirations.
After the baby has cried well it may be laid on the foot of its mother’s bed. At this juncture it seems pertinent to stress two points which must be remembered throughout the entire routine of the baby’s care, namely: the importance of protecting it from infection and from being chilled. As the baby lies on the mother’s bed, before the cord is cut, it finds itself in a room which is many degrees cooler than the very warm habitat from which it has just emerged; it is struggling to establish its functions, which are suddenly deprived of the mother’s help, chief of which at the moment are respiration and the circulation. Body warmth is one of the most valuable aids in promoting an even circulation, and accordingly the baby should be kept warm from the beginning. For this purpose there should be a small sterile blanket, or piece of flannel, in readiness to protect the little body as it lies on the bed, awaiting further developments. The hands and feet of the newborn baby that lies uncovered for even a quarter of an hour, or more, are nearly always cold, and as this must be guarded against in an older, more securely established baby, it cannot be desirable for the newly born.
Fig. 91.—Showing two clamps on cord after pulsation has ceased.
