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In the specific fictional case, one that takes place in my novel, a baby is born medically unassisted at home, with only the mother and father present (so no midwife, doula, no EMS, etc.)

The baby had a nuchal cord, wrapped tightly, twice around their neck. Unable to move the cord, the father clamped and cut the cord - assuming less than a minute before the rest of the baby's body was born.

Immediately following the delivery, there is no cry. Baby is either taking shallow breaths or is reflexive breathing - otherwise needing assistance.

Assume any rubbing/tapping/flicking/spanking do not successfully stimulate the newborn to breathe properly and cry so another method of intervention is needed.

With no ventilation equipment (such as a bulb syringe or nasal/throat aspirator available) at hand, the father gives the child one or two small "rescue breaths" by means of pushing the air already in his cheeks into the mouth and nose of the child struggling to breathe.

Assume the breaths are effective and the baby begins to respond.

What is the MOST REALISTIC OR COMMON reaction that the newborn would exhibit after receiving successful rescue breaths?

Would two breaths suffice in most typical cases? How instantly would baby react - within seconds? Would the baby cough? Would a finger swipe in the mouth result in removing mucus/fluids? Would cries be initially faint/weak and crescendo or could it be strong?

Obviously, I know not all babies would react the same, I understand this, but there must be a textbook or typical reaction.

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  • Why should there be a cry? There is no need for a baby to make any vocalisation once it’s born. Really - get a birth assistant who knows what they’re doing. – rhialto Apr 23 '19 at 20:58
  • @rhialto The question is fictional. – Carey Gregory Apr 24 '19 at 1:37
  • @CareyGregory Are hypotheticals not permitted? – Margaret Belt Apr 24 '19 at 1:58
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    @MargaretBelt Yes, they are. I was simply explaining to hrialto that your question is hypothetical and getting a birth assistant isn't something that's practical. – Carey Gregory Apr 24 '19 at 2:04
  • @rhialto I'm writing a "second-Holocaust" dystopian novel and a midwife/OBGYN is not a choice that's not a feasible option. Although I'm aware a baby does not need to cry directly after birth, I've made it clear that the child is exhibiting respiratory distress. – Margaret Belt Apr 25 '19 at 1:48
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+50

If the cord is the only reason that prevents the baby to start breathing spontaneously and the baby is otherwise healthy then the situation could resolve as you assumed.

  • Two breaths could suffice, because they are needed only to initiate natural breathing and not to overcome any underlying disorder. Various resuscitation guideliness recommend 2 or 5 breaths and 30 chest compressions (nationwidechildrens.org), but in your scenario, compressions are not likely necessary.
  • The baby should start to breathe and cry within seconds thereafter (resus.org.uk). Crying can be loud from the start, as usually.
  • The mucus may not be a problem; some doctors advise against suctioning babies at birth, anyway (PubMed, 2104).
  • The baby could cough, but not necessary.

After starting breathing, the baby's color will change from blue/gray to pink within seconds, which can be very impressive (nzrc.org.nz).

This information is also from my observation of delayed onset of breathing after birth in a baby with a cleft palate.

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  • Thank you for such a thorough and article-based answer! I pride myself in realistic writing and you've helped so much! Thanks for the reassurance that I'm on the right path. You've earned the bounty – Margaret Belt May 1 '19 at 6:00

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