I used to ask the same thing until I learned the truth when I studied nursing, at least in theories. Some of us may think it is an anecdotal representation that the movies use when depicting a baby’s delivery. The doctor would pull the baby out, tip him upside down, and slap him gently by his butt. The newborn will cry, and the mother will sigh out of relief, so the film goes. But why do doctors spank newborn babies really? Is the practice necessary, and is it still observed in the delivery room today?
Spanking of newborn babies is an old-school practice purportedly intended to startle the baby and get him to cry. Crying is important in a newborn to get him to stimulate his breathing. The very first breath that the newborn will take will drain the amniotic fluid from his lungs, replacing it with oxygen. The doctors will also hold the baby upside down to drain more amniotic fluid before cutting off his umbilical cord. However, this obsolete practice is not widely used anymore as some doctors fear the risk of injury in babies. It’s only the last resort if the doctor deemed that the baby does not respond to other stimulation to cry.
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Importance of the Baby’s First Cry
No matter how much you love your baby, there will be a point when his crying also gets you to a level of annoyance. But to your group of medical staff in the delivery room, crying babies are music to the ears. When we hear one, we can tell right away if he is fine or needs extra assistance.
How does a baby’s first cry sound like? It usually starts with a gurgling sound as he expels fluid out of his airways. Once he has taken in more air, the cry gets more stable and stronger. And that strong cry is probably how most moms would remember it as she gets reunited with her little one.
Crying is important to help your baby jumpstart his respiration process. It will let the team know that he is doing well transitioning from his mommy’s tummy into the outside world. He only has a small window of time to transition from the fetal processes – a minute (60 seconds) at most. As you know, inside the tummy, the baby does not breathe through his nose. He is totally dependent on his mother with gas exchange through the placenta.
Now when it is time to breathe on his own, he needs to do it immediately to fill his body with the fresh surge of oxygen. This step will help kick-start all of his bodily processes. Most babies do it naturally, impressing the medical team. But some may take a little while before crying, or what we call stunned baby. Newborn infants who fail to breathe within the 60-second time frame may require extra care and attention.
Stimulating Respiration Right After Birth
One of my friends who gave birth at a hospital recently retells her “expectation vs. reality” experience in childbirth. She said she was expecting her baby to be born with eyes closed, but he was not. Her baby was even sticking out his tongue and licking at his lips, crying his heart out. Like I’ve said about some film stereotype, she was also expecting the doctor to smack the baby’s butt. But she said all she could remember was, they only dry her baby out before laying him on her chest.
In this modern era, the spanking of a newborn baby is a frowned-upon idea. Not many doctors practice it anymore. In fact, I have not encountered doctors doing this technique in my entire nursing training. Spanking may hurt the baby, so gentler ways are practiced instead. Besides, there is no clinical evidence to show the benefits of smacking the baby. Although in dire cases, spanking of unresponsive babies may become the doctor’s last option to induce crying.
So what are the normal and gentle ways of stimulating babies to cry?
Drying is the most accepted form of stimulation that nurses do right after birth. Rubbing the baby with the towel alone will induce crying as a response. The rough texture of the towel against his sensitive skin should be enough to annoy your baby to cry.
So, basically, the nurses do not just wipe the baby just to clean him. They are eliciting a response from the baby while doing a clinical assessment or APGAR scoring of your baby. The APGAR score is the observation of his heart rate, respiratory effort, color, muscle tone, and reflexes.
Towel drying is also necessary to prevent rapid heat loss and keep your baby warm and comfy. Some hospitals practice drying the baby right by their mother’s chest or abdomen.
To aid your baby better in his breathing attempts, the pediatric team will also suction his nose and ears. It will help clear all secretions in his airways to allow him to breathe properly. But this is not a routine process. If your baby is already breathing well, there is no need to repeat the process. They will only wipe the excessive secretions with a clean towel.
The healthy and fit infants are then placed in their mother’s chest for kangaroo care. This skin-to-skin contact is also an important part of mother-and-child bonding. It will keep the baby warm and offer him more benefits for his psychological benefit later in life.
You can learn more about neonatal kangaroo care in this post.
What if the Baby is Not Breathing Well?
Your medical team is probably holding their breaths for that golden minute while waiting for your baby’s cry. By that period, your baby should establish his breathing, often manifested by his crying. Unfortunately, not all babies will breathe well at birth. Some may express gasping, or others do not breathe at all. These newborns, as assessed, will need some assistance to start breathing. They may need immediate resuscitation to establish their vital signs.
But moms, there is no need to freak out if you do not hear your baby crying at first. Some newborns were just distressed during the labor. For babies delivered via C-section, there is a tendency that you will not hear the wailing immediately. The general anesthetics may cause sedation of your baby, but sedated babies will usually respond well to recovery.
Take comfort from the fact that your medical team knows how to act within that minute to assist your baby. They also have all the necessary equipment to help them so.
Spanking as the Last Resort
If the baby does not respond to drying and suctioning, doctors may indeed resort to this classic method of spanking. It will trigger some pain or startle them and make them cry. Sometimes they may also massage the baby to get them to wail out.
So, if you have seen your doctor doing this, there is also no need to flip out. He is probably just doing the best he could to assist your baby’s breathing. If all of these efforts fail within a minute, your baby may spend a few more hours in the NICU. There, he will get his much-needed oxygen through artificial tubes. Some babies may need a bag or mask ventilation to supplement them with oxygen and establish their vitals. But most of them will turn out fine through supportive care.
Does crying tell something about the baby’s personality?
No, there are no studies to prove this. But the newborn’s first cry does tell something about their ability to breathe.
Is the delayed cry an indication of an unhealthy baby?
No. Most babies who do not cry at birth only need stimulation to start crying. Babies, especially those born via C-section or an assisted delivery, may get sedated and will not cry immediately after birth. They only need some help getting air into their lungs.
Should I be mad if my doctor spanks my newborn?
Well, spanking is a traditional method of getting babies to cry. Although this is not widely practiced anymore, there might be doctors who are still doing this. In an extreme situation, they may even resort to this technique. If you think you are not comfortable with it, talk to your doctor beforehand.
For moms and doctors, nothing is more musical in the delivery room than the reassuring wail of a newborn infant. The baby’s cry is his first important task to mark his successful transition as an independent individual from his mom’s tummy. Most babies are born crying their hearts out. The doctors will also perform methods like towel drying, suctioning, and massaging to encourage them to cry.
In some cases, doctors may even use the traditional spanking of the baby’s butt. Although not always practiced because of obsolescence, it is sometimes used in extreme situations. Once your baby proves to the medical personnel that he is well and okay, then he is also good to go. So good luck to the new moms for more crying on the block. Pretty soon you will be looking for crying prevention tips to mitigate it.
Ann Marie is a licensed nurse in the Philippines. She had experiences in handling and assisting deliveries of newborns into the world. She also used to train in labor rooms and pediatric wards – helping soon-to-be mothers and little kids in the process. Though not a mother by nature but a mother by heart, Ann Marie loves to take care of her younger cousins as well as nephews and nieces during her free time.