OVERVIEW

What is neonatal asphyxia?

Neonatal pulmonary asphyxia is a condition where newborns fail to initiate spontaneous breathing or establish regular respiration within the first minute after birth due to various causes occurring before, during, or after delivery, resulting in hypoxia and subsequent multi-organ dysfunction.

SYMPTOMS

What are the manifestations of neonatal asphyxia?

• Abnormal skin color: Cyanosis or pallor.

• Abnormal heart rate: Slow heart rate, less than 100 beats per minute.

• Abnormal breathing: Weak crying, weak breathing, or no breathing.

• Limb tone: Limbs feel floppy with little or no resistance during movement.

• Abnormal response: Weak or no reaction to external stimuli, including pain.

Is it abnormal for a newborn to sleep all the time?

Newborns in their first few days normally sleep most of the time, even up to 20+ hours a day.

Is it normal for a newborn to cry sharply when touched and refuse to feed?

No, this indicates abnormal neurological excitement, suggesting possible hypoxia or asphyxia, requiring close observation.

What are the risks of neonatal asphyxia?

It mainly causes brain damage, leading to short-term symptoms like convulsions and coma, and long-term conditions such as intellectual disability, cerebral palsy, motor disorders, and epilepsy.

It can also damage multiple organs, including the heart, kidneys, liver, and adrenal glands.

Why do some newborns show abnormalities only 2-3 days after asphyxia?

Because brain cell damage from asphyxia often peaks 2-3 days later, making symptoms more apparent.

Is it serious if a newborn turns cyanotic after choking on milk?

If cyanosis is brief and the baby quickly recovers with normal breathing, color, and feeding afterward, it’s usually not a major concern. However, if cyanosis persists or spreads (e.g., red torso with purple limbs or full-body redness), seek immediate medical attention.

What are the signs of neonatal asphyxia?

Symptoms vary from mild (barely noticeable) to severe (coma, convulsions, high-pitched crying, refusal to feed, cyanosis, or grayish pallor).

Does neonatal asphyxia affect intelligence?

Not always. Due to strong self-repair abilities, most mildly affected newborns recover fully. However, severe cases (e.g., repeated convulsions, prolonged coma) have a higher risk of long-term disabilities.

Does neonatal asphyxia weaken the baby’s constitution?

Not necessarily.

If the baby recovers and shows normal growth and development, their constitution will be like any healthy child’s.

CAUSES

What factors generally cause asphyxia in the mother's womb?

• Maternal conditions: The mother has hypertension, diabetes, severe anemia, heart disease, infections, drug abuse, or medication use.

• Fetal abnormalities: The fetus has congenital diseases.

• Other factors: Placental abnormalities or umbilical cord abnormalities.

Can neonatal asphyxia occur during birth?

Yes, it can be caused by dystocia, excessive fetal weight, placental abnormalities, intrapartum hemorrhage, preterm birth, precipitous labor, meconium-stained amniotic fluid, nuchal cord, or meconium aspiration.

What is preterm birth?

Preterm birth refers to the delivery of a fetus before 37 weeks of pregnancy. Generally, the earlier the preterm birth, the less mature the fetus.

What is precipitous labor?

Precipitous labor is when the entire process from the onset of regular contractions to the delivery of the baby lasts less than 3 hours.

Under what circumstances does neonatal asphyxia commonly occur?

Postnatal asphyxia is often seen in severe respiratory diseases, such as severe pneumonia, as well as apnea in preterm or low-birth-weight infants, or severe choking during feeding.

Will a fetus with a nuchal cord definitely experience asphyxia or hypoxia?

Not necessarily. If the cord is loosely wrapped and not tight, it may have no effect on the fetus. However, the possibility of asphyxia or hypoxia should be monitored closely by observing fetal movements and heart rate.

Why are preterm babies more prone to asphyxia?

Because preterm infants often have lower birth weights and immature organ functions, including the brain and respiratory system, making them more likely to experience abnormal breathing and hypoxia after birth.

Why is neonatal asphyxia more common in macrosomic infants?

Because macrosomic infants (weighing ≥ 4 kg) are more likely to experience high-risk factors for asphyxia during birth, such as dystocia, which increases the risk of asphyxia.

DIAGNOSIS

What tests should be performed when neonatal asphyxia occurs?

Generally, blood tests (such as blood glucose, electrolytes, complete blood count, liver and kidney function) are required to assess whether the functions of various organs and systems are normal. Additionally, brain conditions can be evaluated through tests like cranial CT, MRI, or electroencephalogram (EEG).

How is the treatment effectiveness of neonatal asphyxia evaluated?

• First, the severity of the asphyxia at the time of occurrence must be assessed, as this largely determines the recovery outcome after treatment.

• Second, preliminary evaluations of brain conditions can be conducted through tests such as cranial MRI and EEG.

TREATMENT

After neonatal asphyxia, if the baby appears normal, is hospitalization still necessary?

Yes.

Because some symptoms of neonatal asphyxia may not be obvious immediately after birth and can develop gradually, hospitalization for observation is safer for the baby.

How should neonatal asphyxia be managed?

After neonatal asphyxia occurs, the airway should be cleared as soon as possible to ensure it remains unobstructed. If the baby has weak or absent breathing, stimulation (such as tapping the soles of the feet) should be provided to restore breathing promptly, and medical attention should be sought immediately.

Which department should be consulted for neonatal asphyxia?

If signs of asphyxia appear in a newborn, they should be taken to the pediatric department of the nearest hospital immediately.

What treatments are available after neonatal asphyxia?

• First, monitor and ensure the normal function of vital organs such as the respiratory system, heart, and kidneys. Severe cases may require oxygen therapy, ventilator assistance, intravenous nutrition support, etc.

• Second, control symptoms of brain damage, such as seizures.

• Third, after the condition stabilizes, medications to nourish brain cells may be administered to promote recovery of damaged brain tissue.

How long does hospitalization for neonatal asphyxia typically last?

The duration of hospitalization for neonatal asphyxia often depends on the severity of the condition. For mild cases, it may be around one week, while severe cases may require two weeks or longer.

DIET & LIFESTYLE

Can neonatal asphyxia be prevented by refusing vaginal delivery?

No.

Difficult labor during vaginal delivery may lead to neonatal asphyxia, but vaginal delivery helps newborns quickly establish normal breathing after birth. Some newborns delivered by cesarean section may develop wet lungs due to the lack of compression from the birth canal, leading to transient breathing difficulties. Additionally, cesarean sections carry surgical and anesthesia risks, which may also cause neonatal asphyxia. Therefore, vaginal delivery is still the preferred choice when medically indicated.

Can a newborn with asphyxia be fed normally?

No.

Neonates with asphyxia often experience concurrent gastrointestinal injuries. Mild cases may involve vomiting or bloating, while severe cases can lead to hematemesis, bloody stools, or intestinal necrosis. Therefore, feeding should be approached cautiously after asphyxia, and the feeding method should be determined based on the severity of asphyxia and the condition of the gastrointestinal tract.

What should be noted after a newborn with asphyxia is discharged from the hospital?

Close attention should be paid to the baby's growth and development, particularly brain development. Regular follow-ups at the pediatric health clinic or neurology department are recommended. If necessary, periodic head MRI and EEG examinations should also be conducted.

PREVENTION

How to prevent suffocation when the fetus is still in the mother's womb?

• Parents should undergo a medical examination before conceiving, especially the mother, as a healthy physical condition is the foundation for giving birth to a healthy baby.

• After confirming pregnancy, regular and scheduled prenatal check-ups are essential to detect and address issues early.

• In the third trimester, pregnant women should monitor fetal movements daily. If any abnormalities occur, seek medical attention immediately.

How to prevent neonatal asphyxia during delivery?

Every childbirth is a challenge for both the fetus and the mother, with potential risks such as dystocia and severe bleeding. Pregnant women and their families should be mentally prepared, cooperate fully with doctors, and trust their expertise. Unreasonable demands or interference may harm both the baby and the mother.

How to prevent neonatal asphyxia after birth?

When caring for a newborn, pay attention to signs such as rosy complexion, normal breathing, proper feeding, and alertness while awake. Seek medical help immediately if any abnormalities are observed. Breastfed infants should avoid the habit of sleeping while sucking on the nipple to prevent suffocation during sleep.