October 3, 2023

Anthony Ademiluyi  

Paediatricians have expressed mixed reactions on whether a newborn crying or not crying immediately after childbirth is a serious cause for concern.

Speaking with Reportr Door HealthWise in separate interviews, the experts disagreed on the significance of a first baby cry, especially on the notion that the cry is a confirmation that the newborn is healthy.

While one peadiatrician opined that a newborn not crying only becomes an issue when the baby is not breathing, another child care expert said the first cry of a baby is critical for the normal functioning of the infant’s brain.

Speaking with our correspondent, the childcare experts, Consultant Paediatrician/Neonatologist, Federal Medical Centre, Yenogoa, Bayelsa State, Dr. Urire Idholo, and Consultant Paediatrician, Federal Medical Centre, Birnin Kudu, Dr. Umma Idris, while disagreeing on the need for a newborn to cry immediately after birth, however, agreed that the first cry could be an important sign about the health of the baby.

Speaking with Reportr Door HealthWise, Dr. Idholo said that when a baby is in the womb, the lungs are not used as the mother supplies oxygen to the child through the placenta.

She, however, noted that when a baby is born, especially within the first minute after delivery, the cry enables the lung to expand to enable it to send the fluid within out so the lung can be used effectively to exchange oxygen.

She said, “Doctors are worried when a baby does not breathe because the effectiveness of oxygenation or breathing can be compromised resulting in complications known as Perinatal Asphyxia. This implies hypoxia which is the shortage of oxygen and ischaemia which means inadequate blood supply affecting most organs of the body. The worst hit is the brain called hypoxic ischaemic encephalopathy whose long-term consequence is cerebral palsy.

“Other organs that could be affected are the kidneys resulting in kidney failure, the lungs, heart, digestive tract, etc. If the baby is breathing well and is looking pink and responding when stimulated, we would not bother so much about the cry. The baby would definitely cry when stimulated. We often start assessment one minute after birth. If other parameters are there and okay, there is no problem.

“That a baby cries after birth does not also mean all is well. Some may cry and still aspirate after birth and stop breathing. The same complications will occur. So, it is possible for a healthy newborn baby not to cry. With stimulation, they pick up. The cry is not our focus. Heart rate, respiratory effort, and colour are our focus. We just keep them warm. No beating, or turning them upside down. So, a baby should cry after birth but the absence of a cry does not mean a baby is in danger as long as the other parameters are okay. The presence of any other noise other than cry may most probably be an obstruction in the airway.”

However, speaking with our correspondent, Dr. Idris opined that a baby needed to cry immediately after delivery.

She said: “The first cry of a baby is very important for the normal function of the baby’s brain. The baby should cry immediately after it’s born – the first second of its life. If a baby doesn’t immediately cry, then it is a very serious problem that should be expertly managed by trained healthcare workers. It is rare for a healthy baby to refuse to cry. The only sound we paediatricians love is a normal cry of a newborn at birth. It heralds a beautiful beginning of a bright future. It also signifies that ‘so far so good’.

According to a study published online by Paediatric Malpractice Guide (2022), “A baby’s first breath results from hormonal reactions that help empty the fluid from the lungs so that they can breathe air. The first breaths cause lung expansion and fluid expulsion into the circulatory and lymphatic systems. It takes a few breaths or more to regulate the oxygen and carbon dioxide and get the blood circulating through the lungs. The effort of those first few breaths is tremendous, and some newborns need help. As such, neonatal staff massages their skin to stimulate breathing. The vigorous skin rubbing can encourage crying.

“Likewise, when newborns leave the warm womb to exit into the cold hospital room, they experience discomfort that causes them to cry to breathe and expel fluids. That’s why babies who are instantly placed on their mother’s belly may not cry since they are warm and content. So long as their heart rate is stable and breathing normally, newborns do not have to cry to show healthy adaptation to the new world. A baby’s quiet arrival may mean they do not know how to cry yet or other benign reasons for their silence. However, vigilant doctors do not assume that there is some negligible reason for a baby’s silence”.

Another study by Mom Loves Best (2021), however, noted that some newborns whose mothers receive certain painkillers or that were delivered via caesaran section may not cry.

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