During Delivery

• Suction mouth first, then nose, with a bulb syringe before delivery of shoulders to prevent aspiration of meconium.

After Delivery

• If newborn is not vigorous, minimize stimulation and delay ventilation until meconium can be suctioned from airway.

If Newborn Is Depressed (HR <100, Depressed RR/muscle tone)

• Intubate newborn's trachea, but DO NOT ventilate.
• Apply suction and withdraw ET tube to clear meconium.
• Repeat process until no further meconium can be suctioned.
• During process, administer 100% O₂ via blowby.
• Ventilate newborn using bag-valve device after suctioning.