First Cry of a Newborn

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Cry Newborn

In adults, crying typically means that a person is feeling some type of emotion- sadness, happiness, anger, or something else.1 Does crying in newborns after birth mean that they are sad or happy or angry?

The general stereotype is that all newborns cry upon delivery.The truth is MOST babies will breathe or cry within 90 second of delivery.2 Wistrom and colleagues suggest that crying is the first phase in an ordered sequence of behavioral phases that most newborns display during the first hour after delivery.The phases are, in order: birth cry, relaxation, awakening, active, crawling, resting, familiarization, suckling, and sleeping.3

What causes newborns to cry at birth?

You can find several explanations for why newborns cry: 1) the newborn cries to clear fluid from its lungs and begin to breathe normally; 2) the sudden change from the warm, intrauterine environment to the cold and noisy environment of the delivery room causes newborns to cry; 3) the newborn cries in response to handling by the doctor or nurse in the delivery room.2,4

Is newborn crying important?

Regardless of the exact reason(s) that newborns cry, crying is important because it can be an important method of assessing a newborn’s health immediately after delivery. For medical professionals and parents, crying is often a comforting sign during delivery and it means that the baby is healthy and okay. Studies analyzing recordings and sound wave patterns of newborn cries have discovered that there are visible differences in the cries of healthy versus unhealthy newborns and differences in the cries of newborns delivered vaginally versus newborns delivered by Cesarean section.4

Delivery room doctors and nurses use something called the Apgar score to measure a newborn’s “overall status and response to resuscitation” immediately after delivery.

The Apgar score is determined at 1 minute and 5 minutes after delivery. The score assesses color, heart rate, reflexes, muscle tone, and respiration, assigning a score of 0, 1, or 2 to each measure and then summed to provide a total score. Respiration is characterized by a newborn’s cry, whether it’s absent, weak, or good.5 A total score of 7 to 10 means a newborn is normal. A score below 7 may mean a newborn requires resuscitation or oxygen delivery; a score of less than 3-5 means the newborn needs the resuscitation immediately.6 Newborns with an Apgar score <7 at 5 minutes will have it assessed every 5 minutes for up to 20 minutes after delivery.5

While the Apgar score is beneficial for determining a newborn’s condition and overall responsiveness, it can’t determine the health of a newborn as he or she grows up.5,6 The Apgar score can also be influenced by factors such as whether the mother is on a medication during pregnancy or delivery and whether the newborn has specific birth defects or conditions.5

Apgar Score*

Sign 0 1 2
Color Blue or pale Blue or purple Pink
Heart rate Absent <100 per minute >100 per minute
Reflex irritability No response Grimace Cry or active withdrawal
Muscle tone Limp Some bending of limbs and joints Active motion
Respiration Absent Poor cry, slow breathing Strong cry

*Can be repeated at 1, 5, 10, 15, and 20 minutes after birth

 

Total score Meaning
7-10 *where most newborns fall*
<7 More likely in newborns with birthing difficulties such as prematurity or Cesarean section; newborns may need oxygen or resuscitation
<3

Adapted from the American Congress of Obstetricians and Gynecologists

Takeaways

The science of crying and the exact reason humans cry is something that is still being studied. But, most healthcare professionals and parents alike recognize that crying at birth can be a useful indicator of a newborn’s health, condition, or responsiveness. Crying is such a helpful marker of newborn health that it is included as an indicator of respiration or breathing in the Apgar score.

References:

  1. http://time.com/4254089/science-crying/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115782/
  3. https://www.ncbi.nlm.nih.gov/pubmed/20712833
  4. https://www.sciencedirect.com/science/article/pii/S1474667016321450
  5. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/The-Apgar-Score
  6. https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/pages/Apgar-Scores.aspx
Lauren McMahan
Dr. Lauren McMahan has a Doctor of Pharmacy from Lipscomb University College of Pharmacy in Nashville, TN. She currently works for a large national healthcare company, where she provides her research and writing expertise to support evidence-based initiatives to improve patient care. She enjoys exercising, reading, and thrifting in her spare time.

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