What happens when newborns don’t cry after birth?

There is one perfect moment that new parents in the maternity wards of hospitals always wait for — the moment they hear the piercing, unmistakable cry of their baby. It is this moment that relieves all anxiety, brings joy, and usually results in a few happy tears for everyone in the room. But what happens if this cry doesn’t occur immediately after birth?

Here’s the thing: not every baby cries immediately at birth, and this doesn’t necessarily mean there is wrong.

Health assessments

While television shows and films portray the initial wail as a cry of life or death, in actual birth rooms, physicians consider a much larger picture when assessing the health of a newborn.

Crying is critical in a newborn’s first few moments. Within the womb, a baby’s lungs are filled with fluid, and oxygen is supplied by the mother via the placenta. The initial cry assists in forcing fluid from the lungs, enabling them to expand and breathe.

It also indicates that the newborn’s breathing mechanism is switching to independent operation. Nevertheless, some babies transition noiselessly. If a newborn is breathing regularly, presents good muscle tone, and his or her skin becomes a healthy pink, he or she might not cry but may still be perfectly healthy.

Reasons for delayed crying

There are a variety of reasons why a baby may not cry immediately. Sometimes the delivery is just so smooth and easy, particularly with some C-sections, that the baby does not feel compelled to complain. Premature babies may not have the energy reserve to make a good cry right away.

Medication for pain relief administered to the mother during labour will also leave the baby a little sleepy at first. Occasionally, a little mucus or fluid in the mouth and nose may make it harder to cry for a while until these clear. Less often, medical reasons like birth asphyxia, infection, or neurological issues may be responsible.

Not crying immediately is not always a bad omen. During the initial minutes after birth, babies are rapidly checked by the delivery team using the Apgar score, which examines breathing, heart rate, muscle tone, reflexes, and colour of the skin. A baby with good scores on these parameters but remaining quiet is not at risk. An alarm is raised only when a newborn does not breathe satisfactorily, is limp or unresponsive, or has blue skin.

In such situations, doctors act quickly, providing gentle stimulation, clearing the airway, giving oxygen, or assisting breathing if necessary.

Trust the experts

For a parent, it might be unnerving to witness a quiet infant during those first few moments of life, but keep in mind that delivery rooms are filled with trained professionals who deal with such situations on a daily basis. In most cases, a couple of seconds of additional attention is enough for a newborn to begin breathing regularly — with or without a dramatic wail.

Although a baby’s initial wail is a comforting one, it is not the sole indicator of health.

Some babies arrive in this world breathing softly rather than loudly, and that is just fine too. Have faith in your healthcare providers to be on the lookout for proper cues, and know that noisy or not, most newborns get off to a healthy start and safe life.

(Dr. Rajiv Aggarwal, senior consultant, paediatric intensivist & neonatologist, Motherhood Hospitals, Sarjapur, Bangalore. drrajivaggarwal@hotmail.com)