After warming, drying, and stimulating the newborn, what should you do next?

• A. Initiate chest compressions
• B. Place in sniffing position and suction if necessary (mouth first, then nose)
• C. Administer epinephrine
• D. Place infant in prone position

Answer: (B)

The immediate step after warming, drying, and stimulating a newborn is to secure the airway and clear any secretions so the baby can breathe effectively. Placing the infant in the sniffing position helps keep the airway open by aligning the mouth, pharynx, and larynx, which is especially important in newborns where the tongue can more easily obstruct the airway. If there are secretions or debris, suctioning is indicated to clear the airway; do the mouth first, then the nose to ensure the oropharynx is clear before any nasal suction or ventilation. Once the airway is open and clear, you assess breathing and heart rate to decide whether to begin ventilation or move to the next steps. Chest compressions are reserved for a heart rate that remains very low after ventilation attempts, and epinephrine is given only in advanced resuscitation scenarios. Placing the infant in a prone position is not appropriate for the immediate next step in airway management.