Researchers capture images of newborn lungs as they take their very first breath

Nothing fills a parent with relief like the sound of their newborn baby’s cry. That first sip of air defines such a critical moment in our lives, and yet strangely it is one of the least understood human behaviors.

Most of what we know about the physiological activity inside the lungs on a first breath comes either from preclinical studies – often involving animals – or from invasive observations that may interfere with lung function. natural.

Now, using a delicate sensor belt wrapped around the breasts of newborns born at term moments after giving birth, a team of researchers from Australia, Germany, Switzerland and Canada have recorded the changes in volume. pulmonary infections that occur within a baby’s first few minutes outdoors. uterus.

“Healthy term babies use remarkably complex methods of adapting to breathing at birth,” says clinical neonatologist David Tingay of the Murdoch Children’s Research Institute (MCRI) in Australia.

“There’s a reason parents, midwives and obstetricians are happy to hear those first life-affirming cries of the birth of a baby.”

The device generated images of the babies’ breasts, which, along with video and audio data, contributed to detailed descriptions of more than 1,400 breaths taken by 17 tiny humans, all delivered by elective cesarean section.

The results provided a statistical overview of the pulmonary aeration process in newborns – the physiological activity of preparing and swelling the lungs to enable them to take over the role of the gas exchange placenta.

Simply put, while babies are well inside the womb, they are busy exercising their lungs: although they are filled with fluid secreted from the lining of the lungs, they are still moving in a semblance of breathing to give the brain and muscles a lot of practice. .

This training regimen falls immediately before birth. The great pressure that accompanies being pushed through the vaginal canal forces some of the fluid, while delivering a generous dose of adrenaline that tells the lungs to absorb as much fluid as possible.

This still leaves a lot of residue, especially if the delivery is by cesarean section. Much of it is pushed back through the tissues with the first blast of air, with a soapy material called a surfactant helping the tiny air sacs more easily shed their fluid coating and expand as widely as possible.

It is no wonder that our first moments of swinging in the open air are accompanied by a gurgling cry.

Data from this new study helps flesh out the scene. This crying creates a unique gas flow pattern that helps preserve functional residual capacity; the air we hold in our lungs after we breathe out.

This breathing was not necessarily balanced between the two lungs either, tending to favor the right side more than the left.

Of all the breaths recorded, crying was mostly seen in the first minute after birth when babies inflated their lungs; 6 minutes later, more than half of the babies’ breaths had relaxed in a steady flow called tidal breathing.

Having a signature breathing patterns in healthy babies delivered by cesarean section lays the groundwork for exploring how lung aeration differs in other cases, such as in premature infants.

About 1 in 10 newborns, and virtually all children born before 37 weeks, need help catching that important first breath.

For those who find this type of research absolutely fascinating, the MCRI has put together a detailed, but still easily accessible, video clip explaining the study, which you can watch below.

“To improve interventions in the delivery room, one must first understand the processes that define the success and failure of breathing at birth,” says Tingay.

In emergencies, this could require traumatic interventions such as intubation, which – although saving lives – can damage the airways and put infants at risk for airway tissue damage, infection and respiratory disease.

Knowing when drastic measures need to be taken, and when they don’t, could help avoid exposing newborns to unnecessary risk.

The equipment used in the study is about as non-invasive as it gets, so it could be applied to most births, Caesarean and vaginal sections, with virtually no risk to the newborn.

“This new technology not only allows us to see deep into the lungs, but it is also the only method we have to continuously image the lungs without using radiation or interrupting vital care,” says Tingay.

“This study has shown that babies’ lungs are much more complicated than traditional monitoring methods previously suggested.”

This research was published in the American Journal of Respiratory and Critical Care Medicine.