Fetal membranes and fluids should be cleared from each neonate's face immediately after birth. A neonate can often spontaneously clear its airway by vocalizing, but if the neonate fails to vocalize, the nose and mouth should be gently suctioned with a bulb syringe.1
Swinging should never be used to clear a puppy's airway because the practice is dangerous and unnecessary. Swinging puts the neonate at high risk for aspirating stomach contents, developing pneumonia or cerebral hemorrhage secondary to the force of the swinging, and sustaining trauma should the caregiver drop the puppy.1
Each neonate should be immediately dried and warmed via vigorous rubbing with a dry towel. (See Figure 1.) Drying helps prevent hypothermia, and tactile stimulation, particularly in the genital and umbilical regions, helps stimulate respiration.1 If the bitch received opioids during parturition, naloxone (1 drop sublingually q30min as needed to maintain opioid reversal) should be administered to the neonate as soon as signs of cardiopulmonary depression are observed.
Healthy neonates vocalize and become active during examination; have a strong, immediate suckle reflex; and orient to the bitch using tactile and auditory stimuli.4 Basic physical parameters should be obtained for each neonate and the findings compared with established normal values. (See Table 2.)