In a full-term newborn with good tone and breathing, which step should be used to clear excessive secretions?

• A. Suction nose only
• B. Suction mouth then nose with bulb syringe
• C. Suction ears
• D. Do not suction

Answer: (B)

In a healthy term newborn with good tone and breathing, the most appropriate step to clear excessive secretions is to suction the mouth first, then the nose, using a bulb syringe. The mouth first approach clears the largest reservoir of secretions and reduces the chance that material pulled from the mouth will be drawn into the airway during subsequent nasal suctioning. After the mouth is cleared, suctioning the nasal passages with the bulb syringe can more effectively remove remaining secretions from the nose without forcing them deeper into the airway. Suctioning the ears isn’t related to airway clearance, and doing nothing would allow secretions to persist and potentially obstruct breathing. So, mouth first, then nose with a bulb syringe provides a gentle, effective method for airway clearance in this scenario.