Upon assessing a newborn immediately after delivery who is breathing spontaneously with a heart rate of 90 beats/min, what should you do next?

In the scenario presented, the newborn is breathing spontaneously but has a heart rate of only 90 beats per minute. For neonates, a heart rate below 100 beats per minute is concerning and can indicate the need for immediate intervention.

Initiating positive pressure ventilations is the appropriate action here because, while the newborn is able to breathe on their own, the heart rate indicates that they are not adequately ventilating, which may lead to further oxygen deprivation. Positive pressure ventilation helps to ensure that sufficient oxygen is delivered to the lungs, thus potentially increasing the heart rate and addressing any underlying hypoxia.

This action directly targets the critical issues of inadequate ventilation and hypoxia, which can quickly become life-threatening if not addressed. When providing positive pressure ventilation, it is essential to continuously reassess the newborn’s heart rate and respiratory effort to gauge the effectiveness of the intervention.