​Helping Babies Breathe 2nd Edition - Summary of Changes

Helping Babies Breathe (HBB) 2^nd Edition includes scientific updates to harmonize with 2015 ILCOR Consensus on Science with Treatment Recommendations, and 2012 WHO Guidelines on Basic Newborn Resuscitation. It also features strengthened educational advice and new guidance on program implementation and quality improvement, based on feedback and lessons learned from the global community of HBB users. 

Please click here to view and download a printable version of the HBB 2nd Edition Summary of Changes. 

Updates to the HBB​​ Action Plan

• ​Added link with Helping Mothers Survive​.
• Text – "See HMS Action Plan for mother"
• Illustration of baby on mother's chest.
• Eliminated "if meconium, clear the airway" before the action step, "Dry thoroughly."
• Changed indications for suctioning to be performed if airway is obstructed, or if meconium in amniotic fluid and baby is not crying after thorough drying.
• Added option for initiating ventilation.
• Decision to begin ventilation with cord intact or after clamping and cutting the cord.
• Added link with Essential Care for Every Baby.

The Learner Workbook beco​mes the new Provider Guide

• ​ Clear de-emphasis of suctioning​
• Removal of recommendation for suctioning before thorough drying if meconium in amniotic fluid.
• Articulation of two elements of airway clearing - positioning and suctioning (only if indicated).
• Emphasis on hazards of prolonged or overly vigorous suctioning.
• Added option for delayed cord clamping after initiation of ventilation.
• Emphasis on rapid evaluation of chest movement and quick corrective steps after initiation of ventilation.
• Emphasis on uninterrupted ventilation until the baby is breathing spontaneously (simplified red zone – continued ventilation with normal or slow heart rate)​.

The HBB Facilitator Flip Chart​ now contains more detailed educational advice and additional resources for implementation and quality improvement

Updates to the HBB Facilitator Flip Chart

• A checklist to guide facilitator before, during, and after the workshop.
• More specific educational advice to accompany skills.
• Additional segment on implementation.
• Commit to making a difference.
• In-facility routines for practice and mentoring.
• Introduction to quality improvement.
• Emphasis on implementation of resuscitation in a facility.
• Low-dose, high frequency practice; self-reflection, debriefing, and case reviews; quality improvement.
• Annotated Action Plan with suggested quality measures.
• Revised advice on disinfection of equipment to follow ​ Reprocessing Guidelines for Basic Neonatal Resuscitation Equipment in Resource-limited Settings​.