How to Resuscitate Newborn Puppies and Kittens

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Every breeder remembers the first time a newborn didn’t cry. I remember standing in a whelping room at 2 a.m. beside a breeder I’d been consulting with for years. The delivery was smooth. The puppy arrived. And then—silence. Her hands went straight to the bulb syringe, just as I had taught her. Just as I had been taught myself. But new research tells us that reaching for the bulb syringe first may actually delay the one thing that newborn needed most: air in its lungs. The July 2025 RECOVER guidelines have changed neonatal resuscitation. Some of what you’ll read here contradicts what I used to teach. But the science is clear, and you deserve to know what’s changed.

TL;DR: Key Takeaways

The 2025 RECOVER guidelines flip the old resuscitation order: breathing support now comes before suctioning, not after.
Vigorous newborns (crying, moving, pink) clear their own airways through sneezing and coughing—routine suctioning actually slows them down.
Your first and most important tool is a warm towel, not a bulb syringe—vigorous rubbing triggers the breathing reflex more effectively than suction.
Assessing whether a neonate is vigorous or non-vigorous within the first 60 seconds is the single most critical skill in neonatal resuscitation.
The swing method is permanently retired due to the risk of brain hemorrhage and aspiration—use gentle gravity-assisted positioning instead.
Whether you identify as an interventionist or naturalist breeder, evidence now determines what you do once you decide to act.
Four visual signs—movement, breathing, color, and reflex response—give you everything you need to make the right call in seconds.

What Should Every Breeder Know About Neonatal Resuscitation?

The Old Rule Got It Backwards

For decades, the standard approach to newborn puppy and kitten care followed a simple rule: clear the airway first. Newborns arrive with amniotic fluid (the liquid that surrounds them in the womb) in their mouths and noses. The logic seemed bulletproof—remove the fluid so the baby can breathe.

But the 2025 RECOVER guidelines revealed something critical. For healthy, vigorous newborns, suctioning actually gets in the way of lung aeration—getting air into the lungs for the very first time. Every second you spend manipulating the airway is a second that newborn isn’t breathing.

Old Approach	New Approach (RECOVER 2025)
Clear airway first, then focus on breathing	Support breathing first, clear airway only if needed
Bulb syringe used on every newborn routinely	Bulb syringe reserved for non-vigorous neonates with visible obstruction
Suction seen as a safety measure	Routine suction now recognized as a potential delay to oxygenation
Meconium staining required deep suctioning	Immediate breathing support prioritized even with meconium staining

Why Routine Suctioning Can Cause Harm

This was a hard lesson for me, because I had taught airway clearance as a first step for years. But the evidence behind the RECOVER update is impossible to ignore.

Routine bulb syringe use delays the first real breath by an average of 15 to 30 seconds. For a newborn whose entire body is waiting for oxygen, those seconds matter enormously. Suctioning can also trigger a vagal response (a nerve reflex that tells the heart to slow down)—at the worst possible time. And even gentle suction can cause tissue swelling in the throat that lasts 24 to 48 hours, making breathing harder during the exact window when easy breathing matters most.

Risk of Routine Suctioning	What Happens	Why It Matters
Delayed first breath	Airway manipulation postpones lung aeration by 15–30 seconds	Oxygen deprivation compounds with every passing second
Heart rate slowing	Vagal reflex triggered by suction slows heart rate	A compromised neonate cannot afford a slower heart
Throat tissue swelling	Gentle suction can still irritate delicate tissues	Swelling persists 24–48 hours, making breathing harder

The New Guiding Principle

The 2025 RECOVER guidelines boil down to one powerful idea: the intensity of your intervention should be the opposite of the neonate’s vigor. In plain language, the healthier and more active the newborn appears, the less you should do with your hands. The weaker and more limp the newborn appears, the more quickly and deliberately you need to step in.

This flips the old model on its head. Previously, many breeders (and veterinarians, including me) treated every newborn the same way—suction first, assess later. Now, the assessment comes first. Always.

Neonate Vigor Level	Recommended Response	Primary Tool
Strong (crying, moving, pink)	Step back, dry gently, let physiology work	Warm towel
Moderate (some movement, weak cry)	Vigorous rubbing to stimulate breathing reflex	Warm towel with active stimulation
Weak (limp, silent, blue/pale)	Immediate intervention: stimulation, positioning, assisted breathing	Towel, positioning, mouth-to-nose ventilation

What Should You Do During Neonatal Resuscitation?

Assess Vigor in the First 60 Seconds

This is the single most important skill in neonatal resuscitation. Everything depends on answering one question within the first minute: is this newborn vigorous or non-vigorous?

The RECOVER 2025 guidelines give you four visual signs to check. No special equipment needed—just your eyes, your hands, and your attention.

Movement and Muscle Tone: A vigorous puppy or kitten curls its legs inward, squirms, and resists your grip. A non-vigorous one feels limp—like holding a wet towel.

Breathing and Vocalization: A vigorous newborn cries loudly within 15 to 30 seconds with steady chest movement. A non-vigorous newborn is silent, gasps, or breathes fewer than 15 times per minute.

Color: Pink gums and tongue mean oxygenated blood is flowing. Blue, purple, pale grey, or white signals dangerously low oxygen.

Reflex Response: Pinch a paw pad gently. A vigorous newborn reacts strongly. A non-vigorous one barely responds.

Vigor Sign	Vigorous (Healthy)	Non-Vigorous (Needs Help)
Movement and muscle tone	Active limbs, curls up, squirms when held	Limp, flaccid, no resistance when lifted
Breathing and vocalization	Loud crying within 15–30 seconds, steady chest rise	Silent, gasping, or breathing below 15 breaths per minute
Mucous membrane color	Pink gums and tongue	Blue, purple, pale, or white gums and tongue
Reflex response to touch	Strong reaction to paw pinch or body rub	Weak or absent response

Follow the New Resuscitation Sequence

Once you’ve assessed vigor, the steps depend on what you found. But regardless of your breeding philosophy, the sequence follows the same evidence-based order.

For vigorous newborns: Wipe the nostrils with a warm towel. Dry the body with vigorous rubbing along the rib cage—this stimulates the breathing reflex and helps clear fluid passively. Then step back and let the puppy or kitten cry, sneeze, cough, and breathe.

For non-vigorous newborns: Start with aggressive towel rubbing along the rib cage. If there’s no improvement within 30 to 60 seconds, move to gentle mouth-to-nose ventilation—just enough pressure to see the chest rise. Only reach for the bulb syringe if you see visible fluid bubbling at the nostrils or pooling in the throat.

If there’s still no response: Veterinary support is essential. A neonate that remains unresponsive after stimulation and breathing support needs professional intervention.

Step	For Vigorous Newborns	For Non-Vigorous Newborns
Step 1	Wipe nostrils, dry body with warm towel	Vigorous towel rubbing along rib cage
Step 2	Allow crying, sneezing, and natural airway clearing	If no improvement by 30–60 seconds, begin gentle mouth-to-nose ventilationyes d on
Step 3	Monitor color and breathing rhythm	Suction ONLY if visible fluid obstruction is present
Step 4	Place with dam for warmth and bonding	If still unresponsive, seek immediate veterinary support

Retire Dangerous Techniques Permanently

The RECOVER 2025 guidelines are clear: the swing method is permanently retired. This practice of holding a newborn and swinging it in a downward arc to clear fluid is dangerous.

In my clinical practice, I’ve seen the consequences. The shear forces can cause intracranial hemorrhage (bleeding inside the brain). The reversed pressure can push stomach contents into the lungs. The data shows this method caused harm as often as it helped.

If you need gravity to help drain fluid (and you rarely will), hold the puppy or kitten at a slight downward angle—no more than 15 to 20 degrees. Support the head and neck at all times. This gives you the benefit of physics without the violence.

Retired Technique	Why It’s Dangerous	Safe Alternative
Swing method (centrifugal arc)	Risk of brain hemorrhage from shear forces; aspiration of stomach contents	Gentle 15–20 degree downward tilt with head and neck support
Deep mechanical airway clearance	Tissue trauma, delayed oxygenation, heart rate slowing	Towel stimulation followed by assisted breathing if needed
Routine suctioning of all newborns	Delays lung aeration, causes vagal reflex, throat swelling	Reserve suction for non-vigorous neonates with visible obstruction only

What Should You Have Ready for Neonatal Resuscitation?

Your Primary Tool: Warm, Clean Towels

This might surprise you. The most important piece of equipment in your whelping box is a stack of warm, clean towels. Not technology. Not machinery. Fabric applied with intention and skill.

When I work with breeders preparing for a litter, I always emphasize this. Vigorous rubbing with a warm towel along the rib cage stimulates the breathing reflex, promotes circulation, and clears fluid passively as the newborn moves and cries. The tactile input triggers breathing more effectively than any bulb syringe.

Keep towels warmed and within arm’s reach. Many experienced breeders I consult with keep a towel warmer right next to the whelping box.

Towel Preparation Detail	Recommendation	Why It Matters
Temperature	Body-warm (not hot), pre-warmed before delivery	Prevents hypothermia while providing effective stimulation
Quantity	Minimum 6–8 clean towels per whelping	Each newborn needs its own dry towel; wet towels lose effectiveness
Texture	Slightly rough or textured fabric	Better tactile stimulation triggers stronger breathing reflex
Placement	Within arm’s reach of whelping area	Seconds matter—no time to search for supplies during delivery

Backup Suction Equipment: Close But Not in Your Hand

The bulb syringe hasn’t been eliminated from neonatal care. It has been repositioned. In the old model, it was the first tool you reached for. Now, it’s an exception-only tool that stays nearby but out of your hand unless you see visible airway obstruction in a non-vigorous neonate.

Think of the bulb syringe like a fire extinguisher. You want it within arm’s reach and ready to use. But you don’t carry it around, and you don’t use it at every small flame. Keep one or two clean bulb syringes near your whelping box. Know how to use one properly—compress before inserting, release gently to create suction, never insert deep into the throat. But the key change is mental: the bulb syringe is your backup, not your default.

Equipment	Role in RECOVER 2025 Protocol	When to Use
Bulb syringe	Backup tool for selective use	Only for non-vigorous neonates with visible fluid obstruction
Warm towels	Primary resuscitation tool	Every single delivery—vigorous and non-vigorous newborns alike
Clean, flat surface	Assessment and resuscitation workspace	Needed for vigor assessment and stimulation techniques
Clock or timer	Track critical intervention windows	To monitor the 30-second and 60-second decision points

A Vigor Assessment Checklist You Can Use Tonight

One of the most practical things you can do right now is create a simple checklist that sits next to your whelping box. When a newborn arrives, you don’t want to rely on memory. You want the four vigor signs written down where you can see them at a glance.

In my consultations, breeders who post these signs near the whelping box make faster, more confident decisions during delivery. The stress of a whelping doesn’t leave much room for memory recall. A visual reference makes all the difference.

Checklist Item	What to Look For	Vigorous Response	Non-Vigorous Response
Movement	Limb activity and muscle tone	Curling, squirming, resisting	Limp, floppy, no resistance
Breathing	Vocalization and chest movement	Crying within 15–30 seconds	Silent, gasping, or absent breathing
Color	Gum and tongue color	Pink	Blue, purple, grey, or white
Reflex	Response to paw pinch or body rub	Strong pull-back, grimace, louder cry	Weak or no response

What Should You Watch for During Neonatal Resuscitation?

The 30-Second and 60-Second Decision Points

Timing is everything in neonatal resuscitation. The RECOVER 2025 guidelines identify two critical windows that shape every decision you make after delivery.

The 30-second mark is your first assessment point. By this time, a vigorous newborn should be crying, moving, and showing pink color. If these signs are absent by 30 seconds, it’s time to escalate—regardless of your breeding philosophy. An interventionist breeder might start escalating even sooner, by 20 seconds. A naturalist breeder might give a few extra seconds. But by 30 seconds, the evidence says your hands should be actively stimulating.

The 60-second mark is your critical escalation point. If a neonate is still flat, silent, and showing poor color at 60 seconds despite vigorous towel stimulation, you need to move to assisted breathing. Gentle mouth-to-nose ventilation with just enough pressure to see the chest rise. And if there’s still no improvement, veterinary support is no longer optional.

Time Point	What You Should See	What to Do If Signs Are Absent
0–15 seconds	Initial assessment begins—observe movement and breathing	Dry and stimulate with warm towel
30 seconds	Crying, active movement, pink color	Escalate to vigorous rubbing; reassess continuously
60 seconds	Steady breathing, strong muscle tone, good color	Begin assisted breathing (mouth-to-nose ventilation) if still non-vigorous
Beyond 60 seconds	Improvement with assisted breathing	Contact veterinarian immediately if no response to ventilation

Red Flags That Demand Immediate Action

Not every complication announces itself dramatically. In my clinical experience, some of the most dangerous signs are subtle.

Persistent blue or purple color after 30 seconds of stimulation means oxygen isn’t reaching the tissues. This may indicate a heart defect, a diaphragmatic hernia (a hole in the muscle separating chest from abdomen), or severe lung immaturity.

Gasping without chest rise means the newborn is trying to breathe but air isn’t reaching the lungs. There could be a true airway obstruction or the lungs may not be inflating properly.

Heart rate below 120 beats per minute, if you can check it, signals cardiovascular failure. A healthy newborn should have a heart rate between 180 and 220 beats per minute.

Red Flag	What It Suggests	Immediate Action
Persistent blue/purple color after 30 seconds of stimulation	Severe oxygen deprivation, possible structural defect	Escalate to assisted breathing; prepare for veterinary contact
Gasping without visible chest rise	Airway obstruction or lung failure	Gentle repositioning; consider careful suction; begin ventilation
Heart rate below 120 beats per minute	Cardiovascular compromise	Stimulate vigorously; begin assisted breathing; seek veterinary help
No improvement after 60 seconds of active intervention	Condition beyond basic resuscitation capability	Contact veterinarian immediately

Matching Your Monitoring to Your Breeding Philosophy

Here’s where your identity as a breeder shapes how you apply these guidelines. The most successful breeders I work with—the ones with the lowest neonatal mortality—aren’t the ones who intervene the most or the least. They’re the ones who know exactly who they are and match their monitoring to their philosophy.

If you’re an interventionist breeder, your monitoring starts at second one. No cry by 20 seconds? You escalate. Non-vigorous signs by 30 seconds? You’re already moving toward emergency support. The RECOVER guidelines don’t reduce your involvement—they redirect it. Your hands are still active from the start, but now they’re rubbing, not suctioning.

If you’re a naturalist breeder, your monitoring starts with observation. All vigor signs present by 30 seconds? You step back and let the dam engage. Your restraint is now evidence-based, not just instinct-based. But when signs are absent by 30 seconds, the protocol demands your hands. Non-vigorous neonates don’t benefit from philosophy. They benefit from oxygen.

The RECOVER 2025 guidelines give both approaches the same scientific foundation. Your philosophy determines when you assess and how long you wait. The evidence determines what you do once you act.

Breeder Philosophy	Monitoring Style	Escalation Trigger	What Stays the Same
Interventionist	Hands ready from second one; tight assessment windows	No cry by 20 seconds; non-vigorous signs by 30 seconds	Stimulation before suctioning; breathing support before mechanical clearance
Naturalist	Observation-first; allowing time for natural processes	All vigor signs absent by 30 seconds	Stimulation before suctioning; breathing support before mechanical clearance
Both approaches	Continuous reassessment throughout	60 seconds without improvement triggers veterinary contact	The resuscitation hierarchy is identical once intervention begins

Breathe First, Ask Questions Later

The RECOVER 2025 guidelines aren’t just an update to neonatal resuscitation protocols. They’re a correction. They force all of us—veterinarians and breeders alike—to confront the gap between what we were taught and what physiology actually requires.

That gap is where growth lives.

Tonight, when you look at your whelping setup, make one change. Move the bulb syringe from your hand to the shelf. Move the warm towels closer. And before your hands touch anything after a delivery, ask four questions: Is there movement? Is there breathing? Is there color? Is there reflex?

Vigorous? Step back. Let physiology work. Non-vigorous? The protocols take over—stimulation, positioning, breathing support within 60 seconds.

You now have the knowledge that the best veterinary researchers in the world published just months ago. You have a clear assessment framework. You have a resuscitation sequence backed by the latest evidence. And you have something even more powerful than any protocol: the ability to adapt, to revise what you thought you knew, and to give every newborn in your care the best possible start.

That willingness to update your knowledge—even when it contradicts what felt instinctively right—is what separates good breeders from exceptional ones. You’re already proving you have it, because you just read this entire article.

Now go set up your whelping box with confidence. Those puppies and kittens are counting on you.