The 2020 AHA guideline updates for neonatal support include the following recommendations:

• At least one provider skilled in newborn resuscitation should attend every birth to provide immediate care to the newborn when needed.
• A newborn should be placed in skin-to-skin contact with the mother as long as the infant does NOT require resuscitation. This simple procedure supports temperature regulation and other benefits for the newly born.
• Following delivery through meconium-stained amniotic fluid, newborns with apnea or ineffective breathing should NOT be treated with routine laryngoscopy for suctioning. Intubation and tracheal suctioning may be indicated in the presence of airway obstruction.
• The umbilical vein is the preferred route of vascular access. If IV access is not available, the IO route can be used.
• The team should discuss terminating resuscitation efforts with the family after 20 minutes if all resuscitation steps have been completed without the return of a viable heartbeat. Newborns unable to be resuscitated after 20 minutes are unlikely to survive.
• Training for individuals responsible for newborn resuscitation should occur more frequently than every 2 years. Regular training is necessary for team members to maintain the knowledge and skills to perform successfully at a neonatal resuscitation.