The First Minutes After Birth: Inside Neonatal Resuscitation Training
Birth is one of the most dramatic physiological transitions the human body will ever make.
Before delivery, a baby receives oxygen through the placenta. Within seconds after birth, the lungs must expand, fluid must begin to clear, and the newborn’s circulation must adjust to breathing independently.
Most newborns complete this transition without extensive intervention. When a baby does need help, however, the clinical team must recognize the problem quickly and respond with skills designed specifically for the newborn patient.
That preparation is the focus of the Neonatal Resuscitation Program® (NRP®).
A Newborn Emergency Requires a Specialized Response
Neonatal resuscitation is not simply pediatric resuscitation performed on a smaller patient. The physiology, priorities, equipment, and sequence of care are different.
In many adult and pediatric emergencies, chest compressions may be one of the first interventions people associate with resuscitation. For a newborn, establishing effective ventilation is often the most important priority. The care team must evaluate the baby’s breathing, heart rate, muscle tone, and response while determining what level of support is needed.
That support can range from basic measures, such as maintaining warmth and positioning the airway, to positive pressure ventilation, chest compressions, advanced airway management, and emergency medication.
Each intervention must be delivered appropriately for the newborn’s size and condition. Just as importantly, the entire team must understand who is responsible for each task.
What Is the Neonatal Resuscitation Program?
The Neonatal Resuscitation Program is an evidence-based educational program from the American Academy of Pediatrics that prepares healthcare professionals to evaluate and resuscitate newborns at the time of birth.
The program introduces the knowledge, technical skills, decision-making, communication, and teamwork required during a neonatal emergency. Its lessons extend from preparation before delivery through initial assessment, ventilation, advanced interventions, and postresuscitation care.
The course is intended for healthcare professionals involved in newborn care. It is different from an infant CPR class designed for parents, caregivers, or the general public.
Current Science for Today’s Delivery Room
The science of neonatal resuscitation continues to evolve as new evidence becomes available. The Ninth Edition of NRP launched in fall 2025 and reflects the latest American Heart Association and American Academy of Pediatrics neonatal resuscitation guidelines. ACLS Academy currently teaches this updated edition, helping participants train with current recommendations and resuscitation practices.
The Ninth Edition curriculum covers preparation for resuscitation, initial newborn care, positive pressure ventilation, alternative airways, chest compressions, vascular access, medication, postresuscitation care, preterm newborns, ethics, and quality improvement.
Although the evidence and recommendations continue to advance, the central purpose of NRP remains constant: helping trained professionals recognize what a newborn needs and work together to provide it without delay.
What Do Healthcare Professionals Learn in NRP?
NRP helps learners develop an organized approach to the first critical minutes after birth.
Depending on the provider curriculum selected, training may address how to:
Anticipate potential complications before delivery
Prepare and check neonatal resuscitation equipment
Complete the initial newborn assessment
Maintain the newborn’s temperature
Position and manage the airway
Provide effective positive pressure ventilation
Evaluate ventilation and make appropriate adjustments
Coordinate chest compressions with ventilation
Assist with or perform advanced airway placement
Establish vascular access
Administer emergency medication when indicated
Reassess the newborn throughout the response
Support the newborn after resuscitation
The course does more than teach a sequence of clinical steps. Learners must understand how to recognize when an intervention is working and when the team needs to change its approach.
Who Should Take NRP?
NRP is designed for healthcare professionals who may attend births or participate in newborn resuscitation, including:
Labor and delivery nurses
Neonatal and newborn nursery nurses
Respiratory therapists
Pediatricians and neonatologists
Obstetricians
Advanced practice clinicians
Certified nurse midwives and other midwives
Medical, nursing, and respiratory care professionals preparing for relevant clinical roles
Other healthcare professionals whose responsibilities may include newborn care at delivery
Course requirements can vary by employer and clinical role. Participants should confirm which NRP curriculum their organization requires before registering.
Essentials or Advanced: Choosing the Right Curriculum
NRP offers Essentials and Advanced provider curricula to reflect different responsibilities during newborn care.
NRP Essentials is generally appropriate for healthcare professionals who may initiate neonatal resuscitation but are not expected to participate in every component of a full resuscitation. Depending on their role and employer requirements, this may include obstetric providers, midwives, lactation consultants, and emergency medical personnel.
NRP Advanced is intended for professionals who attend births and may participate in a complete neonatal resuscitation. The curriculum includes advanced airway management, chest compressions, vascular access, and medication administration. It is commonly selected by nurses, respiratory therapists, pediatricians, and other professionals responsible for advanced newborn care.
The appropriate choice depends on the learner’s scope of practice, delivery room responsibilities, and employer requirements. Choosing Advanced should not simply be viewed as earning a higher level of credential. The curriculum should match the role the provider is expected to perform.
Teamwork Begins Before the Delivery
Effective neonatal resuscitation begins before the baby is born.
The team considers maternal and fetal risk factors, gathers and tests equipment, assigns roles, and discusses potential complications. That preparation allows team members to respond more efficiently if the newborn requires assistance.
During the resuscitation, the room may include nurses, physicians, respiratory therapists, obstetric professionals, and other specialists. Each person needs to understand the plan while remaining alert to changes in the newborn’s condition.
NRP uses case-based simulation and debriefing to help participants practice:
Leadership
Clear role assignment
Closed loop communication
Situational awareness
Workload distribution
Reassessment
Constructive review of team performance
These are not secondary skills. In a time-sensitive emergency, communication influences how quickly the team recognizes a problem, completes an intervention, and determines what should happen next.
What to Expect at ACLS Academy
The NRP course at ACLS Academy uses a blended learning format. After registering, participants receive information about purchasing and completing the appropriate online NRP curriculum. The online learning must be finished before the in-person portion of the course.
Students then attend an approximately three-hour skills session that uses hands-on practice, case-based simulation, and instructor-led debriefing. Essentials and Advanced learners participate in the same classroom portion, while their online curricula reflect their different clinical responsibilities.
ACLS Academy keeps its NRP classes small so instructors can focus on skills performance, communication, and meaningful feedback. Classes are offered at the ACLS Academy Bridgewater location and may fill quickly.
As with ACLS Academy’s other professional healthcare courses, instruction is grounded in its guiding philosophy: For Providers, by Providers.
Browse our catalogue of courses to register for an upcoming NRP course.
Preparation for the First Critical Minutes
No delivery team can predict every challenge. It can prepare for how it will respond.
The first minutes after birth may require rapid assessment, specialized technical skills, and complete trust among the professionals in the room. NRP gives healthcare providers a structured way to build that knowledge, practice their individual roles, and strengthen the teamwork behind neonatal care.
When a newborn needs help making the transition to life outside the womb, preparation is already part of the response.
Explore Our Comprehensive Course Offerings:
Advanced Cardiac Life Support (ACLS & ACLS-EP) | Pediatric Advanced Life Support (PALS & PALS Plus) | Basic Life Support (BLS) | Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS) | Advanced Stroke Life Support (ASLS) | Trauma Nursing Core Course (TNCC) | Emergency Nursing Pediatric Course (ENPC) | AWHONN Intermediate Fetal
Heart Monitoring Course | HeartSaver CPR/AED & First Aid | Instructor Certification Courses. View our upcoming class calendar and register for your next certification today!