Discussing the “First Cry” as an Initial Assessment for Neonates

Abstract

Background: Crying is common in newly born infants. For many years, it has been considered as a sign of vitality and wellbeing in neonates. However, recent studies have shown that the most important event in neonates’ adaptation to extra-uterine life is “breathing”. Nevertheless, there seems to be multiple organ systems involvement in the act of crying which can be compared with conventional assessments for newly born infants. This review aims at describing the act of crying in newborns, in order to discuss its physiological or pathological significance, so as to elucidate or deny its importance in the initial assessment of a newborn. Method: A review of the literature which was based on the collection and the screening of various scientific articles treating the topic was made, with relevant information reported and their pertinence discussed accordingly. Results: It appears that there is multiple organ systems involvement during crying which can be superposed to conventional assessments such as the Apgar score. Conclusion: The first cry may be considered as an assurance of effective and spontaneous breathing, and is generally associated with multiple organ system involvement, similar to those evaluated by conventional assessments such as the Apgar score. Therefore, the “first cry” alone when present, may be effective in the initial assessment of a neonate, as far as adaptation to extra uterine life is concerned.