Neonatal Resuscitation in Kittens – First, Let Them Transition

One of the most common questions new breeders ask is what to do when a kitten is born flat, quiet, or not breathing immediately.

The first thing to remember is that birth is a physiological process, not an emergency. Most kittens simply need time to transition from life inside the uterus to breathing air. The temptation is often to rush in and start doing things, but in many cases the best intervention is patience.

The transition from life in the uterus to life outside is one of the most dramatic physiological changes a kitten will ever experience. Before birth, oxygen is supplied through the placenta and most blood bypasses the lungs because they are collapsed and filled with fluid. With the first few breaths, the lungs inflate, fluid is absorbed, blood flow through the lungs increases dramatically and the circulation rapidly reorganises into the normal adult pattern. This process requires a surprising amount of energy. The first breath must generate enough pressure to open millions of tiny air sacs that have never previously contained air. Once the lungs are expanded, subsequent breaths require much less effort. If you look carefully at a newborn kitten immediately after birth, they are often quite blue or purple in colour. As breathing becomes established and oxygen levels rise, they gradually "pink up" over the first minute or two of life. This colour change is a normal part of the transition process and is reassuring evidence that the lungs and circulation are beginning to work properly. This is one reason newborn kittens can appear quiet or slow for the first minute or two after birth—they are performing an enormous physiological task. In most cases, warmth, drying and gentle stimulation are all that is needed while nature completes this remarkable transition.

Don't Rush to Cut the Umbilical Cord

Once a kitten is fully delivered, I generally leave the umbilical cord intact for a few minutes before cutting it. This allows blood within the placenta and umbilical vessels to continue draining into the kitten.

The placenta is also an important part of the birthing process. It contains nutrients and hormones, including oxytocin. Whenever possible, I allow the queen to cut the cord and eat the placenta as the ingested oxytocin helps stimulate further contractions and supports the continuation of labour.

Drying is Resuscitation

The most effective neonatal resuscitation tool is often a box of tissues.

I commonly use an entire box of tissues during a litter. Tissues are highly absorbent and allow you to thoroughly dry each kitten as it is born. The rubbing action provides stimulation which encourages breathing and helps the kitten transition.

Most kittens that appear slow at birth will begin breathing with nothing more than drying, stimulation and warmth.

If a Kitten Doesn't Breathe

Occasionally a kitten remains flat or fails to establish breathing despite stimulation.

If this happens, I place two layers of tissue over the kitten's mouth and gently provide 2–3 very small breaths.

The tissue serves two purposes:

• It improves hygiene for the breeder.

• It prevents forming a tight seal around the mouth, reducing the risk of over-ventilation.

Remember that a newborn kitten's lungs only hold a few cubic centimeters of air. The breaths should be tiny—just enough to see or feel the chest rise slightly.

Over-ventilation is far more dangerous than under-ventilation.

Over the years I have successfully revived many kittens with nothing more than a few gentle breaths. One recent kitten was born with a ruptured umbilical cord and appeared extremely flat and floppy. After brief assisted ventilation it established breathing and went on to thrive.

Avoid Suction

Many breeders have been taught to suction mucus from a kitten's mouth and nose.

Modern human neonatal medicine has largely moved away from routine suctioning. Suction is not recommended unless a baby is failing to transition and even then is generally performed only by experienced practitioners.

The reason is simple: suction can traumatise delicate airways and may do more harm than good.

A healthy kitten will usually clear its own airway and absorb most of the fluid as it begins breathing and crying.

Never Swing a Kitten

Swinging kittens was common advice decades ago (think 1960's). Fortunately, most breeders now recognise this as a dangerous practice.

The idea originated from an era when human neonatal resuscitation was equally primitive.

Swinging a kitten can:

• Cause bleeding within the brain.

• Injure the neck and spinal cord.

• Result in the kitten flying from your hands and sustaining major trauma.

There are safer and more effective ways to establish breathing.

Please DO NOT swing kittens.

The Good News About Newborn Kittens

Newborn mammals are remarkably resilient.

Their brains are soft and elastic, which means they often recover surprisingly well from brief periods of low oxygen or minor birth trauma.

A kitten that looks poor immediately after birth can frequently make an excellent recovery if provided with warmth, stimulation and a little support.

Warmth is Critical

Newborn kittens cannot regulate their body temperature effectively.

I use a heat pad beneath the nesting area and keep the room temperature around 22°C. During larger litters I will often replace bedding several times throughout the delivery as it becomes damp and cool. Some breeders remove newly born kittens and place on a heat pad but I haven't found I've needed to do that. Mum manages to deliver the next kitten without squashing her others in the brood.

A dry kitten is a warm kitten, and a warm kitten is far more likely to thrive.

Weigh Every Kitten

Every kitten should be weighed at birth.

I place coloured collars on kittens so they can be identified individually and then record weights twice daily during the neonatal period.

Weight gain is one of the earliest indicators of health.

Any kitten under 70 grams at birth receives particularly close monitoring. In most cases I will begin supplementary feeding early and have a very low threshold for starting antibiotics if there are concerns about infection.

My birthing records, time, gender, weights of Daphne and Rimu's litter.

Infection Matters

One of the biggest causes of neonatal loss is infection.

Breeders often focus on genetics, milk supply or birth complications, but bacterial infections can rapidly overwhelm a newborn kitten.

I have a low threshold for treating kittens where infection is suspected, particularly very small kittens or those failing to gain weight appropriately.

For more information, see my blog on Group G Streptococcus (Streptococcus canis), one of the most important bacterial pathogens affecting breeding cats.

A kitten just born, transitioning from in utero to the big wide world. Notice how blue its peripheries are.

Final Thoughts

Most neonatal resuscitation is not about heroic interventions.

It is about patience, warmth, drying, stimulation and careful observation.

Give kittens time to transition. Keep them warm. Weigh them carefully. Monitor them closely.

And remember that often the most effective resuscitation equipment in the cattery is not a suction device or fancy machine—it is a box of tissues, a heat pad, and a calm breeder.