Do All Babies Cry at Birth?

The first sign of life—and survival–is the sound of a newborn’s cry after birth. At least, that is what most believe is the anatomy of new life. And yet, not all newborns cry. A mother who does not hear her baby cry may worry that something is wrong, that the baby is not breathing or reacting appropriately to living outside of the womb. However, humans are complex beings, and newborns are no exception. If your child did not cry at birth, you and your medical team might be alarmed for a good reason. There may also be un-alarming reasons why your newborn’s after birth cry is delayed.

Importance of an After-Birth Cry

Crying involves the musculoskeletal and respiratory systems. The coordination of the face muscles, opening mouth, quivering chin, esophagus, bronchial tubes, and lungs that occur when a baby cries already begins in the womb, according to a study from the mid-2000s. At 20 to 28 weeks gestation, fetuses were able to cry after receiving sound and vibration stimulation through the mother’s belly. The facial grimace, breathing consistent with crying and frowning all indicated signs of crying without the sound. The research confirmed that stimulation to make the fetus uncomfortable causes crying.

A baby’s first breath results from hormonal reactions that help empty the fluid from the lungs so that they can breathe air. The first breaths cause lung expansion and fluid expulsion into the circulatory and lymphatic systems. It takes a few breaths or more to regulate the oxygen and carbon dioxide and get the blood circulating through the lungs. The effort of those first few breaths is tremendous, and some newborns need help. As such, neonatal staff massage the skin to stimulate breathing. The vigorous skin rubbing can encourage crying.

Likewise, when newborns leave the warm womb to exit into the cold hospital room, they experience discomfort that causes them to cry in order to breathe and expel fluids. That’s why babies who are instantly placed on their mother’s belly may not cry since they are warm and content. So long as their heart rate is stable and breathing normally, newborns do not have to cry to show healthy adaptation to the new world. A baby’s quiet arrival may mean they do not know how to cry yet or other benign reasons for their silence. However, vigilant doctors do not assume that there is some negligible reason for a baby’s silence.

What if a Baby Doesn’t Cry when Born?

A baby who does not cry may alert the doctor to examine the baby for problems. Importantly, an investigation and Apgar testing right after birth measures breathing, heart rate, muscle performance, skin color, and reflexes. This can be significantly revealing and may indicate an underlying medical issue that needs urgent attention.

Potential Reasons for a Baby Not Crying at Birth

Short labor and C-section delivery may interfere with the hormonal shifts that begin the breathing transition. Thus, a baby may not cry at birth. In addition, the mother’s pain medication may cause the newborn to be sleepy at birth, so they may need help jumpstarting the lungs. Other reasons may be a long, exhausting labor and the after-effects of an umbilical cord wrapped around the fetus’s neck, causing oxygen deprivation. When a newborn’s Apgar score for breathing low, the doctor may wait a moment to see if the baby can breathe independently or with further stimulation. The optimal score is 9 or 10 after assessing at one minute, five, ten, and fifteen. However, after five minutes, a low breathing score requires a doctor to act.

Babies who are breathing but do not cry are more likely to have some type of condition that threatens their survival. A baby may suffer from asphyxia or oxygen deprivation before, during, or after birth due to many causes. A low Apgar score of 3 or less at one and five minutes postpartum with poor muscle tone, respiratory problems, elevated acid levels in the cord blood, and bluish skin should raise the suspicion of oxygen depletion. In these situations, a baby whose breathing is not vital may need oxygen, but other than oxygen deprivation due to adjusting outside the womb, there are many potential reasons why a baby may not cry when born, some of which include serious congenital conditions and birth injuries.

In other words, many reasons, both benign and malignant, exist for babies not crying at birth. Some require medical assistance to start their breathing, while others may cry after birth, and a delay does not necessarily mean trouble.

Responding to Causes for Concern if Your Baby Doesn’t Cry after Delivery

Most see the cry as a sign of working lungs. Thus, if the cry is not audible after birth, the medical team begins to encourage crying by eliminating any impediments like fluid or meconium that must be suctioned from the mouth and nose. Silence and other troubling signs should cause the medical team to act. The baby may need breathing assistance with a ventilator or may have other medical conditions obstructing breathing or other bodily functions. An abnormal fetal heart rate before or during labor with high acid levels in the blood could be the first clue.

Coupled with a mother with low blood pressure, a poor functioning placenta, overdue pregnancy, compressed umbilical cord, or a highly agitated uterus, a doctor may suspect fetal or neonatal asphyxia. A baby that does not cry after the warning signs of asphyxia should medical professionals to act immediately after registering a low Apgar score. Delayed diagnosis of or response to the condition could lead to brain damage or death. It’s also possible a silent baby is one with congenital disabilities. Premature babies also do not cry, typically, and these infants often have health conditions that require additional assistance from doctors, nurses, and medical professionals.

Failing to Take Action to a Baby Not Crying may be Considered Medical Malpractice

All healthcare providers, especially doctors, must practice medicine competently, up to the appropriate standard required of them, given the circumstances. When other physicians would likely have known the signs and prepared for emergency delivery of a fetus in distress before the damage occurred or responded immediately to signs of a potential birth injury, your doctor’s choices and inaction may be considered medical malpractice. If your physician acted within reason given your pregnancy history, fetal development, and signs throughout labor and delivery, then even the best decisions may lead to poor childbirth outcomes through no one’s fault. This is why it is so important to have your case reviewed by an experienced birth injury lawyer who can investigate what happened in your case and identify possible negligence that may be reason for legal action.

Investigate What Happened in Your Baby’s Birth and Know Your Options if they were Injured in New Jersey

Consulting with our seasoned team of New Jersey birth injury attorneys can be incredibly helpful for your peace of mind and your understanding of your rights and options. You deserve to know whether your doctor may have caused injury to your newborn at birth or neglected to prevent one. Our lawyers can help you determine malpractice, consulting with knowledgeable medical experts who can review your pregnancy, birth, and postpartum medical records and give their expert opinions about your doctor’s performance and decisions.

If you suspect your physician’s, nurses, or other healthcare providers’ responses to your newborn’s silence caused or failed to identify the source of an injury requiring urgent care, contact us today for a free legal consultation. You can reach us anytime at 866-708-8617 to discuss your baby’s birth and learn more about how we may be able to help.

Additional Resources:

• Kc A, Lawn JE, Zhou H, et al. Not Crying After Birth as a Predictor of Not Breathing. Pediatrics. 2020;145(6):e20192719. doi:10.1542/peds.2019-2719
• Gingras, J. L., Mitchell, E. A., & Grattan, K. E. (2005). Fetal homologue of infant crying. Archives of disease in childhood. Fetal and neonatal edition, 90(5), F415–F418. doi:10.1136/adc.2004.062257