Foal CPR

Know what to do if your foal doesn’t breathe after birth.

Most newborn foals start breathing immediately after passage through the birth canal of the mare. However, some foals do not, and emergency resuscitation procedures might be needed.

Everyone involved in pregnant mare care and foaling should get annual training in normal foaling, obstetrical intervention, routine care of the newborn foal and birth resuscitation procedures. A foaling kit, resuscitation equipment, emergency procedure codes and phone numbers should be available.

What Happens

In most cases, a foal will be delivered 10 to 20 minutes after the mare breaks her water. Foals usually begin spontaneous breathing immediately after delivery. The heart of a newborn foal should be beating regularly at a rate of about 70 to 80 beats per minute. To check for the heartbeat, place your hand (or a stethoscope) on the foal’s chest just behind the left elbow. Foals should have sensory awareness at birth and exhibit a righting reflex within five minutes after birth.

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If there is no respiratory movement after delivery, or no heartbeat or if there is respiratory distress, you will need to intervene. Call for assistance and then follow the guidelines below.

    • First, make sure the airway is open. Remove the amnion from the nose (if needed) and remove any mucus, meconium or debris from mouth or nose.
    • Second, attempt to stimulate the foal to breath. Vigorously dry the foal with towels for 20 to 30 seconds. If breathing doesn’t begin, tickle the inside of the nostrils with a clean piece of straw or stick your fingers in the ears.
    • If the foal is still not breathing, provide emergency ventilation support.

Mechanical Aid

A resuscitation bag or tube attached to a mask can be an effective way to ventilate a newborn foal on a breeding farm. The foal should be positioned on the ground, preferably on its right side. The mask goes over the nose of the foal until the rubber gasket is firmly seated. If available, an assistant should extend the neck of the foal and apply firm pressure on the esophagus (along the left side of the neck) to prevent air from entering the gastrointestinal tract during resuscitation. The attendant should squeeze the resuscitation bag with two hands to force air from the bag into the lungs of the foal. Movement of the chest wall should be evident when the bag is compressed. The bag should be released, allowing air to be expelled from the foal. The squeeze-and-release resuscitation cycle should be performed at a rate of 10 to 20 breaths per minute.

Pause briefly every 30 seconds to see if the foal has started breathing on his own. If an oxygen tank is available, an oxygen line can connect the tank to the resuscitation bag.

Later Problems

Foals that survive after emergency birth resuscitation procedures are at risk of medical problems early in life. They often do not have a strong suckle instinct and are consequently prone to failure of passive transfer. It is common to provide these foals with supplemental colostrum and/or plasma.

In summary, breeding farm personnel should be educated, trained and prepared for the possible need for emergency birth resuscitation. Contact your equine veterinarian to discuss:

  • When to call for veterinary assistance.
  • What procedures can be performed on the farm.
  • Training for emergency intervention.
  • What equipment and supplies to have on hand.

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