AHA/AAP 2025 neonatal resuscitation guideline update: Key changes and practice implications for pediatricians

The 2025 neonatal resuscitation guidelines, developed jointly by the American Heart Association and the American Academy of Pediatrics, provide evidence-based recommendations for the most crucial actions during delivery and throughout the neonatal period. Ventilation remains the cornerstone of resuscitation, starting with ventilation rates of 30-60/ min, ≥ 30% oxygen for very preterm infants (<32 weeks), guided by pulse oximetry and electrocardiography monitoring to avoid hyperoxia. Deferred cord clamping (≥60 sec), strict thermal regulation and skin-to-skin contact are strongly encouraged. Laryngeal mask airways can be used as an alternate device in failed bag-mask ventilation in term infants. The 2025 guidelines shift neonatal resuscitation from an algorithmic event to a continuum of care, emphasizing system readiness, team integration, precise physiological targets and structured recovery - while maintaining core resuscitation principles established in 2015.