Attending the newborn foal: being there can make a difference.

Usually mares give birth with no problems, and the foal is strong and healthy, but it pays to be there. If something goes wrong, a little help at the proper time can make the difference between life or death for the foal. A hard birth, or premature separation of the placenta (part of the placenta coming through the birth canal ahead of the foal because it has detached too soon) can severely stress the foal. He may become short on oxygen during birth and will need resuscitation as soon as he is fully born.

Whether the birth was normal or difficult, make sure the foal begins breathing as soon as he emerges. Gently take the sac away from his head if it has not already broken (and do it with speed if it is still intact and full of fluid!) and clear the mucus from his nostrils. The foal cannot go very long without oxygen. Oxygen deprivation can cause permanent damage. Even if a vet is enroute, the crucial time for the foal to start breathing is right after birth, so it may be up to you to help him get going if he is slow.

Immediately after being born, most foals position themselves upright, enabling the lungs to expand properly. If a foal lies flat, he is not able to breathe as well; his lungs cannot fully fill. If he is tired from a hard birth, make sure he is upright. Some foals will show obvious signs of weakness and lack of oxygen (lying flat and unable to roll up onto their chests, or limp and listless) while others may appear normal at first and then begin gasping for breath. These foals can usually be helped by vigorous rubbing with a towel to stimulate circulation, and moving their legs while giving body massage, to increase heart and lung action.

If a foal is not breathing at all, clear the nasal passages with a suction bulb, if you have one, and give artificial respiration (see sidebar on page 51). As long as there is a heartbeat (and you can feel it with your hand on the lower left side of the ribcage just behind and above the elbow) there is hope for the foal, if you don't let him go without oxygen too long.

Heartbeat is easy to feel in a foal because there is very little tissue between it and the outside chest wall. Heart rate can be an indication of respiratory distress, because it drops as the body tissues are depleted of oxygen. Normal rate should be between 30 and 90 in the first few minutes after birth, going up to between 60 and 200 in the first hour, then leveling off between 70 and 130 during the first 48 hours. If the heartbeat stays very low, the foal is usually in trouble. Usually once the tissues become less oxygen starved, the heart rate will rise.

Even in a normal, easy birth, the foal should be closely monitored for the first few hours to make sure he is healthy and doing all right. Close attention to small details can often make the difference in early detection of a problem.

After the birth, the mare and foal usually lie there a few moments. The foal will often be trying to stand before the mare does. The umbilical cord breaks when the mare gets up. The foal's navel stump should be dipped in tincture of iodine (7% solution), tamed iodine, or chlorhexadine (Nolvasan) solution as soon as the cord breaks, to guard against infection. The advantage to using the traditional strong iodine (7% solution) is that it acts as an astringent to help the navel cord dry quickly and shrink up--to seal off the opening to prevent infection. The disadvantage is that it burns the tissues, and if you get any on the foal's skin it can cause irritation. If you get very much on the skin around the navel stump it can sometimes cause enough damage to encourage bacteria. A less harsh disinfectant like tamed iodine or chlorhexadine is often preferred.

The easiest way to apply the disinfectant solution is to completely immerse the navel stump in a small jar of it (a shot glass or baby food jar works well). Press the jar up tightly against the foal's abdomen to immerse the stump, and swish it around, being careful not to spill any on the foal (especially if using strong iodine). The important thing is to keep the navel disinfected until the stump completely dries up; this may mean repeating the dipping another time or two during the first 12 to 24 hours, unless the foal was born in a very clean place, such as out in a nice grassy pasture.

If weather is cold, dry the foal quickly with towels. The normal foal will try to get up soon after birth. Out in a pasture the foal has less problems getting to his feet and finding his coordination, since footing is better and he is not encumbered by straw bedding. He's also not hindered by walls, or banging against a manger. If he's in a stall, make sure bedding is not too deep and there are no feed buckets and other obstacles for him to crash into in his wobbly efforts. Remove any objects that might cause injury during his first uncoordinated struggles (including screw eyes or nails at foal height). Put yourself at foal level when checking a foaling stall for hazards.

He will usually fall down several times before gaining his feet. It's tempting to help him, but usually unnecessary, and in some instances harmful. Sometimes a foal may have a fractured or cracked rib from the pressures of birth, which will heal fine under normal circumstances. But too much handling (trying to pick him up or help him stand), may displace the fractured ends and cause them to puncture a lung. Monitor his progress in finding the udder, and help him only if he really needs it.

Too much help may interfere with bonding, especially if it's the mare's first foal.

Crucial colostrum 

It is important that he nurse within the first two or three hours of birth, and get an adequate amount of colostrum in the first six hours--to get the most benefit from its antibodies. The foal's intestinal lining begins to thicken soon after birth, and he loses ability to absorb the large molecules; the antibodies can no longer slip through the gut lining into the lymph system and bloodstream. A foal that fails to nurse soon after birth gets only a fraction of the antibody protection he needs. Research a few years back showed that by four hours after birth, the foal's intestinal walls have lost about 75 percent of their ability to allow antibodies to slip through.

The antibodies within colostrum consumed after the critical early hours still have some beneficial action; the antibodies that stay within the gut can counteract some of the ingested pathogens that might otherwise lead to diarrhea. For protection against systemic infections however, the foal needs the temporary immunity (passive transfer) he gains from absorbing his dam's antibodies into his bloodstream. This is the only way he can be protected in his early weeks of life from diseases like influenza, sleeping sickness, West Nile Virus, etc. His immune system is too immature to develop resistance to disease, or to obtain any benefit from vaccination. Thus his best protection for a while is to obtain adequate antibodies from his dam's colostrum--which he will do if you kept her vaccinations up to date during pregnancy so she has strong immunity and created antibodies in her colostrum--and if he can nurse soon enough after birth to absorb them.

The normal, healthy foal will have a strong desire to nurse and will keep trying until he accomplishes it. But he may need assistance if the mare is uncooperative and won't stand still, or kicks at him. Someone may have to hold the mare (up against a fence or stall wall) while you guide the foal to the udder. If for some reason the foal is unable to nurse, he can be fed colostrum from a bottle, or by stomach tube if he is weak and unable to suck.

Colostrum not only provides antibodies against diseases, but also serves as a gut stimulant to help the foal pass his first bowel movements. These first evacuations are often firm and hard-packed and can be difficult to pass. Sometimes an enema is necessary to help the foal get rid of these hard pellets, but in most cases the laxative effect of colostrum will get things moving.

Some foals are slow to nurse due to foaling complications or because of some birth defect or impairment, but others are slow for no apparent reason. In these instances, you may have to feed the foal with a bottle or by tube until he begins to nurse on his own. If he will nurse a bottle, that's the easiest way to get him fed if he cannot nurse his mother. But if he is weak and unable to suck, you may have to feed him by syringe or stomach tube. With most weak foals it is beneficial to syringe milk into the mouth, rather than use a tube, just to keep their swallow reflex going.

A stomach tube is generally used as a last resort, though some vets prefer to use it for any foal that has trouble sucking. This is a plastic tube that goes into the nostril to the back of the mouth and then down the esophagus into the stomach. The vet may put it in place and leave it, stitching it in place with a few strands of suture thread so it won't come out. Then you can milk out the mare periodically (with very clean hands, into a sterilized container) and carefully funnel the milk down the tube into the foal's stomach at specific intervals and specified amounts. This method has some advantages over bottle feeding if the foal is weak. You can get the proper amount of milk into him without any effort on his part that might tire him, and without danger of milk getting into his windpipe and possibly causing aspiration pneumonia. Also, the foal can still nurse the mare with the tube in place, and if you are not bottle feeding him he won't think of you as his mother. He may still try to nurse the mare. Once he starts nursing enough on his own, the tube can be removed.

Bowel movements

During the first day of life, make sure the foal is passing bowel movements and urinating. Sometimes a foal will be constipated and straining (and uncomfortable), even if you gave him an enema soon after birth. Some foals have a large number of hard, tightly packed pellets and will need several enemas to help get rid of them, until the colostrum works through. A cup or two of warm, slightly soapy water or mineral oil, can be used, gently squirted into the rectum with a big syringe, or with a regular enema tube (put carefully into the rectum a few inches) and squeeze bulb.

Some stubborn cases may need a small quantity of mineral oil orally, or Milk of Magnesia, to soften up the high impaction that is out of reach of an enema. If the foal continues to have trouble passing bowel movements or shows discomfort, consult your vet.

Close attention to details and being aware of how the foal is doing (perky and alert, bright and strong--or uncomfortable, dull, or weak) can help the horseman become aware of any small problems before they become serious, and get veterinary help in time to make a big difference for the future of the foal.

Heather Smith Thomas

Idaho

Getting him breathing, and giving artificial respiration

After a normal birth, the foal rights himself, resting on his chest with forelegs extended in front of him. Because of the way his chest and ribcage are constructed, he breathes best when standing or lying upright, so his lungs can expand. By contrast, a foal lying flat has his lungs partially collapsed.

Foals in an upright position also experience a pressure change in the blood vessels, which opens more of the vessels near the air sacs in the lungs, so they can take on more oxygen. If a foal is weak or limp at birth and lying flat instead of trying to sit up, take action to help him. If you don't have a squeeze bulb to suction mucus and fluid from his nostrils and it is obvious his airways are somewhat obstructed, position him briefly with head downward to help fluid drain out, and gently squeeze out fluid by pressing thumb and forefinger along the top of the nostrils toward the muzzle (like squeezing a toothpaste tube).

After making sure airways are not obstructed, position the foal on his chest in upright position, and gently rub him with a rough towel to stimulate circulation. If he cannot stay upright, prop him with bedding or hay bales to make sure he continues to sit up. Left unattended, a weak foal may not try very hard to sit up and will lie flat--becoming weaker due to compromised respiration. He may be weak and short on oxygen because of a difficult birth, premature detachment of the placenta during birth, or some other problem. But if he is otherwise normal, you can help by sitting him up and stimulating his respiration and circulation until his blood has sufficient oxygen to give him strength to try to get up.

If he is not breathing at all, immediately resuscitate him after birth. With him lying on his side (head and neck extended), cover one nostril tightly with your hand, holding the mouth shut. Gently blow into the other nostril (but not forcefully or rapidly or you may rupture a lung). Blow until you see the chest wall move and rise. Let the air come back out on its own. Then blow in another breath until the chest rises again to show the lungs are filling. Continue filling the lungs and letting them empty, until the foal starts breathing on his own. Usually once the tissues become less oxygen-starved, the foal will regain consciousness and start breathing, and his heart rate will rise to normal level. His breathing may be erratic at first, but if everything else is normal he will develop a more regular breathing pattern in a few minutes.