Vigorous suctioning of a newborn's airway is indicated if:

• A. If the newborn is crying loudly.
• B. If the newborn shows signs of strong spontaneous breathing.
• C. If there is respiratory obstruction due to meconium in the amniotic fluid.
• D. If the umbilical cord is wrapped around the neck.

Answer: (C)

Vigorous suctioning is used when the airway is actually obstructed and needs to be cleared. Meconium in the amniotic fluid can be aspirated into the neonate’s airway, causing blockage and breathing difficulties. In this situation, actively clearing the mouth and airway with suction helps prevent aspiration and supports ventilation.

If the newborn is crying loudly or breathing strongly on their own, the airway is typically clear, so suctioning isn’t needed and could cause unnecessary airway irritation. A umbilical cord wrapped around the neck is a potential delivery issue to manage, but it doesn’t by itself create an airway obstruction that requires suctioning.