The Right Start: What Foals Need During the First 24 Hours

The care a foal receives during his first 24 hours of life can make all the difference for his future. By Pat Adkins for EQUUS magazine.


After 11 months of waiting, the big day has arrived; your mare is about to deliver. Of course, the birth itself is a miracle of sorts, but as you'll soon discover, a youngster's first minutes and hours of life are a remarkable mixture of joy and anticipation.


This, after all, is the period when a newborn foal adapts to life outside the womb. His first gasps of breath inflate the alveoli in his lungs. An arterial shunt, which before birth channeled blood past the pulmonary system, will soon close so that freshly oxygenated blood can be sent from the lungs to the rest of the body. When the foal nurses for the first time, his gastrointestinal tract springs into action with a burst of hormones, enzymes and other substances. Meanwhile, other vital systems--renal, thermoregulatory, neurological--quickly come on-line, ready to meet the demands of this brave new world.


The vast majority of the time, all of this goes off without a hitch, and all you need to do is to schedule a veterinary exam within the first day to confirm that all is well. But if anything does go wrong, detecting the problem quickly can make the difference between life and death.


"A newborn foal can deteriorate very quickly, so call your veterinarian at the first sign of a problem," says Heather Kaese, DVM, of the University of Minnesota College of Veterinary Medicine. "Oftentimes it is easier and less expensive to treat sick foals right away, and it can improve the chances of a positive outcome."


It's important, then, to understand the normal stages of development during those first critical hours so that you can recognize the earliest signs of trouble. The following time line tells you what to look for during your newborn foal's first day. As long as everything appears normal, mare and foal will take care of themselves. But if you find yourself considering whether to make an emergency call to your veterinarian, err on the side of caution: All of these times are approximate, and if you have any doubts, it's best to go ahead and seek help.


The Birth

Once the mare's amniotic sac ruptures (known as the water breaking), the birth is under way. Within 10 to 20 minutes, you will see one front hoof appear, followed by the other, about three to four inches behind. In a normal birth, both hooves will be front side up, or just slightly turned. The muzzle follows, on top of the legs. Once the body of the foal is on the ground, possibly still encased in the amniotic sac, the mare may stop to rest while his hind legs are still inside her. If the first two hooves to appear are sole upward, you may be seeing the hind feet, an indication of a breech presentation; a breech birth may also proceed normally, with little harm to the foal.


Your role: During a normal birth, you are primarily an observer. Disturbing the mare or interfering with the process won't help and may cause problems. Unless something goes wrong, don't intervene.


Call your veterinarian if: having medical help at hand would make you feel more comfortable. "Some people call the veterinarian as soon as the mare's water breaks, then hope there's nothing for him to do when he gets there," says Jon Palmer, VMD, director of Perinatology/Neonatology Programs, New Bolton Center, University of Pennsylvania. "That's a personal preference, not a necessity, as long as what you are observing appears normal. If it doesn't, call your veterinarian immediately."


It's an emergency if: more than 20 minutes elapse from the time the mare's water breaks until the delivery is completed or if an improper presentation seems to be delaying the birth. The appearance in the birth canal of only one forelimb, or of both legs but not the muzzle, or the soles facing upward indicates that the foal may need to be repositioned by an expert. If the first thing you see is not the white amniotic sac but rather the bright red surface of the detached placenta, the foal's life is in immediate danger.


Two Minutes

The foal will begin to draw his first breaths within about 30 seconds of birth, and within two minutes, he ought to be breathing regularly at a rate of about 60 breaths per minute. The first breaths will be irregular and ragged as the lungs inflate for the first time. As the foal starts to breathe, don't be surprised if you see some clear liquid coming out of his nose. In utero, the fetus's lungs are filled with fluid; during birth most of this fluid is squeezed out and some is later absorbed into the blood and lymph system, but a small amount may still need to drain, a process that may continue for up to an hour.



Within a minute or so of birth, the foal's mucous membranes will become pink, and his heart rate should be 60 to 80 beats per minute, climbing as high as 120 to 150 beats per minute within the first hour.


The normal foal will shake his head, blink, look around and get up on his sternum. He will respond to lights, sounds and other stimuli, and he may whinny.


Your role: "Don't interfere if everything is proceeding normally," says Palmer. "Cleaning the foal is the mare's job, and unnecessary human involvement interferes with mare-foal bonding."


Call your veterinarian if: the foal's breathing and heart rates remain significantly lower than normal and/or he seems unresponsive to his new environment. He may eventually grow stronger and develop normally without intervention, but he will require more careful observation over the next hours.


It's an emergency if: the foal isn't breathing within two minutes of birth. You need to take quick action. "If there are membranes over the foal's nose, remove them; then rub the foal with straw or a towel to stimulate breathing," says Palmer. "If rubbing doesn't work, you can do mouth-to-nose resuscitation by covering one nostril and breathing into the other." Before the birth, ask your veterinarian to instruct you on performing resuscitation techniques safely.


Ten Minutes

When the mare rises, the umbilical cord usually breaks on its own at a point a few inches from the foal's body. This natural break allows the blood vessels to retract, which helps to seal them with minimal bleeding.


Your role: Avoid the temptation to cut the cord; it's more likely to bleed. To ward off infection, dip the stump of the cord in a cup of disinfectant as soon as you can after it breaks. Nolvasan diluted with water to a sky blue color works well and is not as caustic as iodine solutions. Avoid stronger or more caustic solutions since they can irritate the skin. If the stump continues to bleed for more than a minute or two after it breaks, wrap it with umbilical tape, a clean shoelace or cotton string. Repeat the disinfection procedure two or three times per day for the first few days.


Call your veterinarian if: an umbilical vein hemorrhages. In rare cases, tying off the stump may be inadequate to stop the bleeding or a foal may bleed from the umbilicus as he strains to defecate. A veterinarian may need to clamp or suture the umbilicus.


One Hour

After 15 minutes or so, many newborns will make their first attempts to stand, and most succeed in getting up within an hour, though some foals can take two hours or more. The youngster will be clumsy at first, and poor balance is normal.


Once up, the foal begins searching for the udder, often in dark places such as walls, corners or the wrong end of the mare. Most mares will circle or put a hind leg back to help the foal find the udder. Nursing is a sloppy affair at first but should improve in efficiency over the next few hours. The mare may be distracted during the first hour as she passes the placenta.


Your role: If the foal is struggling to rise but the floor is too slippery, add more bedding so he can get a purchase. Do not attempt to help the foal to his feet; if his bones are not yet fully formed, you may do permanent damage to his joints.


Make sure the foal actually ingests most of his first gulps of mother's milk. "Get yourself in a position to observe the nursing," says Palmer. "The left side of the foal is best as you can see his esophagus and swallowing action. You want to be sure the foal is actually swallowing the colostrum, which provides antibodies, hormones, antibacterial proteins and anti-inflammatory agents, as well as nutrition."


Call your veterinarian if: the foal is up but cannot stand normally because of lax tendons, loose joints, crooked legs or contracted tendons. These conditions often are resolved on their own but your veterinarian may decide supportive bandages or splints would be beneficial.


Also talk to your veterinarian if your foal exhibits any other unusual physical or neurological signs, such as a persistent tilt of the head, swelling in the legs or limb deformities.


It's an emergency if: the foal has not stood within two hours and nursed within three to five hours. Failure to do these things may indicate a problem that requires urgent medical care. And time is critical because he needs to ingest colostrum within the first six to eight hours of birth.



If the mare is young and inexperienced, she may be too excited to allow the foal to suckle; it may be necessary to sedate her. Also be sure the mare has passed the entire placenta within an hour or two of giving birth; if not, she requires immediate medical attention.


Three Hours

With an hour or two of practice under his belt, the foal will settle into a pattern where he stands and nurses about every 20 minutes, and he will become much more efficient at getting the milk. He will also be active and inquisitive, interacting with the mare and exploring or playing before lying down to rest again--a pattern that will continue for the first days of his life. At this stage a wide stance, an exaggerated gait and sensitivity to sound and touch are normal.


By now the foal should have begun passing meconium, dark brown to black pelletlike fecal wastes consisting of swallowed amniotic fluid, glandular secretions and cell debris.


Your role: If the foal postures and strains to defecate but does not evacuate meconium after four hours, he may need an enema; foals who had been overdue are more likely to experience these impactions. It takes some skill to administer an enema properly, and rectal tissue is fragile and easily injured, so it would be wise to have a veterinarian or someone with experience show you how to do it before you try it on your own. Restraining a foal this young also requires special care. Unlike an adult horse, the foal's rib cage is pliant, and his body was most likely bruised during the trip through the birth canal, so grabbing the foal around the barrel is likely to hurt him and may impair his breathing. Instead, gently hold him steady with one arm in front of his chest and the other behind his haunches.


Call your veterinarian if: the foal is still straining after receiving a single enema. "Multiple enemas can be irritating and cause electrolyte imbalances in foals," says Kaese. It's better to let a veterinarian help you decide what to do next.


Also call your veterinarian if sloppy nursing persists after a few hours. Fresh milk on the foal's forehead could indicate a weak suck reflex, and milk coming from the nostrils could be a sign of weak swallowing muscles, a cleft palate or other problems.


Twelve Hours

The foal urinates for the first time and continues to do so every hour or two thereafter. The foal's respiratory rate slows to 30 to 40 breaths per minute; his heart rate slows to 80 to 120 beats per minute. He continues to get up several times each hour to nurse, and his energy levels will increase. He will become ever more inquisitive and playful.


Your role: Even if everything has gone by the book so far, ask your veterinarian to examine the foal within 12 hours of his birth just to ensure that all is as well as it seems. Since most foals are born overnight, a good time to place the call is first thing the next morning. The veterinarian will perform a physical examination to make sure there are no defects or injuries; fractured ribs resulting from the birth can be a serious hidden problem in newborns, especially if the foal is large or the labor was difficult. When the foal is about 12 hours old, your veterinarian may also want to draw blood to check on the foal's immunoglobulin levels, which would indicate whether the youngster has ingested enough colostrum to acquire a safe level of immunity from infection.


It's an emergency if: the foal is sleepy every time you check on him. Unusually low energy levels can be a sign of many problems. "If a foal is always sleeping, something is wrong," says Kaese.


Twenty-four Hours

Between 12 and 24 hours of age the foal will begin producing the soft, yellowish feces that result from ingesting milk. The foal's respiratory rate is now about 30 breaths per minute, with a heart rate of 80 to 100 beats per minute. The foal continues to nurse approximately every 20 minutes or so, and he is active and playful when up. "Once the foal is 24 hours old, it can be turned out with its dam in a clean safe pasture, if the weather is good and it has bonded with the mare," says Kaese. "Assuming the foal is healthy, exercise and sunshine are the best things for it."


Your role: Continue to observe the foal closely during the first 24 hours for any signs of trouble. "Most foals are born at night, and most owners have lost sleep for several nights waiting for the birth," says Palmer. "I hate to tell sleep-deprived owners this, but they need to continue checking the foal every couple of hours throughout that first 24 hours. They can't just decide everything is fine and come back eight hours later. Too many things can go wrong in the interim." Also check the mare's udder periodically. An unhappy mare with an engorged udder is a sign that nursing is not taking place as it should.



Call your veterinarian if: your foal develops persistent diarrhea during his first days of life. Diarrhea can be a sign of several different serious infections that require treatment, and even if the cause is not immediately life-threatening, the foal may need supportive care--i.e., fluids and electrolytes--to recover more quickly.


It's an emergency if: a foal who initially appeared healthy suddenly deteriorates. Sometimes foals who had been progressing normally may suddenly begin to weaken, lose their focus on the mare and quit nursing. The problem may be an infection, a congenital abnormality, neonatal isoerythrolysis or a hereditary disease. Whatever the cause, quick intervention is vital.


The first day of a horse's life sets the stage for his future health, as his early growth and development prepares him for the world outside the womb. But with vigilance and care, you can help make sure that he's getting the best possible start in life.


This article originally appeared in the May 2004 issue of EQUUS magazine.