The updated 2015 guideline by International Liaison Committee of Resuscitation (ILCOR), warrants need to start positive pressure ventilation if the heart rate is less than 100 beats per min (bpm) at birth . Heart rate (HR) is the most important, objective clinical indicator of the health of newly born infants . Increasing HR is considered to be a good marker of effective resuscitation, and a HR exceeding 100 bpm is considered normal . The evidence for setting 100 bpm as cut off for initiating neonatal resuscitation is arbitrary and has poor quality evidence. Determining HR immediately after birth is usually done by auscultation or palpation of the umbilical cord. A study by Dawson et al. has shown that the median HR was