Microbes in Baby

Assumption: All babies have similar microbiota when they are born.

FALSE
In this study, babies and their mothers were tested for microbes just after birth.  The babies who were born vaginally had microbes resembling their mother’s vaginal microbes while those born by cesarean section had microbes resembling their mother’s skin.  This could explain why babies born through cesarean section often have immune systems that work differently than those of babies born vaginally.

http://www.pnas.org/content/107/26/11971.full

My Views:
This was a very small study, but is worth follow-up.  There are certainly implications here that could affect babies throughout their lives.  For example, most MRSA skin infections on infants occur in babies born via cesarean section.  Allergies and asthma are also more likely in children who were cesarean babies.  This study begins to answer the question, “Why?”

 

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Newborns and Sleeping

Assumption: Newborn babies should sleep by themselves in a crib because adult beds are too dangerous for them.

FALSE
A new study out of South Africa finds that babies who are 2 days old experience higher levels of stress and do not get as much beneficial sleep if they are not next to their mothers during sleep.

http://www.sciencedirect.com/science/article/pii/S0006322311006391

My Views:
While the American Academy of Pediatrics has begun to encourage room sharing, they have not yet encouraged bed sharing.  It is the skin to skin contact with the mother that was measured in this study.  I think that too many women are scared away from bringing their babies to bed with them.  The fact is that if a bed is prepared to welcome baby, it can be perfectly safe and, according to this study, saf*er* than a crib.  Problems occur when moms have not been educated about how to make the bed safe and only bring the baby to bed because the mom is exhausted and has no other options.  By this point, the bed is not prepared, the mom is not in good shape, and there are dangers.  Sleeping with baby is normal and healthy and should be seen as a viable option in our society.  For a quick list of precautions, see http://pregnancy.about.com/od/familybed/a/cosleeping.htm.

Skin to Skin Contact

Assumption: Mother and baby having skin to skin contact following birth is a good thing for both.

TRUE
1,925 women and babies were studied.  Positive results include breastfeeding initiation and duration, attachment behaviors in moms, less crying in infants, and greater cardio-respiratory stability in pre-term infants.  No adverse effects were seen.

http://www2.cochrane.org/reviews/en/ab003519.html

My Views:
As a mom I know the great peace I felt holding my babies immediately after birth.  I believe this is something that both moms and babies crave.  I don’t want to discount the dads in this either, though.  Although they were not part of these studies, I know that holding a newborn skin to skin provides a connected and warm feeling for dads when mom is unavailable due to stitching, recovery, etc.  There is nothing sweeter than the feel of a newborn’s soft skin and no more comforting place for baby to be than against mom or dad’s skin, listening to a heartbeat.  I love it when scientific studies tell us what we intuitively knew!

Swaddling

Assumption: Swaddling is good for babies.

TRUE, BUT
Swaddling has been proved to comfort newborns and help their brains regulate, but there are dangers in swaddling as well.  Hip dysplasia can be caused by swaddling an infant with legs straight.  This article sums up the research on this problem and has pictures of the best way to swaddle a baby.

http://aapnews.aappublications.org/content/32/9/11.1.full

My Views:  Swaddling has become more and more used in the past decade or so, as infants have been put on their backs to sleep (to avoid SIDS).  Newborns startle easily and swaddling seems to help some babies feel more secure when placed on their backs.  If you observe a newborn, you will see that the natural position of the hips is flexed.  Swaddling with this natural position in mind can help prevent hip dysplasia (misalignment of the hip joint).  As a side note, those who like to “wear” their babies should keep this positioning in mind as well.  If your baby is hanging from his/her crotch, the legs are not in a natural position.  A carrier that allows the baby to “sit” with hips flexed is better for the baby’s development.

Jaundice: Bad or Good?

Assumption: The newborn body cannot cope with high levels of bilirubin and those who become jaundiced must be treated.

TRUE… but
Apparently, many studies have sought to determine whether bilirubin is a good thing or a bad thing.  This article pulls the studies together and comes to a couple of conclusions: (1) Bilirubin definitely has positive properties- mainly as an antioxident, but (2) bilirubin that is out of control can be very dangerous to the newborn brain.

http://pediatrics.aappublications.org/content/113/6/1776.full.html

My Views:
After my last post, I began to wonder, WHY do so many newborns (60% full-term and 80% of premature infants) become jaundiced if it is such a terrible thing?  Why is this such a naturally and normally occurring phenomenon?  The good news is that bilirubin is an antioxident that has proven to help infants is several ways (see the article for specifics), including protecting the body from toxins.  The bad news is that if the bilirubin numbers become too high, brain damage can occur.  So, it is still wise to treat jaundice and to keep track of levels.  What levels are acceptable and what levels need to be treated are under some debate in the medical community.  I’m just glad to know that there is a natural purpose to the jaundice itself and that 60-80% of our babies aren’t just born “out of whack.”

Cord Clamping and Iron

Assumption: The umbilical cord should be immediately clamped and cut after birth.

FALSE
This study demonstrated that delaying cord clamping by just 2 minutes had a significant effect on the iron levels in a newborn’s blood and continued to have an effect when checked again at 2 months and 6 months.

http://nutrinet.org/pages/downloads/documetos-HO/Otros%20Documentos/Umbilical_Cord_Clamping_Lancet_Mexico.pdf

My Views:
Yesterday I reviewed studies that showed the benefit of delayed cord cutting on premature newborns.  Then, two friends posted this article on Facebook.  It is lengthy, but basically states that immediate cord cutting can be dangerous to the newborn brain.  This encouraged me to look for more studies about delayed vs. immediate cord clamping (in full-term newborns) and I found this one that supports the findings in the article mentioned above.  If waiting just 2 minutes before clamping and cutting the cord helps a newborn to regulate iron levels in the blood, I am amazed that immediate cutting is still the norm.  Are there downsides to delaying that I am not aware of?  Maybe I’ll look into that for tomorrow’s post. 🙂

Cord Clamping in Premies

Assumption: It is best to clamp and cut the umbilical cord as soon as a baby is born.

FALSE
When cord clamping was delayed by just 30-120 seconds, there were more positive outcomes for premature infants.  Receiving the continued blood-flow through the umbilical cord prevented the need for transfusions and resulted in fewer cases of intraventricular hemorrhage.

http://www2.cochrane.org/reviews/en/ab003248.html

My Views:
A lot about what happens immediately after birth seems rushed to me.  I think that giving the baby time to transition while still attached to the placenta certainly won’t cause harm!  Allowing Mom, Dad and baby to relax and just BE together after the birth without a lot of intervention from staff helps establish a peaceful loving bond. Delaying the clamping of the cord seems natural to me, as does delaying eye treatments, immunizations, baths, and warmers.  Baby against Mom’s skin and no one rushing them to DO anything is a great way to welcome a new life! 🙂  These studies focused on preterm infants, but I think all infants could benefit from this kind of treatment.