Saturday, January 28, 2006

C-Sections, Breastfeeding and Bugs

An excellent editorital from OhmyNews International titled C-Sections, Breastfeeding and Bugs For Your Baby. The author (who, by the way, could use a good copyeditor) writes:
The intestine of the unborn fetus in the mother's womb is sterile, devoid of any bacteria at all. However, during vaginal delivery the newborn comes in contact with bacteria-rich vaginal and fecal matter of the mother. These bacteria quickly invade and populate the newborn child. Saving of umbilical cords and the creepy ritual of eating the mother's placenta aside, this cycle links the co-evolution of intestinal "microflora" of the mother to child, and may represent a more significant bond for those who understand it exist. This evolutionary bacterial right of passage has been and continues to be critical to the success of our species, and all mammals for that matter.

A child born through c-section essentially skips this critical evolutionary process. Though a c-section baby does receive bacteria from the mother, it's not the diverse and dense "base population" that it would have received from the vaginal fluids and fecal matter via a traditional birth. In either birthing method, the baby is subject to all the bacteria in the room -- that even means the weird looking rubber-gloved fellow in the corner -- who appears to be assisting the delivery staff in some way. But who can be sure?
And then on to breastfeeding:
Breast-feeding newborns, like the evolutionary process of vaginal birth, is about bacteria. The breast milk of a human mother, like other mammalian mothers, is species-specific, having been adapted over eons to deliver specific and sufficient nutrition to guarantee proper growth, health, and immunity development. Researchers have long known that breast-fed babies possess an intestinal flora that is measurably different than formula-fed infants. Of specific interest is a group of bacteria known as bifidobacterium. Some of you may immediately recognize the name, as they are often added to dairy-based foods such as yogurt, often advertised as "live cultures" on the packaging. These are probiotics.

Studies have shown that at one month of age, both breast-fed and formula-fed infants possess bifidobacterium, but population densities in bottle-fed infants is one-tenth that of breast-fed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life contributes significantly to the child's resistance to infection and overall development of defense systems -- not to mention the physical development of the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known inhibit the growth of pathogenic bacteria, they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breast-fed babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent -- and softer -- bowel movements.
One commentor corrected Mr. Leach's language - it's not that breast-fed babies are sick less, are less fussy, and have fewer and shorter duration of bouts of diarrhea - it's that babies fed artificial baby milk are sick more, are more fussy, and have more and longer duration of bouts of diarrhea. Watch your language!
The dominance of health-giving bifidobacterium in breast-fed babies is due the presence of special carbohydrates in mother's milk known as oligosacchrides. These special carbohydrates are virtually absent in cow's milk. From a physiological point, these special carbohydrates escape digestion and absorption in the small intestine of the infant, and thus reach the colon intact -- where they serve as food for, among other bacteria, the all-important bifidobacterium. As the bacteria thrive on this "food" from mother's milk, they grow in number and absorb water, resulting in more regular and soft bowel movements. It's important to know that the bulk of infant feces are made up of live and kicking bacteria. Look next time if you don't believe me!
Yeah, thanks for that reminder. And here's the "take-home":
In the dozens of doctor visits my then wife and I made during pregnancy, and through two births, never once did the doctor or any other person involved tell us what I just told you. In all of the "how to be a new parent" and "how to take care of your new baby" books we read, not one detailed reference to the critical passing of mother's microflora to the child via the birth canal or the importance of feeding bifidobacterium, was ever provided.

Sunday, January 22, 2006

Elective Cesarean Birth

Red State Moron has a two-parter, More on elective cesarean birth and More on elective cesarean birth, 2. Among other things, RSM writes:
In order to truly determine whether or not we should be offering (and performing) elective cesarean, aren't we obligated to determine it's safety or lack thereof? Obstetrical care in this country has a history of adopting technology into clinical practice before it is proven to be beneficial. The classic example is electronic fetal heart rate monitoring (EFM) in low risk pregnancies. Remember that EFM was going to prevent cerebral palsy (C.P.), because it was believed that C.P. was a result of "difficult labor" and decreased oxygen delivery to the fetal brain during labor and delivery. Before the near universal acceptance of EFM in this country, the incidence of C.P. in term neonates was 1-2/1000 and the cesarean delivery rate was 5-6%. Now the incidence of C.P. in term neonates is 1-2/1000 and the Cesarean delivery rate (overall) approaches 30%. Had EFM been subjected to rigorous randomized controlled trials in low risk pregnancies before it was adopted for use in this country, it is unlikely that the technology would have been embraced so readily. Now, however, the horse is out of the barn, and guess what; it ain't coming back. The same thing is likely to happen with elective cesarean delivery. Which means what 40 years down the road? Just consider these points for the sake of argument. I know many will disagree, but I would like to see an dispassionate debate on the topic: is a randomized clinical trial to address this issue (elective cesarean delivery) ethical or not?

Saturday, January 14, 2006

It's a Boy!

Announcing the arrival of

Andrew Josiah

Date: Jaunary 13th

Time: 8:50 pm CST

Weight: 8 lbs. 10 oz.

Height: 21.25 in.

Check The Baby Blawg for details and photos.

Friday, January 13, 2006

Announcing the Arrival Of...

A new blog: The Book Blawg

What, did you think I was going to say a baby?

Women Bloggers Part II

Via BlogHer, Nick Wilson of Performancing starts a discussion on Where are the Women in professional blogging. I think the comment by Jill Manty of Natural Family News hit the nail on the head, although some took it as a dis to Mommy Bloggers. I'd gladly be a professional blogger. Just show me the money.

P.S. Am I a mommy blogger? Despite the fact that I am a mom who blogs, and the name of my blog notwithstanding, I don't really spend much time blogging about my kids, my house-cleaning schedule, or the latest recipie I'm trying, although I am blogging contractions.

Thursday, January 12, 2006

Women Bloggers

Christine of The Conglomerate is tired of the question Why Aren't More Women Blogging?. Lots of good points and comments. Most of the blogs I read are written by women, by the way. So maybe we should ask questions like, "why aren't there more daddy bloggers?"

Fetuses Don't Count in HOV Lanes

For anyone who's ever wondered if being pregnant qualifies them to use the HOV lane, a Phoenix judge says no.

Monday, January 09, 2006

Midwifery Legislative Update - Missouri

Missouri midwifery and homebirth advocates are rallying support for that state's proposed legislation:
Proposed House Bill 974 and Senate Bill 637 describe midwifery as a service and not, as Missouri statute holds, the practice of medicine. Under current law, helping women give birth at home without a Certified Nurse-Midwife license is a Class C felony. Missouri is one of eight states, along with the District of Columbia, that prohibit midwifery in the home.
And here's a great evidence-based statement. Would somebody please give this guy a clue?:

Rep. Jeff Harris, D-Columbia, opposed Davis’ legislation in 2005 and plans to do so again this year. “Given all of the advances in technology, our great physicians, great training and great hospitals, physicians should be delivering babies, and babies should be delivered in hospitals,” Harris said. “It is the safest and best practice.”

So, with all these advances in technology, great physicians, and great hospitals, why does the U.S. still rank # 28 (near the bottom) of industrialized nations in infant mortality rates, while nations where midwives deliver most of the babies rank near the top?

**Updated** 1/10/06 to add this link: Midwifery in Missouri blog