Re: Clamping baby's cord - is baby still breathing through it?
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Todd Gastaldo writes:
> Everyone knows that babies breathe through their umbilical cords until they
> start breathing with their lungs.
Unborn babies don't breathe at all. They receive oxygen from the
mother's respiration.
> Do not let the OB immediately clamp your baby's cord.
Why not? It has ceased to be useful for providing the baby with oxygen
long before it is born.
A newborn baby need only inhale to begin oxygenating itself, and that's
exactly what it will do as soon as it has a chance. The umbilical cord
is not needed. It has been severed from the connections with the mother
much earlier. Communication between the baby's body and the mother's
body through the cord begins to shut down as the process of delivery
starts.
Additionally, neonatess are extremely resistant to anoxia, no doubt
because this resistance helps them to get through delivery, during which
they may be deprived of oxygen for significant periods.
The argument about blood volume seems reasonable enough, but Baby
doesn't need the cord to breathe.
--
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>Subject: Re: Clamping baby's cord - is baby still breathing through it?
>From: Mxsmanic mxsmanic@hotmail.com
>Date: 6/15/2004 1:56 PM Mountain Daylight Time
>Message-id: <3qkuc0dblb8k103qf64u3m0k0fdiiah8ks@4ax.com>
>
>Todd Gastaldo writes:
>
>> Everyone knows that babies breathe through their umbilical cords until they
>> start breathing with their lungs.
>
>Unborn babies don't breathe at all. They receive oxygen from the
>mother's respiration.
>
>> Do not let the OB immediately clamp your baby's cord.
>
>Why not? It has ceased to be useful for providing the baby with oxygen
>long before it is born.
>
It screws up the kid ..
It is in the news as of late ..
Can't really remember the scenario .. though ..
Who loves ya.
Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://pages.ivillage.com/ironjustice/manisaherbivore
DEAD PEOPLE WALKING http://pages.ivillage.com/ironjustice/deadpeoplewalking
In misc.kids.pregnancy Mxsmanic <mxsmanic@hotmail.com> wrote:
: Todd Gastaldo writes:
:> Everyone knows that babies breathe through their umbilical cords until they
:> start breathing with their lungs.
: Unborn babies don't breathe at all. They receive oxygen from the
: mother's respiration.
A fine point indeed. :-) I think Todd is using the word "breathe"
colloquially to mean "receive oxygen." Of course you couldn't know
that! :-)
:> Do not let the OB immediately clamp your baby's cord.
: Why not?
Hmm. We could get off topic very fast with a question like that. You
already mention blood volume below. Iron stores is another. I am
just pointing out that just because you disagree with Todd's comments
about oxygen doesn't mean there aren't other reasons for delayed clamping.
: It has ceased to be useful for providing the baby with oxygen
: long before it is born.
I don't know where you get that!! Cites!! In the case of my children,
the placenta did not detach from the uterus until weel after they were
born. I would question this conclusion.
: A newborn baby need only inhale to begin oxygenating itself, and that's
: exactly what it will do as soon as it has a chance.
Well, approximately. In most case, what you say is true, but in the case
of my first son, there was several minutes before he started breathing on
his own.
: The umbilical cord
: is not needed. It has been severed from the connections with the mother
: much earlier. Communication between the baby's body and the mother's
: body through the cord begins to shut down as the process of delivery
: starts.
There are two points to be made here...
1. Often it is not the case that the placenta detaches immediately.
2. There is some time involved in the circulation of the umbilical
bloot INTO the baby (where it stays after the baby is born). This
is oxygenated blood that can provide additional oxygen to the baby.
(although I would hazard not a great deal)
: Additionally, neonatess are extremely resistant to anoxia, no doubt
: because this resistance helps them to get through delivery, during which
: they may be deprived of oxygen for significant periods.
Define significant period. 6 minutes often equals brain damage, 10 minutes
death. These numbers are highly variable and are only approximate, but
they also probably represent the maximum possible. Admittedly, the
oxygen in the cord probably represents only a fraction of a minute, but
it might be the fraction that makes a difference in a particular instance.
: The argument about blood volume seems reasonable enough, but Baby
: doesn't need the cord to breathe.
I agree that blood volume is a more important factor overall, and would
argue that iron stores is also.
You may think that Todd did not argue his point very well, but that is
no reason to claim a protocol (delayed clamping) is not beneficial just
because he did not pick what most people recognize as the biggest risk
factors.
Larry
Larry McMahan writes:
> A fine point indeed.
Not nearly as fine a point as any argument about clamping the cord.
> Hmm. We could get off topic very fast with a question like that. You
> already mention blood volume below. Iron stores is another.
Iron is needed mostly for blood; the baby doesn't need extra iron if
there's no blood to go with it.
> I am just pointing out that just because you disagree with Todd's comments
> about oxygen doesn't mean there aren't other reasons for delayed clamping.
The whole discussion is rather like arguing over how many angels can
dance on the head of a pin. In the absence of careful double-blind
studies, there's no way to know whether early clamping is bad or good,
or even if it makes any difference at all.
> I don't know where you get that!! Cites!!
The first step of the delivery process is to begin shutting down
connections between mother and child. Indeed, it's air hunger that
stimulates the baby to take its first breath. If the supply of oxygen
from Mom were intact, the baby would have no inclination to use its own
lungs at birth.
> In the case of my children,
> the placenta did not detach from the uterus until weel after they were
> born. I would question this conclusion.
It doesn't have to detach. It's already inoperative for exchange of
nutrients and breathing gases.
> Well, approximately. In most case, what you say is true, but in the case
> of my first son, there was several minutes before he started breathing on
> his own.
Your first son doesn't establish a general rule. All babies go through
some degree of anoxia for some number of minutes when they are
delivered; that's what triggers their own breathing (the rise in CO2
that accompanies the fall in oxygen as the placental route for breathing
gases shuts down).
> There are two points to be made here...
> 1. Often it is not the case that the placenta detaches immediately.
"Detaches" isn't the same as "stops working."
> 2. There is some time involved in the circulation of the umbilical
> bloot INTO the baby (where it stays after the baby is born). This
> is oxygenated blood that can provide additional oxygen to the baby.
> (although I would hazard not a great deal)
Very little. And I'm not sure why you think the blood is particularly
oxgenated, any more than the blood in the baby itself.
> Define significant period.
Several minutes with varying degrees of anoxia. This is what stimulates
breathing. A baby is disinclined to breathe as long as it is getting
oxygen; the lack of oxygen (or more precisely the rise in CO2) is what
starts it breathing on its own.
> You may think that Todd did not argue his point very well, but that is
> no reason to claim a protocol (delayed clamping) is not beneficial just
> because he did not pick what most people recognize as the biggest risk
> factors.
I think that none of this really matters. Clamping or not clamping
isn't going to have any significant effect on Baby. Human beings are
not that delicate, and in any case the cord is essentially
non-functional by the time the doctor can get to it to clamp it.
--
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Mxsmanic <mxsmanic@hotmail.com> wrote in message news:<pbjvc0ppvdctdo1ub5uo9fe6teauru3vr1@4ax.com>...
<snip>
> In the absence of careful double-blind
> studies, there's no way to know whether early clamping is bad or good,
> or even if it makes any difference at all.
<snip>
> Clamping or not clamping
> isn't going to have any significant effect on Baby.
Um, er, ah, how can you possibly start by arguing that with in the
absence of proper statistical studies it is impossible to know whether
early clamping of the cord matters, and then just a few paragraphs
later assert confidently that it *doesn't* matter?
You can't have it both ways. If, as you say, no suitable studies of
the question exist, then both you AND Todd (and anyone else either)
are just articulating your opinions, with no more empirical evidence
for the one position than the other, and while you may find your
version more plausible, that is waaaay insufficient basis to conclude
that you are definitely correct.
Pat, wearing researcher hat for a moment
edd July 21
P Harris writes:
> Mxsmanic <mxsmanic@hotmail.com> wrote in message news:<pbjvc0ppvdctdo1ub5uo9fe6teauru3vr1@4ax.com>...
> <snip>
> > In the absence of careful double-blind
> > studies, there's no way to know whether early clamping is bad or good,
> > or even if it makes any difference at all.
> <snip>
> > Clamping or not clamping
> > isn't going to have any significant effect on Baby.
>
> Um, er, ah, how can you possibly start by arguing that with in the
> absence of proper statistical studies it is impossible to know whether
> early clamping of the cord matters, and then just a few paragraphs
> later assert confidently that it *doesn't* matter?
>
> You can't have it both ways. If, as you say, no suitable studies of
> the question exist, then both you AND Todd (and anyone else either)
> are just articulating your opinions, with no more empirical evidence
> for the one position than the other, and while you may find your
> version more plausible, that is waaaay insufficient basis to conclude
> that you are definitely correct.
>
>
> Pat, wearing researcher hat for a moment
> edd July 21
--
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P Harris writes:
> Um, er, ah, how can you possibly start by arguing that with in the
> absence of proper statistical studies it is impossible to know whether
> early clamping of the cord matters, and then just a few paragraphs
> later assert confidently that it *doesn't* matter?
I'm not sure where you see the confident assertion. I was merely
expressing an opinion. In the absence of evidence in one direction or
the other, I see no reason to blithely assume that clamping the cord
makes any difference.
--
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In misc.kids.pregnancy Mxsmanic <mxsmanic@hotmail.com> wrote:
: P Harris writes:
:> Um, er, ah, how can you possibly start by arguing that with in the
:> absence of proper statistical studies it is impossible to know whether
:> early clamping of the cord matters, and then just a few paragraphs
:> later assert confidently that it *doesn't* matter?
: I'm not sure where you see the confident assertion. I was merely
: expressing an opinion. In the absence of evidence in one direction or
: the other, I see no reason to blithely assume that clamping the cord
: makes any difference.
: --
: Transpose hotmail and mxsmanic in my e-mail address to reach me directly.
I'd look up the studies on Medscape, but you're too opinionated
to be worth the effort.
Larry
Larry McMahan writes:
> I'd look up the studies on Medscape, but you're too opinionated
> to be worth the effort.
Then why do you mention them?
There are no double-blind, controlled studies on Medscape, or anywhere
else.
--
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"Mxsmanic" <mxsmanic@hotmail.com> wrote in message
news:6qa2d0loagh2fchr4sejd73jhka0q522lj@4ax.com...
> Larry McMahan writes:
>
> > I'd look up the studies on Medscape, but you're too opinionated
> > to be worth the effort.
>
> Then why do you mention them?
>
> There are no double-blind, controlled studies on Medscape, or anywhere
> else.
If this is the case, then it's foolish to assume that immediate clamping of
the cord has no ill effects, and to *do* it as a matter of routine. It is
true, in many species, that the mother will chew the cord shortly after
birth. However in many cases, the cord breaks spontaneously when the mother
lurches to her feet. In no other species that I know of is birth attended by
a third party who severs the cord, or certainly not immediately.
One cannot ever do a proper study on the effects on any given individual
child - the child is either clamped immediately, or not. We cannot see how
the child might have fared if the other had been done. Better, I think, to
err on the side of caution: allow the cord to remain until it clearly ceases
to function. If not when the placenta comes away from the uterine wall, then
at least when the cord stops pulsing.
--angela
Mxsmanic <mxsmanic@hotmail.com> wrote in message news:<cqc1d09uldhs4pi7kvah4hd61a2hnisoi1@4ax.com>...
> P Harris writes:
>
> > Um, er, ah, how can you possibly start by arguing that with in the
> > absence of proper statistical studies it is impossible to know whether
> > early clamping of the cord matters, and then just a few paragraphs
> > later assert confidently that it *doesn't* matter?
>
> I'm not sure where you see the confident assertion. I was merely
> expressing an opinion.
Um, expression of an opinion starts with "I think..." or "in my
opinion..." or "it seems to me...". That is how one indicates that
what follows is an opinion.
What you WROTE was simply, baldly, plainly, >>Clamping or not clamping
isn't going to have any significant effect on Baby.<<
(If for some reason you do *not* feel there is any necessity to
advertise clearly whether you are stating a documented fact or just
expressing your own opinion, then it is unreasonable not to apply the
same rule to (say) Todd's post too :-> )
>> In the absence of evidence in one direction or
>> the other, I see no reason to blithely assume that clamping the
cord
>> makes any difference.
Nor to blithely assume that it *doesn't*.
BTW, I don't have easy access to the medical literature here (and I
really do NOT go for simply reading the abstract of an article and
believing whatever it says, because fairly frequently there are major
design limitations or 'peculiarities' of interpretation that can't be
discerned without reading the actual paper), so I can't check this out
for myself...
....but frankly it would surprise me a good bit if there weren't at
least SOME reasonably-relevant semi-believable data on the subject of
early vs late cord clamping. Lack of perfect studies (and on damn few
subjects ARE there perfectly-done studies!) does not mean that NO
usable information exists; it just limits how strongly one draws what
kinds of interpretations.
Pat
edd July 21
Chotii writes:
> If this is the case, then it's foolish to assume that immediate clamping of
> the cord has no ill effects ...
It's foolish to assume anything, be it ill effects or a lack of ill
effects.
Unless and until there is some reason to believe that immediate clamping
causes problems, there's no reason not to do it.
> Better, I think, to err on the side of caution: allow the cord
> to remain until it clearly ceases to function.
It ceases to function long before Baby has been delivered.
> If not when the placenta comes away from the uterine wall, then
> at least when the cord stops pulsing.
A pulsing cord isn't necessarily a useful cord.
Your mistake is to assume that there is something bad _by default_ about
clamping the cord. There is no evidence to support your belief.
--
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P Harris writes:
> Um, expression of an opinion starts with "I think..." or "in my
> opinion..." or "it seems to me...". That is how one indicates that
> what follows is an opinion.
All statements made on USENET are opinions.
> If for some reason you do *not* feel there is any necessity to
> advertise clearly whether you are stating a documented fact or just
> expressing your own opinion, then it is unreasonable not to apply the
> same rule to (say) Todd's post too :->
That's what I did.
> Nor to blithely assume that it *doesn't*.
There is no reason to assume anything, and thus there is no reason to
criticize or endorse clamping of the cord on the basis of any imagined
effects (or lack of effects) on the baby.
> ...but frankly it would surprise me a good bit if there weren't at
> least SOME reasonably-relevant semi-believable data on the subject of
> early vs late cord clamping.
Semi-believable data is legion. Unfortunately it's ... well,
semi-believable, which is largely synonymous with useless.
--
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In misc.kids.pregnancy Chotii <res0vi4u@verizon.outdamnedspam.net> wrote:
Angela! Why do you keep arguing with this person. It is clear
that he, she, or it is completely immune to logic or reason!
Larry
"Larry McMahan" <mcmahan@spike.cup.hp.com> wrote in message
news:40d24628@usenet01.boi.hp.com...
> In misc.kids.pregnancy Chotii <res0vi4u@verizon.outdamnedspam.net> wrote:
>
> Angela! Why do you keep arguing with this person. It is clear
> that he, she, or it is completely immune to logic or reason!
Who knows? Maybe there's actually a crumb of truth in here. I doubt it, but
I keep hoping. I mean, I don't know everything. I may play an omniscient
demigoddess on the Internet, but I'm not really one in real life. ;)
--angela
"Chotii" <res0vi4u@verizon.outdamnedspam.net> wrote in message
news:lrsAc.6820571$iA2.774927@news.easynews.com...
>
> "Larry McMahan" <mcmahan@spike.cup.hp.com> wrote in message
> news:40d24628@usenet01.boi.hp.com...
> > In misc.kids.pregnancy Chotii <res0vi4u@verizon.outdamnedspam.net>
wrote:
> >
> > Angela! Why do you keep arguing with this person. It is clear
> > that he, she, or it is completely immune to logic or reason!
>
> Who knows? Maybe there's actually a crumb of truth in here. I doubt it,
but
> I keep hoping. I mean, I don't know everything. I may play an omniscient
> demigoddess on the Internet, but I'm not really one in real life. ;)
>
> --angela
I understand what she is trying to say I think. While I do not see the need
to wait any longer then the midwife wants to take to clamp the cord and have
dh cut the cord, I understand that people see the need to hold out longer.
I supose some could say that you never should cut the cord and let it fall
off in tact but I would think that could be icky so I would not go that
route;) Sorry off topic. while I never have researched this topic at all I
do not see any need for me to hold out on the clamping and I am sure that
would mean that I am just ill informed but really unless a study is done
that can prove one way or the other to change the way it is done then why
would someone do differantly unless they really felt strongly about it. Ok
so I was really no help but I am going to blame it all on pregnancy brain;)
Tori
--
Bonnie 3/20/02
Anna or Xavier due 10/17/04
Larry McMahan writes:
> Angela! Why do you keep arguing with this person. It is clear
> that he, she, or it is completely immune to logic or reason!
In other words, you disagree.
--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.
"Chotii" <res0vi4u@verizon.outdamnedspam.net> wrote:
>I mean, what does it hurt the doctor to wait a minute, or
>three, or five, for the cord to stop pulsing, so that you KNOW the ductus
>arteriosis has closed well by itself (and so that whatever fetal blood
>remains in the placenta has a chance to go into the baby)?
That's the gist of training for paramedics and EMTs. Leave the cord alone
(other than keeping it moist) until it stops pulsing, and then clamp.
Cutting is considered optional and basically irrelevant, but clamping is
not.
Mxsmanic <mxsmanic@hotmail.com> wrote:
>P Harris writes:
>
>> Um, expression of an opinion starts with "I think..." or "in my
>> opinion..." or "it seems to me...". That is how one indicates that
>> what follows is an opinion.
>
>All statements made on USENET are opinions.
Bull****. Usenet is just another written medium. The medium doesn't render
language irrelevant, and it's a pathetic crutch to claim it does. You've
been making assertions of fact, so I'd say it's time for you to support
those assertions with evidence or rephrase them for what they are.
Mxsmanic <mxsmanic@hotmail.com> wrote in message news:<cgn3d0h2db897ejesmben4dj9i3jetejp0@4ax.com>...
> P Harris writes:
>
> > Um, expression of an opinion starts with "I think..." or "in my
> > opinion..." or "it seems to me...". That is how one indicates that
> > what follows is an opinion.
>
> All statements made on USENET are opinions.
That is the silliest thing I have ever heard.
One can't just blithely assert that "Donald Duck was the third
president of the United States", or "water is actually composed of two
parts plutonium to one part hydrogen", and then disclaim any need to
back up those statements with references or fact just because "hey, it
was just something I said on usenet".
Even on usenet, if you say "I think" then you are billing something as
opinion, and if you do not put that sort of qualifier on it, then you
are billing it as an externally-verifiable fact.
Otherwise -- if nobody is expected to have any basis for anything they
say here, and no discussion of the factual basis of statements is
wanted/permitted -- then there is no point in even posting, unless you
just need some practice typing.
(And frankly, those who *do* just want typing practice, please do it
somewhere less underfoot of the people trying to have actual
discussions, eh?)
> > ...but frankly it would surprise me a good bit if there weren't at
> > least SOME reasonably-relevant semi-believable data on the subject of
> > early vs late cord clamping.
>
> Semi-believable data is legion. Unfortunately it's ... well,
> semi-believable, which is largely synonymous with useless.
Well, I have some really heartbreaking news for you then.
No data are EVER more than semi-believable. Ever, anywhere, in any
situation, period, full stop.
ALL data from ALL studies require their interpretation to include the
clause "but we can't exactly tell from this study whether some of X
result was due to This or That or The Other Thing" or "but the results
may have been different if we had done Y differently".
ALL studies have limitations. At the very least, even a double-blind
randomised controlled study will STILL depend on what population was
studied... for instance you might well get substantially different
results if you study 5,000 people randomly selected from all over the
world versus 5,000 people randomly selected from people admitted to Mt
Sinai Hospital in NYC versus 5,000 underweight male nonsmokers being
treated for asthma versus 5,000 identical clones. Likewise with other
aspects of a study's design and protocols.
This is just the way the world IS - there are so many factors that
help determine the outcome of an event, it is just impossible to study
or control or account for the effects of every single one of them at
once.
So, what do you want. You have to work with what this universe permits
:-> You get what information you can from the studies can be (and are)
done.
Hardly any studies (tho, yes, a few) are COMPLETELY useless. You just
have to bear in mind what *exactly* the limitations were of each study
and thus what exactly holes/questions/uncertainties there are in your
picture of The Answer. If a study isn't double-blind, you asterisk its
results in your head as "...though I wonder whether some subtle bias
could have caused subjective things to be measured differently between
the two groups". If a study didn't use what you would consider the
most relevant treatments (like, suppose someone's idea of early vs
late cord clamping was just "at 1 min past birth" versus "at 1.5
minutes past birth" whereas you're really interested in a comparison
to 5 or 10 minutes later) then you put the asterisk there and mentally
scribble "but that wasn't exactly the factor I was wondering about an
effect of". If a study is done in a major research hospital and what's
more relevant to your life is what goes on in a medical clinic in
rural Kenya, then you think about factors that could potentially give
different results there and put *that* in your mental Post-It note on
the results. Even anecdotal reports provide a *little* bit of
interesting information that's worth mulling over if there's not much
better information available, although you would not want to place
more than a millionth of an ounce of confidence that they really mean
what they appear to. But a millionth of an ounce of a clue is better
than nothing.
Saying that The One Perfect Study has not been done and therefore we
know nothing whatsoever about <some subject> is just a lazy cop-out.
The only things we truly know *nothing* about are those things that
nobody has ever in any way observed :->
Pat, strongly feeling that logic and experimental design should be
taught to everyone in high school, but giving up to go do something
more productive with the morning, and still curious what studies
*have* been done on the timing of cord clamping,
edd July 21
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