One of the first arguments I found AGAINST the practice of waiting before the umbilical cord is cut, or even leaving the cord attached to the placenta until it dries up and falls off of its own accord (as is the practise in the ‘lotus’ birthing method), is that prolonged attachment can lead to increased risk of jaundice.
From The Cochrane Library (ISSN 1464-780X) “Effect of timing of umbilical cord clamping at birth of term infants on mother and baby outcomes”.
This review of 11 trials showed no significant difference in postpartum haemorrhage rates when early and late cord clamping were compared. For neonatal outcomes it is important to weigh the growing evidence that delayed cord clamping confers improved iron status in infants up to six months after birth, with a possible additional risk of jaundice that requires phototherapy.
I did some research on janudice and found an article (with no connection to anything other than diagnosing janudice in babies) which said that jaundice cases were on the INCREASE in the US.
“Jaundice is caused in babies when their livers cannot filter bilirubin, the byproduct of hemoglobin from decomposing red blood cells,” says Renee Fox, M.D., director of neonatology at UMHC.
If not treated, high levels of bilirubin can cause serious health problems, such as cerebral palsy, seizures and a rare brain condition called kernicterus.
The increase in untreated jaundice cases may be due in part to shorter hospital stays following a delivery. Doctors and nurses are given just 48 hours to screen for jaundice.
Premature babies are at a higher risk of becoming jaundiced because their livers are less mature and not as capable of handling the bilirubin compared to full-term babies.
From: A manual of physiology By George Neil Stewart p 53
At birth, great changes take place in the circulation, and these are intimately connected with the commencement of the respiratory activity of the lungs. The causes of the first respiration are: (1) The increasing venosity of the blood circulating in the bulb, which stimulates the respiratory centre when the umbilical cord has been cut or tide and the placental circulation thus interfered with; (2) the stimulation of the skin by the air, which, as we have seen, acts reflexly upon the respiratory centre.
From: http://www.thenakedscientists.com/forum/index.php?topic=17925
He pointed out that the haemoglobin in foetal blood is different from the haemoglobin needed for breathing air.
The difference in oxygen concentration across the placental barrier is lower than the difference in concentration in the lungs. Consequently the haemoglobin has to take up Oxygen more readily before birth than after.
So basically, unborns have haemoglobin that grabs onto the oxygen really hard because that’s the only way of getting it out of the mother’s blood. When the baby starts to breath on its own, it has a direct oxygen intake and so the haemoglobin doesn’t need to grab on so hard.
So the baby needs a complete new set of red blood cells to deal with oxygen in this new manner.
As a side-note, I have also read that the potential for Bilirubin build-up is due to the foetus actually having a higher volume of blood (neccessary in order to absorb the oxygen needed) than a breathing newborn who has a direct intake of oxygen.
The transition from foetal to adult-type haemoglobin does occur around the time of birth, but the reason for neonatal jaundice is that prior to birth excess bilirubin produced by the destruction of senescent (old) red cells was shunted to the maternal circulation across the placenta for processing by the mother’s liver. But post-partum the baby no longer has this facility and has to stand on its own two metabolic feet. Consequently, any short-fall in liver processing power is reflected in a slight excess of bilirubin in the bloodstream for a few days, triggering jaundice. This is dealt with by exposure to sunlight or, more correctly, light containing blue wavelengths. Bilirubin is photolysed (broken apart) by blue light, yielding a more soluble form of the molecule which can be excreted in urine rather than by the liver. This is why phototherapy is so effective at treating the problem.
One can see how leaving the umbilical cord attached could lead to too much of the ‘wrong’ type of blood being passed from the placenta to the baby … but until the placenta disattaches from the mother, wouldn’t the mother continue to process the excess bilirubin via the reverse path?
For the umbilical cord to pulse, it has to have blood flow … and if blood is flowing one way, why would it not also be flowing the other way?
Once the placenta has separated and especially after it has been birthed, it will no longer pulse. Therefore the baby should not be receiving any more of this placental blood with oxygen-hungry haemoglobin, and will also not need to eliminate the same by the reverse path.
In fact, to take this arguement a stage further, if, while the umbilical cord and placenta are still attached and ‘in place’, the mother’s liver IS processing the bilirubin from the no-longer-needed dying oxygen-hungry red cells, why would you cut the line that allows for its elimination?
Wouldn’t cutting the cord cause these unneeded cells to remain IN THE BABY, forcing the baby’s very young liver to suddenly deal with the bilirubin on its own?
Breast-fed babies have a higher risk of jaundice, but for most newborns the risk is slight and is far outweighed by the benefits of breast-feeding. In addition, if a mother’s milk is slow to let down, her baby may not gain weight as readily, which makes jaundice more pronounced. A slow start to breast-feeding may also lead to some dehydration in the baby, which may raise the bilirubin level.
More frequent feedings of breast milk or formula to help infants pass the bilirubin in their stools may also be recommended.
Breast-feeding more than the daily usual of 8 to 10 times, which will encourage your baby to have more bowel movements, might reduce the risk. Breast-milk-related jaundice normally appears four to seven days after birth and may last for several weeks.
Colostrum, the “first milk,” helps your baby pass these stools. The sooner you put your baby to the breast, the quicker colostrum gets into her system. Colostrum acts like a laxative and helps push the meconium (meconium, a tarry substance made up of all her bowels have accumulated during nine months in the womb) out of your baby’s bowels. Your baby will have these stools until your milk comes in — so the sooner and more frequently you breastfeed, the quicker the meconium clears from her system.
Since meconium buildup can cause jaundice, it’s important to breastfeed at least 10 to 12 times in 24 hours to clear it out of your baby’s system.
Study confirms and state that although breastfeeding per se does not seem related to the increased frequency of neonatal jaundice but to the higher bilirubin level in a very small subpopulation of infants with jaundice. In fact, in the breastfed infants, there is a small subpopulation with higher serum bilirubin levels. These infants, when starved and/or dehydrated, could probably be at high risk of bilirubin encephalopathy.
I found a research document which stated that the practice of early cord clamping began during the days of heavily medicated births. Doctors deliberately stopped the blood flow to keep the newborns from retaining too much of the anesthesia their mothers were under.
To my surprise (pleasant surprise!), I also found that there is a growing number of doctors who are claiming that early cord clamping (which effectively cuts the blood flow that the baby has become used to, and temporarily starves the baby of oxygen as its body is changing over to lung absorbtion) puts the baby into a near-stroke state of trauma … and MAY be a primary contributing factor to autism!
I was VERY interested to learn that “Pitocin, routinely used in hospitals to induce and hasten labor, is known to cause high bilirubin levels“.
Why am I not surprised?
All in all – does this post bring any firm answers to the ongoing dispute?
No. Of course not.
There is still so much that is not known.
All I can say, is that I believe in nature’s perfected way.
Whether you look at human existance as having spanned thousands of years, or hundreds-of-thousands of years … the birthing process has stood the test of time. We’re all here, aren’t we?!
Here are some tips I found that assist in optimum liver function and the reduction of jaundice:
• Try and cook food in minimal oil and stay away from fried foods.
• It may be better to make fruits and vegetables a major part of your diet. Red meats contain too much fat. Try consuming more lean meats and trim the fat off wherever possible.
• Reduce your intake of spices and sour foods and try and take less salt as well.
• Have plenty of orange juice
• Also take barley water regularly
• Give yourself an enema whenever you feel constipated to ensure proper elimination
• Carrot juice is known to have benefits for jaundice
• 4 gms of Indian gooseberry taken with water every day for 15-20 days helps regulate over all liver functioning
• Burdock root, Red clover, Celandine, Chaparral, Oregano, and Silymarin (Milk thistle) are very beneficial herbs for helping with jaundice.
• Babies that nurse often excrete bilirubin more efficiently and are often less likely to be jaundiced. It is imperative to ensure that the mother is getting plenty of fluids to help establish a plentiful supply of breastmilk. (Although you don’t want to be overly hydrated, as this can causes the breasts to dry up)
• Catnip or Catmint tea sipped by the mother and given in small amounts to the newborn is good for treating physiological jaundice. The mother should drink at least 2 cups a day, preferably just prior to nursing. Catnip tea is also helpful for colic.
• Dandelion included in your prenatal diet and during early lactation helps your fetus/baby to develop a strong liver. Dandelion leaves, cooked or raw, and Dandelion root, tinctured or decocted is used.
A tablespoon of decoction or 10 drops of tincture several times a week, or one serving of Dandelion weekly during the last three months of pregnancy.