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Advantages and disadvantages of breastfeeding
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Let It Pulsate! A Look Into Delayed Cord Clamping
William C. Borntrager
Virginia College School of Nursing
Mary Vogen MSN, RN
November 24, 2014
Abstract
Cord clamping has long been practiced to occur immediately after birth of a neonate. There is much discussion and evidence based practice that shows improvements to health when we delay the clamping and cutting of the umbilical cord. Delayed clamping allows for more nutrient rich blood to flow to the infant’s body, which is going through shock at birth. Early clamping is generally done between 10 seconds after expulsion of the fetus to one minute , whereas delayed clamping ranges from two minutes until the cord finishes pulsating. The research collected will analyze early clamping and delayed clamping to see which practice is found to be healthier for mother and child.
Let It Pulsate! A Look Into Delayed Cord Clamping
Cord clamping takes place after birth, during the third stage of pregnancy. Once the infant is born , the umbilical cord, which is still supplying nutrient rich blood to the fetus from the mother, must be clamped and cut. This is followed by the delivery of the placenta, which completes the third stage of pregnancy, and thus the cycle is complete. Time is something that can be argued by health professionals all around . Neither physicians nor midwives can scientifically say what is the optimal time for cord clamping because each pregnancy and thus each birth is different and unique . Universal protocol does not necessarily apply during the birthing process. However, majority is something that can be considered and is what this study will look at. Taking a look at the comparisons of delayed cord clamping and the historically accepted practice of quick c...
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... Umbilical Cord Clamping After Birth. (2012, December 1). Retrieved November 2, 2014, from http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth
Chaparro CM, Neufeld LM, Tena Alavez G, Eguia-Liz Cedillo R, Dewey KG. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomized controlled trial. Lancet 2012;367:1997–2004. Retrieved November 9, 2014
Asfour, V, and S Bewley. 2011. Cord clamping practice could affect the ratio of placental weight to birth weight and perinatal outcomes. BJOG: An International Journal of Obstetrics & Gynecology 118 (12): 1539–40. Retrieved November 8, 2014
Weeks, A. (2010). Umbilical cord clamping after birth, Dr. Philip Lanzkowsky, M.D. British Medical Journal, 335(312), 1075-1101. Retrieved November 9, 2014
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
When pregnant, many expecting mothers are faced with a very tough decision, the decision to have an epidural during labor or to have a natural birth. Both methods have negative and positive aspects. This topic has such conflicting views that about 50% of women decide to get an epidural when going into labor and the other 50% of women choose the alternative: natural childbirth. It is important for an expecting mother to look into both options thoroughly to ensure they make the best choice for both themselves and for their child. With all of the speculations circulating about both options, it is hard for mothers to see the truth about both epidurals and natural childbirth.
He also suggested drying the neonate and providing tactile stimulation to encourage breathing, and covering with a dry blanket to maintain warmth. If after thirty seconds of tactile stimulation, the neonate’s breathing is not sufficient, paramedics should follow protocol for newborn resuscitation, see appendix (L) (QAS, 2014; Saunders, 2012). If the neonate is breathing adequately, leave the newborn with the mother and encourage breastfeeding, which stimulates the nipple resulting in a release of oxytocin which promotes uterine contractions (Stables & Rankin,
In doing this project the literature drawn from is largely non-scholarly for the reason that I am prevailing upon the reader to think outside the box about birth. Most of the “scholarly” research that is available was written by doctors or nurses/nurse midwives who were trained in the medical model of birth. Since part of my premise is that the high rate of Cesarean sections is caused in part by viewing birth as a medical and therefore pathological event, and in part for its emergence as a capitalistic industry, it was then necessary to find literature written by people who have expertise in birthing though not from the traditional obstetrical/medical school approach.
Greene, A. (2008, July 30). Why Infants Suck Their Thumbs. Retrieved April 17, 2014, from http://www.drgreene.com/qa-articles/infants-suck-thumbs/
The focus of this paper is to discuss the different characteristics of the two most effective methods of child births: Natural births and Cesarean section (C-section). Child birth includes labor and delivery; the entire process of passage from the womb, to the birth canal, to the outside world. Natural birth is a method of child birth in which medical interventions are minimal and the mother usually practices relaxation and breathing techniques to minimize pain during delivery. Cesarean section (c-section) is a method of birth which involves delivery through incisions in the abdominal walls and uterus. Natural births and C-sections both pose documented medical risks to the mother’s health including infections and other medical mishaps (Rowe- Murray 2002).
Nowadays, there are many alternatives or any other methods to improve the healthcare especially in a transplantation world. There are few choices available for the people today such as the embryonic stem cells, bone marrow stem cells, peripheral blood cell and the most new is the umbilical cord blood. The umbilical cord blood (UCB) defined by Chima and Mamdoo (2011, p. 79) as the blood which taken from the cut umbilical cord attached to the placenta of a newborn baby after a delivery. It been stated (Chima and Mamdoo 2011, p. 79) that the cord derived from the allantois have a rich source of multipotent stem cells, including the CD34+ , CD38- and haematopoietic progenitor cells. This shows that the cord blood could be more potential as the bone marrow cell in the patients with the haematological or non-haematological problems. The first successful umbilical cord transplantation done was in 1989 in a child with a Fanconi’s anemia and since then, the growth or demand for the cord blood increased. As we can see, this contributed to a major reason for the need of umbilical cord blood donation, storage, processing, freezing, and releasing of cord blood to the patient. Thus, establishment of the cord blood bank (CBB) because of the demand increased (Ballen 2010, p. 8). As mentioned by Ballen (2005, p. 3786), the first establishment of cord blood bank was in the early 1990s in New York, Milan, and Dusseldorf. The storage of the cord blood could last for about 15 years (Fadel 2006, p. 1). The point is that there are many ethical and legal issues raised by this CBB that need clarification and justification like the informed consent, ownership and property rights, collection of cord blood, and public CBB vs private CBB.
According to Steen and Marchant (2007), 60-70% of women will require sutures after vaginal delivery. A common morbidity of lacerations in the perineum is acute pain (Steen et al., 2007). Indeed, many women who have had birth related lacerations have decreased mobility, difficulty sitting comfortably, or fear of defecation due to pain (Steen et al. 2007). Furthermore, this pain may impede a mother from breastfeeding, focusing on newborn care and can lead to increasing irritability (Steen et al., 2007).
As defined by Lowdermilk, Perry and Cashion, preterm labor is “cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy”. Preterm birth is a dramatic event causing distress for both the child and parents. There is a significant amount of information available on the risk factors related to preterm labor. Seeing the ineffectiveness of interventions directed towards known risk factors emphasizes the lack of maternal understanding of possible underlying pathways.
Between five to ten percent of all infants are born more than two weeks before their due date due to several factors that include infections, illness, poor nutrition, or complications during the pregnancy. Fetal monitors are used in the cases of C-sections because there is a much higher risk of detecting the infant’s distress and therefore can go in more quickly to remove the baby from the uterus. When the mother is under general anesthesia, which is rare in the United States, the mother is not aware of any kind of pain or even the birth of her child. When the mother has spinal anesthesia she has no feeling from the waist down. Sometimes, the best indication that the baby is in distress is the mother- an unfamiliar pain occurs or something else could be a sign of problems.
The correlation between maternal smoking and low birth weight has been strongly established. Nicotine affects the placental function by inducing the release of norepinephrine and epinephrine into the maternal blood, which causes decreased blood flow to the placenta (1). The decreased blood flow causes a decrease in delivery of oxygen and nutrients to the fetus. This may have an effect on cell growth and development. High levels of carboxyhemoglobin are present in the blood of the mother and the fetus. This may decrease the capacity of the blood to transport oxygen and fetal hypoxia is the result (2). Fetal hypoxia and ischemia are major contributors to developmental defects, but nicotine has been implicated, in various studies, to have a direct affect on fetal development (3).
...as than others. The oldest source was the textbook Infants and Children. The other three sources were from the Internet written in 1996. Doctors wrote two of the articles and the other one was from the health information for Lenox Hill Hospital. I believe that overtime birthing methods have changed and have alternative ways to proceed, however, the cesarean delivery is pretty much the same procedure and cannot really be changed in any way, which means that the information given will be basically the same.
Therefore, many parents believe that banking umbilical cord is unique opportunity to save these stem cells in order to guarantee 100% match for their baby in case treatments is ever required6. One of the few disadvantages of this source of stem cells, there are limit amount of haematopoietic stem cells that can be extracted from each cord blood units. In addition, the UCB cells take longer to engraft than do stem cells from more mature sources. This delay leaves the recipients vulnerable to infection. In spite of certain disadvantage cord blood has huge potential in medical treatments3. Likewise, donating cord blood is generous gift that basically doesn’t cause harm or problem to the donors and may save or improve quality of someone’s life4. However, UCB stem cell donation and preservation are endorsed by many world religions. Though, there are many ethical concern including proper informed consent, genetic screening of the donors, autologous & allogenic UCB storage, truth in advertising by private banks and distributive justice6. In addition to cord blood banking, the expectant parents also have a chance to store their new-born baby’s cord tissues. Umbilical cord tissue (Wharton’s jelly) is rich source of umbilical cord mesenchymal stem cells (MSCs)10. It has abilities to self-renew and differentiate into many tissues cellular tissues including adipocytes, osteocytes, chondrocytes, cardiomyocytes, hepatocytes and nerve cells. Their proliferative properties have abilities to migrate at site of inflammation which makes MSCs highly desirable for tissue engendering and cells based
Parents are looking more into having a lotus birth and its benefits for the baby even after birth. Lotus Birth is the practice of leaving the umbilical cord uncut, so that the baby remains attached to the placenta until the cord naturally separates at the navel, exactly as a cut cord does 3-10 days after birth. The problem that many don’t realize is that a lot of issues dealing with infections and furthermore the fact that the placenta would not be no longer usable, seeing that the tissue would be dead shortly after birth. The point that low iron and bad blood wouldn’t be a reason for clipping at birth but obviously not an overall sufficient reason to leave the cord attached. Michelle Castello writes an article titled “Lotus birth advocates argue against cutting
General hospital-based obstetric practice introduces clamping as early as 1 minute after the birth of the child. In birthing centers, this may be delayed by 5 minutes or more, or omitted entirely. Clamping is followed by cutting of the cord, which is painless due to the lack of any nerves. The cord is extremely tough, like thick sinew, and so cutting it requires a suitably sharp instrument. Provided that umbilical severance occurs after the cord has stopped pulsing (5-20 minutes after birth), there is ordinarily no significant loss of either venous or arterial blood while cutting the cord. Umbilical cord clamping is part of the third stage of labor, the time between delivery of the baby and the placenta (Rabe, et al.; 2007).