We are excited today to share a guest post from Jennifer Margulis, PhD. An investigative journalist, activist for children and mother of four, she has gained increased recognition recently for her eye-opening new book, The Business of Baby. (The Business of Baby is now titled, Your Baby, Your Way.)
(Photograph credit Jennifer Margulis)
When Taylor Hengen Newman had her baby at Mount Sinai Hospital in New York City four years ago she had just a few minutes with him, skin-to-skin, as she had requested, and then he was taken out of her arms to be examined by a pediatrician, weighed, have a PKU heel prick, and warm up in an incubator. The obstetrician instructed her to push harder to deliver the placenta.
Taylor and her husband then held their baby for about twenty minutes until he was whisked away by the hospital staff.
An hour went by.
A nurse came in to say the baby had fluid in his lungs and was under observation but no doctor came to talk to the worried young couple about what, if anything, was wrong. To her knowledge, her son was not taken to the NICU. Though Taylor kept asking for her baby she did not see him again for almost five hours.
"I couldn't find a nurse to bring me a glass of water, let alone a lactation consultant. And I had no idea where my baby was," Taylor remembers. I felt so disoriented. And when he was brought back to me, bathed and smelling different, I wasn't even sure he was mine.
When my baby girl, who was born at Crawford Long Hospital in Atlanta, Georgia, was taken out of my arms I felt like someone had cut off my arm. I ached for her in a primal way I had never felt before. Every cell in my body wanted my baby in my arms, on my chest, by my side. We had spent the past nine months inseparable. Not every mom bonds right away with their baby. I wasn't even sure how I felt about the funny-looking creature with the skinny frog legs and sticky outy ears. But I needed her with me as urgently as I needed to breathe.
That was 14 years ago. It still hurts to think about the time we spent apart because of hospital protocol.
Although every hospital follows a different protocol, in most American hospitals it is standard procedure to separate the mom and the baby just minutes after birth, wash the baby with some kind of commercial soap, and take the newborn out of the room to a nursery for observation. American babies also routinely have their umbilical cords clamped just seconds after birth, are given antibiotic ointment for their eyes to protect against venereal disease, have a vitamin K shot in their thigh to avoid blood clotting disorders, and are given a hepatitis B vaccine. Though the numbers are declining, the majority of American baby boys are also circumcised within a day of being born.
Does a newborn baby really need so much medical intervention in the first few hours of her life?
Should a healthy newborn be separated from her mother, the way it is routinely done in many American hospitals?
The short answer to these two questions is no. A healthy newborn needs no medical intervention in the first few hours of life. And in the absence of a real medical emergency, the safest, healthiest, best place for a baby to be is in your arms.
Babies needs skin-to-skin: More than half a dozen studies show that the outcome for mother-baby bonding and an infant's health is better when a mother and a baby are not separated. Dozens more nonhuman mammal studies show that early, uninterrupted contact stimulates oxytocin and other hormones, which enhance nurturing and protective feelings. Nils Bergman, M.D., who has conducted several studies on infant sleep and maternal-infant bonding, points out that animal researchers separate newborn mammals from their mothers to study the damage separation causes on the developing newborn brain. Early uninterrupted skin-to-skin contact has been shown to reduce crying, improve bonding, keep the baby warm, and facilitate breastfeeding.
It turns out that when Taylor wanted her infant in her arms was not just Taylor's whim, it was nature's way of insuring her baby's survival. When Bergman was working as a mission doctor in a rural hospital in Zimbabwe, Bergman found that the survival rate of low-weight premature infants jumped from only 10 percent to 50 percent when mothers were instructed to carry them skin-to-skin in pouches on their fronts. Survival rates for bigger babies jumped to 90 percent. That experience changed Bergman's understanding of what human infants needed after they were born. "I realized that I was seeing the real biology of Homo sapiens at work, and that what I had learned at medical school was a result of modern culture equipped with amazing technology, but no understanding of human biology," Bergman told me when I interviewed him for my book.
Do babies need antibiotic eye ointment?: The practice of putting silver nitrate in a baby's eyes, which became popular in the late 19th century as a way to stop babies from going blind due to infection from gonorrhea, was discontinued after silver nitrate was found to be highly irritating, cause chemical pinkeye, and even cause blindness with incorrect dosing. Using antibiotic ointment in the form of a cream or medicated eye drops is a hold-over from that practice: the idea being that it will protect a baby from chlamydia or gonorrhea or other contamination from the mother's vagina.
The use of this ointment is recommended by the American Academy of Pediatrics and mandated by law in many states. But if you have had proper prenatal care, you have been tested for any potentially contagious STDs. If you have had a C-section and your baby's eyes have not come into contact with your vaginal canal, there is no proven way for your baby to contract an STD from you. As mentioned above, there is a growing body of evidence that shows that the vaginal and even fecal flora that your baby is exposed to during birth is crucial to the long-term health of his immune system.
The antibiotic ointment not only irritates a baby's sensitive eyes, it also makes it harder for your nearsighted baby to see you in those crucial moments after birth when you and he are hormonally primed to gaze at each other and bond. In countries that have dramatically lower infant mortality rates and dramatically healthier babies in the first five years of life, including Norway, Sweden, and Great Britain, medicated eye drops are not routinely given to infants.
Babies don't need the Hepatitis B vaccine: The CDC's recommendation that every newborn in America get a Hepatitis B shot, regardless of whether his parents have Hepatitis B, is one of the most unfortunate medical mistakes of our time. Hepatitis B is a sexually transmitted disease. Heather Zwickey, Ph.D., a former vaccine developer who earned her doctorate in immunology and microbiology from the University of Colorado Health Sciences Center, did a postdoc at Yale University, and is now Dean of Research and Graduate Studies at The National College of Natural Medicine, explains that a newborn's immune system can't mount an effective response to diseases or vaccines because it is protecting the baby's brain, which would be damaged by a full-fledged immune reaction the way an adult would react to a virus or bacteria.
So newborns rely on their mother's antibodies, which they get in breast milk, to give them the immune cells and proteins needed to combat infections. Until an infant's brain is more developed probably between nine and twelve months old he will only have a mild, general immune response (the scientific name for this is a TH2 response), the sort we associate with allergies, but which doesn't tailor any of the special white blood cells (called TH1 cells) to respond to a specific bacterium or virus.
A baby's short-lived and immature immune response is the reason we give so many doses of vaccines in the first few months of life. Vaccines given before twelve months of age must be repeated at or after twelve months, according to Zwickey, because the immune system is not able to really learn anything from doses given before then. In nursing school, Michele Pereira's instructors informed students that from an immunological standpoint it would be better to give vaccines to children when they are a bit older.
But since parents less reliably bring children over a year old to the pediatrician, the best way for public health officials to ensure high levels of vaccinated children is to vaccinate them as early as possible. Zwickey believes early vaccination makes sense from a public health perspective but is not immunologically optimal. It is only after about twelve months that the immune system is sufficiently mature to have a memory. That is, a baby can develop antibodies in response to a vaccine, and these antibodies will stay in the bloodstream without needing booster after booster.
Everyone who studies human immunology knows that the TH1 response doesn't come up until the end of the first year of a human baby's life, Zwickey told me matter- of-factly when I interviewed her.
The birth dose of the Hepatitis B vaccine is completely unnecessary for the vast majority of newborns born in the United States. Your baby is not going to be engaging in intravenous drug use or unsafe sex and the chance of getting Hep B from a tainted blood transfusion in America is very low. But the birth dose of the Hep B vaccine is potentially very damaging. The immune system can sometimes mistakenly identify the body's own cells as foreign, causing the body to attack itself. When the body inappropriately attacks its own proteins, a child develops an autoimmune disorder.
There has been an exponential rise in autoimmune disorders among children since the 1950s. One study found that cases of type 1 diabetes among children under five increased five fold between 1985 and 2004. Graves disease, once unheard of in children, is becoming common. Other autoimmune disorders on the rise in American children include asthma, allergies, Crohn's disease, and atopic dermatitis. One 2008 epidemiological study found that infant immunization leads to a statistically significant increase in type 1 diabetes in children.
Babies should not be bathed: We know from research published in Cellular and Molecular Life Sciences that the white creamy substance infants are born with (vernix caseosa) contains powerful proteins that have both antibacterial and antifungal properties. These proteins, researchers have found, contribute to an infant's healthy immune system by protecting the fetus and the newborn against infection.
As I've already mentioned, recent research has also found that as the baby journeys through the mother's vaginal canal, he is inoculated with beneficial bacteria that will boost his immune system (babies born via C-section are colonized mostly by bacteria found in the hospital, a disturbing finding that scientists still aren't sure how to interpret). What all this means is that when the nurses scrub your infant, they deprive him of the beneficial microorganisms and substances on his skin. The natural smell of a baby has further been found to stimulate the pleasure centers of the brain. Bathing a newborn interferes with bonding and with a human's need to smell her baby. A baby bath can also chill an infant whose ability to regulate body temperature is still immature, according to Susan Markel, M.D., a Connecticut-based pediatrician who has been practicing for over 30 years.
And then there's the soap itself. When the Safe Cosmetics Action Network tested a variety of brand name baby soaps five years ago they found that several contained 1,4-dioxane, a carcinogenic by-product that has been shown to cause cancerous tumors in over a dozen animal studies and has been banned in Europe. Consumers will not find the ingredient 1,4-dioxane listed on the bottle. Instead they will see PEGs. PEGs are made from polyethylene glycol, a petroleum-based compound that is often contaminated during the manufacturing process with 1,4-dioxine and ethylene oxide, another known carcinogen.
Johnson & Johnson's Head-to-Toe Baby Wash, the soap used to wash newborns in most hospitals, contains PEG-80 and PEG-150 Distearate. Advertised as gentle enough even for newborns, dermatologist-tested, and #1 hospital recommended, Head-to-Toe Baby Wash also contains Quaternium-15, a chemical preservative that kills bacteria by releasing formaldehyde, another known carcinogen. Formaldehyde is the chemical used to embalm dead bodies to keep them from decaying. Johnson & Johnson changed their baby formula for the European market and parts of Asia virtually overnight. They also publicly committed to stop selling baby products with Quaternium-15 in the United States. But they haven't.
When Taylor Hengen Newman became pregnant for the second time, she and her husband chose a home birth attended by midwives. By then her family had moved to Austin, Texas. The midwife handed the baby to Taylor right away. Taylor pushed out the placenta while her son cuddled on her chest. The midwife conducted the newborn exam so gently and quietly that it did not disrupt their bonding. Afterwards she rubbed Taylor's feet with lavender oil. Otto was not given eye ointment or a Hepatitis B vaccine. He did not have a bath. They waited more than an hour to cut the cord, which they did just before Taylor got up to take a shower. This time they chose not to circumcise. Taylor's doulas (she had two at the birth) brought her a smoothie and her husband a sandwich. Big brother Kaspar came in to see his new baby. The next day her midwife came back and gave Otto a Vitamin K shot since Taylor had been on blood thinners during the pregnancy.
It all completely clicked that this was just a completely different way of caring for people, delivering babies, Taylor says. I wish medical care of all kinds could emulate this model.
This article is adapted from The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby BEFORE Their Bottom Line. An extended discussion of after birth practices and relevant references for the article can be found in the book.
Jennifer Margulis is a Senior Fellow at the Schuster Institute for Investigative Journalism at Brandeis University and a sought-after speaker. Her fifth book, The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby BEFORE Their Bottom Line has been called a must-read by Ina May Gaskin. Join her on Twitter, Pinterest , and Facebook