newborn medicine


On The Optimal Time To Cut The Baby’s Umbilical Cord

The New York Times reports on a new analysis that lays out the benefits of waiting at least a minute or so before cutting a newborn’s umbilical cord; the standard practice in mainstream maternity care is an immediate snip, in under 30 seconds.

By delaying the time in which the mother is literally separated from her new baby, more blood can move from the placenta, the report says, which “significantly improves iron stores and hemoglobin levels in newborns and does not increase the risks to mothers.” The study was published Wednesday in The Cochrane Database of Systematic Reviews.



Even with mounting evidence of its benefits, delayed cord-clamping remains controversial  (the influential American College of Obstetricians and Gynecologists issued a statement in December saying there’s not enough evidence to endorse or refute the practice). However “delayed” cord cutting — or the preferred term “optimal cord-cutting” has been common among midwives, doulas and mothers around the globe for decades.

Somerville doula Ananda Lowe (my co-writer on a book about birthing practices) recently posted this informative piece about “optimal” cord-cutting following either vaginal or cesarean birth. It’s written by Dr. Alan Greene, who in 2012 launched a worldwide campaign called Transitioning Immediate Cord Camping To Optimal Cord Clamping or TICC TOCC. Greene’s post clearly lays out problem, the history and the physiology of practice, and makes a powerful argument that optimal cord-clamping is a simple, inexpensive fix Continue reading

New, ‘Electronic Apgar’ To Predict Health of Premature Babies

Researchers says they've developed a better system to predict the future health of premature babies

Stanford University researchers say they’ve developed an electronic version of the traditional Apgar score for newborns that can more accurately assess and predict the future health of premature infants.

The new system, called the “PhysiScore,” comes up with a “prediction algorithm” by taking into account information like the newborn’s gestational age and birthweight and then filtering in a stream of real-time data routinely collected in neonatal intensive care units – heart rate, respiratory rate and oxygen saturation. According to the research, published today in Science Translational Medicine, the PhysiScore out performed the Apgar, the standard, low-tech method to assess babies that has been used for more than half a century, as well as three other assessment systems that require needles or other invasive laboratory measures.

And the PhysiScore might even be a cost-cutter: Suchi Saria, the Stanford graduate student who led the research as part of her doctoral thesis in computer science wrote in an email: “The tool can be cheaply implemented on a bedside monitor utilizing existing resources in the NICU. A tool such as ours can help identify more accurately which infants need to be moved to a specialty hospital over being kept at the local nicu so it can save money by giving more accurate information based on which treatment plan/transport decisions can be optimized.” Continue reading