Natural Child Birth
Many parents have concerns and questions about the numerous requirements around giving birth in the hospital or at birthing centers. Here are a few issues discussed in detail that my families ask about and you might be wondering about too:
Hepatitis B Vaccine
This is currently the only vaccine offered to newborns, and the reason for its inclusion dates back to when routine testing for Hepatitis B in the mother was not widely available or utilized. The risk of contracting Hepatitis B is minimal for newborns, unless the mother is positive for Hepatitis B, since it is a virus that can only be transmitted through the blood. Major concerns in the past were related to the ingredient Thimerosal (a Mercury-based preservative), but this has been phased out since 2003. Most parents are not excited to give their newborns vaccines, and wanting to avoid this one is understandable, as the risk of catching it is close to zero. A needle stick, sexual abuse or blood transfusion would be the only ways a newborn could contract this virus. Besides, the Hepatitis B vaccine has one of the highest rates of adverse events reported to the Vaccine Adverse Event Reporting System, which is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). Some parents report to me that they were never given a choice and their child was vaccinated without their consent. Do not let this happen to you. This is your child, and depending on which state you reside in, you have a say in whether your child gets this vaccine.
Newborn Screening Test
This test is used to screen your child for congenital diseases that, if not treated, could lead to brain damage or even death. I suggest this to all my patients. The test is completely safe for the child and could save their life!
Newborn Hearing Test
Hearing in the newborn is well developed at birth, and so much language development occurs in first 6 months; Infants can start saying “Mama/Dada”, they can combine syllables, and jabber by this time. Therefore, in order to give the best advantage to your child, it’s important to know if they have normal hearing. The risk for congenital (newborn) hearing loss is about 1: 1000, and even higher in Hispanics & the poor (Mehra, 2009). This rate is much higher than most of the diseases we check for on the Newborn Screening test, which makes it just as important for your child. If you don’t think that your child is at risk for newborn hearing loss because mom and dad have perfect hearing, think again: 90% of children w/congenital hearing loss have parents with normal hearing!
This is given at birth, usually in the form of a shot, to prevent “Hemorrhagic Disease of Newborn”. This means the baby can have serious bleeding somewhere in the body. Some parents choose to use oral vitamin K drops, because they don’t want to give their child a shot so early in their life. There are some pros and cons to discuss here. Getting the oral vitamin K may not be as protective as the shot, but does decrease baby’s risk of hemorrhage nonetheless. Concerns with the shot came from some research in the past that spoke of a possible connection between Leukemia and the vitamin K shot. The connection may be related to phenol, a carcinogenic ingredient found in vitamin K shots, which was reported in the journal “Gulf War & Health” to be linked to cancer and leukemia. However, many physicians say that the studies are inconclusive, and that the shot is safe. What needs to be created is a Phenol-free vitamin K shot, which would alleviate concerns of parents. New Zealand, Australia and Canada all have oral vitamin K guidelines, which include at least 3 doses spread out over 4-6 weeks. Consult with your physician on dosing for your child. The American Academy of Pediatrics in 2003 stated: “The rate of late Vitamin K Deficiency Bleeding (often manifesting as sudden central nervous system [CNS] hemorrhage) ranges from 4.4-7.2 per 100,000 births [.004-.007%], according to reports from Europe and Asia. When a single dose of oral vitamin K has been used for neonatal prophylaxis, the rate has decreased to 1.4-6.4 per 100,000 births.” [.001-.006%]
It is important to note that 30-50% who get CNS hemorrhage die or have lasting brain damage, so this is not an issue to take lightly.
Here is the American Academy of Pediatrics statement in 2006: “Prevention of early vitamin K deficiency bleeding (VKDB) of the newborn, with onset at birth to 2 weeks of age (formerly known as classic hemorrhagic disease of the newborn), by oral or parenteral administration of vitamin K is accepted practice. In contrast, late VKDB, with onset from 2 to 12 weeks of age, is most effectively prevented by parenteral administration of vitamin K. Earlier concern regarding a possible causal association between parenteral vitamin K and childhood cancer has not been substantiated. This revised statement presents updated recommendations for the use of vitamin K in the prevention of early and late VKDB.
For your own information, here are the studies implicating the vitamin K shot and leukemia:
• Golding J, Paterson M, Kinlen LJ. Factors associated with childhood cancer in a national cohort study. Br J Cancer.1990; 62 :304 –308
• Golding J, Greenwood R, Birmingham K, Mott M. Childhood cancer, intramuscular vitamin K, and pethidine given during labour. BMJ.1992; 305 :341 –346
• This is used to protect the baby from contracting gonorrhea or chlamydia from the mother if the child is born through the birth canal. Gonnorrhea will almost always show symptoms in the mother, but chlamydia can show no signs of infection. The original concern was that these diseases, if untreated, can cause blindness in the baby. However, this occurred at times when we did not have antibiotics developed and widely used if a child did contract this disease. However, we do have antibiotics now for it. Mom should be tested for this and as long as the couple is monogamous (and honest!), there should be no risk of these diseases in the child as long as mother tests negative. Some parents have a concern that there is a decrease in bonding with mother and father because they have the ointment in their eyes and this would not allow the child to catch the first glimpses of their parents. This is a reasonable concern that should be respected. The bond in the first few hours of life is critical and important.
These are some of the big topics I come across in my practice and find myself repeatedly answering. I hope they helped!