When does a baby take its first breath?

Factual Questions
21

This is as good a summary as any of the “mammalian diving reflex”

Anecdote: My niece was born with a heart defect (surgically repaired when she was 7 years old) that meant that her heart went into fibrillation every so often. And the resuscitation technique that her parents were taught involved abruptly plunging her tiny face into a bowl full of cold water, preferably ice water with actual ice cubes in it. Evidently this would cause her MDR to kick in, and cause the symptomatic bradycardia, which in the baby’s case was a Good Thing. We once babysat the wee one while brother and SIL went to the movies, and my brother coached us in how to do this, which is why I remember it.

Factoid left over from Lamaze classes: The reason they used to spank babies was because they were using chloroform or ether on the mother during labor and delivery, and babies often emerged drugged and groggy. A stinging slap startled the baby into an involuntary squawk, which served to oxygenate.

22

Here is a great article on unraveling the Mammalian Dive Reflex.

And here is a great article on waterbirth, infant breathing under water and hospital protocols etc…etc…

23

[QUOTE=Phlosphr]
Here is a great article on unraveling the Mammalian Dive Reflex.

And here is a great article on waterbirth, infant breathing under water and hospital protocols etc…etc…
[/QUOTE]

Thank you Duck Duck Goose and **Phlosphr **for the links, I learn so much from posters on this board. I am not sure why the diving reflex is not included as reflexive neonate behavior in standard child development courses, maybe because it is not an assessed reflex after birth. Based on the wiki source, the dive reflex is weak in humans or weaker than other mammals, but it still exists.

24

[QUOTE=unconventional]
Thank you Duck Duck Goose and **Phlosphr **for the links, I learn so much from posters on this board. I am not sure why the diving reflex is not included as reflexive neonate behavior in standard child development courses, maybe because it is not an assessed reflex after birth. Based on the wiki source, the dive reflex is weak in humans or weaker than other mammals, but it still exists.
[/QUOTE]

Its existence was still in dispute when I had my son, 15 years ago. That is, I’m sure the actual biologist’s new about it, but the textbooks were less inclined to commit.

[QUOTE=cornflakes]
Strange, I seem to remember that when both of my sons were born the midwives mentioned that the babies were pinking (showing oxygen rich blood flow) before they cut the cord.
[/QUOTE]

Sure, the baby CAN breathe as soon as his mouth is born (or as soon as any mucus and amniotic fluid is cleared out with the sucky thing). But it doesn’t HAVE to until the placenta detaches from the uterine wall, usually about 5 minutes after the birth. It’s ingenious, really. There’s enough time for Mom to catch her breath, pick up her baby and cuddle him to her breast before he needs to organize his system enough to breathe on his own. Only once her placenta detaches is his oxygen belly line cut off internally.

Remember, we didn’t evolve to need birthing attendants to rush in there with scissors and paddles, in most cases. We’re animals, too.

In the next 24 hours after breathing air, the PDA, a small hole in the heart that bypassed the lungs in utero, should close up. After that, you couldn’t give oxygen through the umbilical cord anymore, even if it was still attached to Mom.

There are people, however, who never cut the cord at all. If the whole placenta is carried around in a basket, it will dry out and the cord will whither and fall off near the belly in about a week.

25

[QUOTE=Sarahfeena]
“Rooting” is the reflex mammalian babies have to look for a nipple to suck on.
[/QUOTE]

For a moment, I thought it explained the instinctive tendency to watch pro sports.

26

[QUOTE=Duck Duck Goose]

Anecdote: My niece was born with a heart defect (surgically repaired when she was 7 years old) that meant that her heart went into fibrillation every so often. And the resuscitation technique that her parents were taught involved abruptly plunging her tiny face into a bowl full of cold water, preferably ice water with actual ice cubes in it. Evidently this would cause her MDR to kick in, and cause the symptomatic bradycardia, which in the baby’s case was a Good Thing. We once babysat the wee one while brother and SIL went to the movies, and my brother coached us in how to do this, which is why I remember it.
[/QUOTE]

This is a form of cardioversion. The most common one we’re used to seeing (on television) is electric cardioversion with a defibrillator (“Clear!” WHUMP) but it’s also often done pharmaceutically, and sometimes the heart can be cardioverted by having the patient cough deeply.

27

[QUOTE=unconventional]
Thank you Duck Duck Goose and **Phlosphr **for the links, I learn so much from posters on this board. I am not sure why the diving reflex is not included as reflexive neonate behavior in standard child development courses, maybe because it is not an assessed reflex after birth. Based on the wiki source, the dive reflex is weak in humans or weaker than other mammals, but it still exists.
[/QUOTE]

As Whynot said, it’s still a relatively new concept; it can take a while for a new “thing” to trickle down to the textbook level. Not infrequently the doctors practicing at the grassroots level are implementing new findings long before the medical schools are officially teaching them.

Also, as noted, its very existence was doubted for a long time, being relegated mainly to speculation in news reports about children falling through ice and miraculously being revived at a hospital even though they appeared dead when fished out. It’s taking a while for Science with a capital S to reach a consensus as to whether this might be a standard hard-wired reflex in homo sapiens, and not just something extraordinary that happens occasionally with children who are suddenly plunged into freezing water.

28

[QUOTE=WhyNot]
There are people, however, who never cut the cord at all. If the whole placenta is carried around in a basket, it will dry out and the cord will whither and fall off near the belly in about a week.
[/QUOTE]

Seriously? Why? :confused:

29

Standard procedure for an EMT or Paramedic is (or was when I was certified) to clear the airway of the baby with a bulb syringe or suction device and allow the infant to begin breathing on their own. IF they failed to do so, then procedures were initiated, as needed. Regarding the cord, it was clamped and cut after several minutes.

30

[QUOTE=WhyNot]

And Dr.Cube is right, making a baby cry is an easy way to make sure he’s breathing. Of course, they have all those shiny stethescopes that could tell them the same thing, but for some reason having pain be a child’s first experience of the world is preferable. :rolleyes:
[/QUOTE]

Wait, you think that the child’s first experience of pain is when someone stimulates them to breathe “too” early? Why would the entire process of childbirth not be perceived as painful by the child?

31

[QUOTE=brossa]
Wait, you think that the child’s first experience of pain is when someone stimulates them to breathe “too” early? Why would the entire process of childbirth not be perceived as painful by the child?
[/QUOTE]

Cecil touched on this back in '92:

32

[QUOTE=Bryan Ekers]
For a moment, I thought it explained the instinctive tendency to watch pro sports.
[/QUOTE]

No, but watching pro sports and looking for breasts and nipples are closely correlated behaviors in some populations.

33

Underwater birthing, while often uneventful, can be very dangerous. I’ve cared for at least 4 newborns who were not lucky. Three died in a few days one lived with profound brain damage.
There is no way to be sure the placenta hasn’t detached.

The reason for stimulating the babe is not just to make him breathe, it’s to make him breathe deeply, to open all the alveoli.

34

[QUOTE=nyctea scandiaca]
Seriously? Why? :confused:
[/QUOTE]

'Cause people is weird.

[QUOTE=brossa]

Wait, you think that the child’s first experience of pain is when someone stimulates them to breathe “too” early? Why would the entire process of childbirth not be perceived as painful by the child?
[/QUOTE]

I think that adding to a possibly painful experience with more unnecessary pain is sadistic.

I’m also not convinced that going through the pelvis is “painful”. Babies’ common response to pain is to cry. If they’re not crying on exit, then they’re probably not in pain. Most newborns love to be squeezed and held tight for many weeks after their birth, and wrapped in tight blankets, a technique called swaddling.

[QUOTE=Bryan Ekers]
Cecil touched on this back in '92:
[/QUOTE]

“Touched” indeed. The article wasn’t about childbirth, and didn’t claim to be. It was a one-line aside mentioning someone else’s ideas about if near-death experiences were old childbirth memories. It was Cecil Snark, not information.

[QUOTE=picunurse]
Underwater birthing, while often uneventful, can be very dangerous. I’ve cared for at least 4 newborns who were not lucky.
[/QUOTE]

Is there good information out there about comparative risk rates with other childbirth techniques? I believe you that you saw 4 complications, but I’m sure you’ve seen more than that with c-sectioned infants, or VBACs, or natural childbirth, or…

“4” is a meaningless number without knowing how many water birthed babies in your community during that time period, and how that percentage compares to other birthing techniques.

35

[QUOTE=WhyNot]
Is there good information out there about comparative risk rates with other childbirth techniques?
[/QUOTE]

The Establishment’s “Insufficient data–Wait and see” position.
http://pediatrics.aappublications.org/cgi/reprint/115/5/1413.pdf

Study from 1999.
http://www.bmj.com/cgi/content/full/319/7208/483

From 2000.
http://www.public.iastate.edu/~chart/JournalAbstractsForBirthing.html#wbsafety

From 2002, four case histories where it all went pear-shaped.
http://pediatrics.aappublications.org/cgi/content/full/110/2/411?ijkey=e2181133f2b8256a39e1810679388c37c3aa4591&keytype2=tf_ipsecsha

Rebuttal to the above, and rebuttal to the rebuttal.
http://pediatrics.aappublications.org/cgi/eletters/110/2/409

There’s a bunch of other stuff on Google, but I don’t have a password, or am not a member, etc.

The consensus so far seems to be that statistically, it doesn’t matter whether the baby emerges underwater or on a sterile delivery table–as long as people are paying attention to what’s going on, and are competent at what they’re doing. Sounds pretty much like normal L & D to me. An incompetent midwife or OB can screw up a regular delivery, too.

36

[QUOTE=WhyNot]

Is there good information out there about comparative risk rates with other childbirth techniques? I believe you that you saw 4 complications, but I’m sure you’ve seen more than that with c-sectioned infants, or VBACs, or natural childbirth, or…

“4” is a meaningless number without knowing how many water birthed babies in your community during that time period, and how that percentage compares to other birthing techniques.
[/QUOTE]

I’m sure there is, but I’m now out of the loop. Even if the death rate in underwater birthing is rather low, is there really a reason to add yet another risk? All 4 of those babies drowned. That isn’t a risk one sees in other birthing methods.

37

Duck Duck Goose, thank you so much! I have an afternoon of reading ahead, on my favorite topic! Yay!

picunurse, it would be worth it to add “another risk” if, as waterbirth moms attest, it makes labor and delivery easier and less prone to riskier interventions. Keeping Mom calm goes further than pitocin in keeping labor productive sometimes.

38

[QUOTE=nyctea scandiaca]
Seriously? Why? :confused:
[/QUOTE]

If you are curious enough to google this or check wikipedia about it, it’s called “lotus birth”. I cannot answer the ‘why’ – it sounds as weird to me as it does to you, I’m sure. I heard about it in the childbirth class my wife and I attended…it emphasized “natural” childbirth, and talked about things like lotus birth and other things that seemed weird to me.

We got to watch a home video of a waterbirth. My thought at the time was the same as picunurse – I realize it’s fascinating to see a baby underwater and not needing to breathe, but, umm…what if it DOES start breathing and it’s still underwater?? Is the benefit really worth that risk?

More to the point, how many people have you met, and thought “Gee, he’s a real asshole. Too bad he wasn’t born underwater, that surely would have made all the difference”. :rolleyes:

39

[QUOTE=WhyNot]
“Touched” indeed. The article wasn’t about childbirth, and didn’t claim to be. It was a one-line aside mentioning someone else’s ideas about if near-death experiences were old childbirth memories. It was Cecil Snark, not information.
[/quote]

Hey, if you’ve got some commentator out there who says being born is a fun experience, lay it on me, babe.

40

[QUOTE=Bryan Ekers]
Hey, if you’ve got some commentator out there who says being born is a fun experience, lay it on me, babe.
[/QUOTE]

Certainly. Meet Frederic Leboyer. Michael Odent. Robert A. Bradley, and Ina May Gaskin(who speaks in one of her books the deep dark secret of the birthing room: sometimes women orgasm during labor!)