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Can we talk about routine suctioning of babies at birth? - Page 6

post #101 of 109
Hmmmmm, just chiming in... a little late. Anyhoo, I don't suction routinely at cesarean births. It isn't really supported in the literature. Anyway, hasn't anyone here ever heard of a perforated stomach? It is really fun to look at an xray with a feeding tube as soft as a usual suction catheter heading down towards the liver, hmmm!

Now, as far as the bulb, If there are copious secretions from a c/birth baby, I find that placing baby on the side, allowing fluid to collect in the cheek pocket and then gently suctioning the cheek pocket, avoiding the back of the tongue. As far as delee, I only do this if the infant is having a lot of difficulty clearing the upper airway and even then usually only pass down one side and not all the way to the stomach. That leaves one nare not all congested from suctioning and doesn't empty the stomach unnecessarily. I have seen many providers roughly bulb suction the hypopharynx of babies and this can cause delay in breastfeeding.
post #102 of 109
Quote:
Originally Posted by rowantreeinak View Post
She was only out for 10 seconds before they said 'she's not breathing' and stole her away from be to put her of the baby exam table. They rubbed her and she cried immediately, but they said she had the infected water in her lungs so they deep suctioned her 4 times. I was barely aware of what was going on and couldn't get any words out to stop it. Her Apgars were 8 and 9 for color.

Several weeks later I asked the hospital midwife why she had done it that way instead of respecting our wishes and she said that because of the infection it wasn't standard of care to let her try to breathe while still getting oxygen from her cord. I asked why they had to suction her 4 times, and got the same answer (very defensive I would like to add). "Well it's better than *not* breathing, isn't it" she asked me twice - but my answer that she was, was lost on her.
While I understand the concern about infected fluid being in the lungs, I'm wondering why she thought it would interfere with breathing. Maybe someone else can weigh in on this.

The bolded part makes absolutely no sense. If it looks like a baby should have fluid removed, they should be doing it while the baby is still attached, because obviously any difficulties breathing would be ameliorated by the fact that the baby is still receiving oxygen through the cord. It is just counter to reason to prematurely sever a baby from its most efficient life support system in order to treat it, and logically to do so would in some cases create or exacerbate problems. I assume then that they do it because it's more efficient for the birth attendants. If the situation worsens so that they have to move the baby, well, the baby is already separated from the mother so they don't have to take that extra step. As well, the baby team isn't in the mama team's space, so if the mother is hemorrhaging, for instance, they're not getting in each other's way. Understandable, but the mistake that is made is to assume that it should be routine standard of care, in other words, that the possibility that it will be a real benefit (not just a convenience) to not have the baby and mother in the same space, always outweighs any other considerations.
post #103 of 109
The other thread going on recently about this: http://www.mothering.com/discussions...d.php?t=742856
post #104 of 109

suctioning at water births?

My midwife at our consultation meeting said that she has to suction babies that are born in a water birth more than babies not born in water.

Will the baby have problems if not suctioned when born in water? Or would it be fine just like in a regular birth as you all have been saying in this thread?
post #105 of 109
Thread Starter 
Quote:
Originally Posted by hippiekaren View Post
My midwife at our consultation meeting said that she has to suction babies that are born in a water birth more than babies not born in water.

Will the baby have problems if not suctioned when born in water? Or would it be fine just like in a regular birth as you all have been saying in this thread?
This is a common misconception. Water born babies do not have to be suctioned - what are we suctioning? Goop in the mouth? Again, it's not necessary and potentially harmful. We overestimate the benefit of things like this simply because we hear babies that are 'gurgly' or 'wet'. Once babies continue to breathe and open their lungs and nurse things clear up. Midwives need to learn to just trust the process and sit on their hands. It all is a perfect design!

If you need to discuss this more with her and she still carries this belief, please have her contact Barbara Harper at Waterbirth Intl.

All hands should be off that baby unless it needs resusciation for at least the first 15 minutes to a half hour - including the routine of putting on hats and towels. Nobody touches that baby but the mom/dad!
post #106 of 109
Quote:
Originally Posted by courtenay_e View Post
Because it keeps them busy. Because it's something they can control. Probably because some babies who have snot/fluid in their head/gut gag on it. So they treat them all. KInd of like they treat all babies for chlamydia and gonnorhea (I know I prob. spelled that wrong) even though a tiny population are actually affected by it. Because they can.
That´s exactly why. Ugh. Seriously I have plenty of things to do to ¨keep me busy¨ than jam things down babies throats that don´t need it, just to piss parents off and exert my ¨control¨ over them.

When I attend deliveries as the nurse for the baby, I personally do not suction unless the baby needs it. And I define ¨need¨ by the baby actively spitting up huge gobs of stuff...gagging on it, turning blue...obviously blocking the air way. When this happens I turn the baby on its side and gently use the bulb syringe or the Delee to gently suction the oral cavity. I don´t cause the baby to gag and I have never had to go all the way down.

I have had to suction endotracheally on a baby that aspirtated meconium, but the baby NEEDED it. The baby was blue, limp and NOT breathing.

This is me personally...I do still see a few nurses and old school doctors that still deep suction. I know the new NRP guidelines do not recommend routine deep suctioning. For wet sounding babies I find that some gentle CPT helps break up secretions. And really sounding wet shortly after birth really isn´t a big deal...itś normal, the baby was swimming around in fluid for 9 months.
post #107 of 109
I come from the training that believes bulb syringes are useless-that if you have to suction, it makes the must sense to use the delee. Not to mention most bulb syringes are sterilized with that awful carcinogenic stuff.
Funny story: I was at a birth where the granny to be was an ob nurse. This was a primip, had a beautiful, fast labor with a hard, long 2nd stage requiring lots of position changing for a nuchal hand. We break the water to see if that will help the baby come faster- and there is mec. Not much at all. So, the Granny is holding the mama on the birth stool, the baby finally comes out. he's a little stunned, but fine and the Granny FREAKS out, BEGS for this bulb syringe (which is always on the tray to be PC)and goes to town on this baby! Oh it was horrible and shocking and funny all at once!
post #108 of 109
For the midwives who do not suction: I would hope that you discuss this with your clients before the birth, and warn them that there may be some or a lot of gagging, choking, crying at first. My midwife did not use the bulb suction, and my baby cried a lot after birth. We were worried there was something wrong, and after a few hours of crying right after birth, I began to feel distant and resentful of my baby. The crying was a result of mucous.
post #109 of 109
Quote:
Originally Posted by janellesmommy View Post
For the midwives who do not suction: I would hope that you discuss this with your clients before the birth, and warn them that there may be some or a lot of gagging, choking, crying at first. My midwife did not use the bulb suction, and my baby cried a lot after birth. We were worried there was something wrong, and after a few hours of crying right after birth, I began to feel distant and resentful of my baby. The crying was a result of mucous.
Yes, we let them know what is normal and what isn't normal regrading breathing. And that sneezing the goopies out is good, etc.

Lying the baby across your lap with the head slightly down for a couple of minutes will help stuff drain.
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