Can we talk about routine suctioning of babies at birth? - Page 2

[the elyse]

my dd had a tube inserted down her nose to suction her stomach. i had the same thing done after a major car accident to check for internal bleeding...so it really bothered me to see them do it to her, i could feel it going down my own throat. yuck. :

[LemonPie]

Someone asked about studies. I'm copying and pasting a response I put up on another thread. HTH. BTW--if you go to the PubMed studies, they'll usually have links to related studies as well.

I just attended a conference (the LLLI conference mentioned above) where Linda Smith, IBCLC spoke. She said that routine suctioning of newborns at birth is not necessary unless there are actual respiratory problems. In her opinion, the baby tongue-thrusting at the aspiration device might create a "muscle memory" that can cause breastfeeding issues later. Some studies she cited:

-Vain et al, Lancet 2004; 364 (9434): 597-602
-Anand, Runeson, Jacobson, J Pediatr 2004; 144: 449-54

And a couple more that I found with a routine PubMed search:
Evidence-based practices for the fetal to newborn transition.

Building evidence for practice: a pilot study of newborn bulb suctioning at birth.

Oronasopharyngeal suction versus no suction in normal and term infants delivered by elective cesarean section: a prospective randomized controlled trial.

Edited to add: Oops, the links didn't come with it You can see the original post here for links to those studies.
Jen

[mwherbs]

yep babies cough, sputter, sneeze even throw up- what is the heart rate? is the baby breathing? will the baby nurse?
babies that are wet or seem wet are not remedied by suctioning- we are talking expansion of the aveoli and changes in surface tension on that level in the lungs -- not the little bit that is in the upper passages - when you suction you are changing the circulation and can cause swelling/edema --

try using some suction on yourself- see what your response is - holding your breath and shallow breathing - and the bulb syringe is relatively small for you -- the small bulb is about the size of a baby's fist


now I think that a baby that is not breathing - and is in need of resuscitation then yes I suction first then blow--

[lilylove]

I have a question about the stomach full of fluid thing...
Do we(they) know that a baby having fluid in their stomach at birth is bad? Is there any specific consequences that are citied for tubing and suctioning this out? It's not like it's a foriegn thing to thier digestive tract.

[kerikadi]

After the baby is born my MW likes the baby to lay on his or her tummy for the first few moments to allow any fluid to come out of the mouth naturally. Of course this is immediately after birth just before nursing.
It just makes sense that if you put a baby on their back right away they are going to swallow and possibly choke on fluid but if you hold them a certain way (rounded back) and place them tummy down on Mama the fluid will come out on it's own.

Keri

[Nan'sMom]

I think it's horrifying. It's also one of those things that childbirth instructors and books don't seem to warn you about...that you should be ready to say "NO SUCTIONING!" when your dear little one is born. Thankfully my first mw didn't do it, but I hadn't known to ask for it not to happen. Second was UC and I knew more so of course I didn't think of suctioning.

I do know that at a nearby freestanding birth center (one that has decent transfer stats), they routinely suction babies. It's so strange, unkind and non-evidence-based.

[Nan'sMom]

Originally Posted by kerikadi

After the baby is born my MW likes the baby to lay on his or her tummy for the first few moments to allow any fluid to come out of the mouth naturally. Of course this is immediately after birth just before nursing.
It just makes sense that if you put a baby on their back right away they are going to swallow and possibly choke on fluid but if you hold them a certain way (rounded back) and place them tummy down on Mama the fluid will come out on it's own.

Keri

Apparently there's a parenting school in Russia that advocates this as well. I found out because I was describing my UC to a friend from Russia and how my baby came out onto the bed herself from a low hands and knees position (no one "catching") and then I picked her up and she said her parenting school says that this is natural and helps fluids drain.

[BugMacGee]

Originally Posted by mwherbs

so I am not for routine suctioning at birth and haven't done it for years but- I prefer a bulb syringe to a deelee-- and there are some studies that show that a bulb syringe gets as much out as a deelee-- so I don't know why the deeper suctioning devices are important at all- they are more likely to trigger a vagal response- that is where I am going with this-- normal babies even babies that sound a little juicy- if they are breathing and coughing and sneezing and sputtering- they are clearing their own airways much softer and healthier than I can do it--
and if a baby will nurse- even better because nursing clears airways as well and the viscosity of the colostrum dries out the lungs too--

Mwherbs, could you expand on this bolded statement a bit? I've never heard this and it intrigues me.
FWIW-I don't suction babies that are crying unless it is apparent they need help clearing thier airway in respiratory distress.

[mwherbs]

human colostrum immunoglobulin A- a mucin-type glycan holds water/fluid-- as well as forming a healthy mucous membrane surfaces

if I were to give you something that acts similar in the herbal world it would be mallow/marshmallow or corn silk- it is a slicker (mucopolysaccaride) and draws fluids to it as well as being anti-inflammatory at the same time-- and that is just the plant activity- not all the other things/goodies colostrum has--

[lyttlewon]

Originally Posted by lilylove

I have a question about the stomach full of fluid thing...
Do we(they) know that a baby having fluid in their stomach at birth is bad? Is there any specific consequences that are citied for tubing and suctioning this out? It's not like it's a foriegn thing to thier digestive tract.

I have always heard it is to keep them hydrated until milk comes in and that some babies swallow more than others. DS spit up fluid after he was born and didn't nurse for about 12 hours. This seemed completely normal for him. My MW told me I didn't need a bulb syringe for my birth kit that she doesn't suction babies. I have one for colds and such but it was never used on DS.

[Magali]

I just never thought about the suctioning before. I am glad i have you ladies to fill me in though!

[Arwyn]

Originally Posted by Romana9+2

I'm going to make this short as it's off-topic, but don't really feel like I can just ignore it -

Just have to express my strong disagreement with that statement. Maybe for some, although really, I haven't seen this attitude much among UCers. There's no way I would have done any suctioning on my UC baby if she'd been born at home. (At the hospital, she got a tiny bit of totally needless suctioning.) Somehow I just can't imagine reaching for a bulb syringe I didn't even have.

just responding to this before i finish the thread -
I'm sorry I wasn't clear - I certainly did not mean that this is a good or accurate description of UCers or what UC is supposed to be. I only meant that when UCers suction routinely with bulbs (or do any of the other mostly pointless things too many midwives do), it is reflecting that (unfortunate) idea about UC, rather than the birth/body/self trust that makes UC such a powerful and safe birth option.

Sorry that wasn't clearer.

[courtenay_e]

Just attended a hospital birth of twins today. First was vaginal and non-medicated, second was single footling breech for whom they tried a version FOUR times before the heartrate went up to about 220 and they decided to section him, used a fast acting spinal...but they really tried before they went to surgery. The boys were 38 weeks, seven pounds and six and a half pounds, placenta was beautiful and healthy, babies apgars were 9 and 9 for both...and the nicu nurses deep suctioned them all the way down to their bellies, simply because they were twins. *WHAT!?* It made me sick. The babies were quiet and peaceful after their initial birth cries, nice and pink, breathing beautifully, and they took them away and suctioned them. *sigh* This mama had a great doc (known for supporting the homebirth midwives in the area, and VERY supportive of this mama and her wishes), and got so much of what she wanted in a birth that she didn't complain too much when they did this...but it made me sick to watch it. They were screaming by the end...poor babies!

[lilylove]

Originally Posted by lyttlewon

I have always heard it is to keep them hydrated until milk comes in and that some babies swallow more than others.

This seems to make sense.
What reason do docs and nurses cite for doing it though? I mean are they just guessing it's bad because some babies spit up some fluid? I just don't understand why something as drastic as suctioning a baby's tummy is done for something that they have been swallowing all along

[courtenay_e]

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.

[Romana]

Originally Posted by Arwyn

I certainly did not mean that this is a good or accurate description of UCers or what UC is supposed to be. I only meant that when UCers suction routinely with bulbs (or do any of the other mostly pointless things too many midwives do), it is reflecting that (unfortunate) idea about UC, rather than the birth/body/self trust that makes UC such a powerful and safe birth option.

Oh, okay. Thanks for clarifying - I didn't catch that you meant it that way.

[LiLStar]

i cringe at what dd was put through I don't even know what all of it was, because I could only hear it. hb transferred to a c/s.. records say they used the delee upon delivery of the head. i remember hearing a very strong loud cry, but who knows if that was before or after the delee. then they took her over to the warmer for some nice dramatic extra suctioning, because when my water broke there was very very light mec staining. pffft. my records said they didn't find any though. great, confirm that it wasnt necessary! after that she was wrapped up and dh held her by my face.. wrapped up so that all i could see was her eye brows to her chin! she was breathing kinda loud and sounding wet, and dh was kind of concerned about that and i kept telling him she's fine, its normal. then they took her back to mess with her some more and i didn't see what happened but i heard a smacking sound dh said it was gentle but it sounded awful. i could do nothing! and i was too drugged and loopy to yell at them to stop. i hate that they were hitting her for no reason. then they did a cbc and it came back with one number high, possibly indicating infection "but sometimes its high due to stress"..GEEZ! Unceremoniously rip her out of me, orally assault her, smack her, then repeatedly stab her in the heal..I imagine that would be a wee bit upsetting So then they poke her precious little baby foot again. after she'd gotten to snuggle and nurse a bit. shocker: it was normal that time.

[Softheart]

Thanks so much all! I am adding this to my birth plan!

[jennica]

When ds was born he would not nurse for hours. They were all really concerned about this and kept informing us that his blood sugar was going down and if he didn't nurse soon then they would have to give him formula. They wanted to give him formula within about 5 hours after birth, but I held out until that night (he was born at 7:00 am). By that time he was breathing fast and they told me his blood sugar was low and they had to give him formula. I finally consented because I didn't know what else to do and I had already been through so much with the birth anyway that I wasn't myself by that point. Well, dh accompanied ds to the nursery where they were to finger feed him formula and then return him to me. When they came back dh told me how they put a tube down his throat and suctioned a bunch of mucous out of his stomach. No one ever bothered to ask me or dh if this was okay or anything, but they weren't really big on informed consent there anyway I guess : Anyway, they told dh that the mucous makes them sick to their stomach and then they wont nurse, so they have to suction it out. Is this true? It didn't seem to do anything, he didn't start nursing well until we got home and we both relaxed. And I figured out his breathing would slow down if I just layed him face to face with me and I breathed slowly and deeply. I think the breathing thing was just because he was seperated from me too much after the birth. Oh, and I later found that is blood sugar was not "low", it was just getting lower, so what I now think happened is that the last ped was about to go off shift and wanted to suction him before she left, so seeing how reluctant I was, she told me his blood sugar was low so that I woud let him go off with her, and she then took that oppertunity to shove a tube down his throat. Poor baby

[Softheart]

Oh, and not to hijjack the thread, but you all seem uncommonly (to me) knowledgable on this subject--like I'd never heard of not suctioning and now I am so grateful to be on the way to a gentler birth for ds, so does the OP or anyone else just have a brief list of other procedures/practices you would refuse for your newborn (we will be in birth center w/mix of docs and midwives)? I know to refuse circ, Vit K, vaccines, eye drops, cord cutting before its ready, formula, being taken away to nursery...Do you think there is more to refuse? Weighing to soon when it should be bonding time?, bath?, other stuff I don't know about...? Just briefly, someone, and then I can go research it all...THANKS!