New Research





Over the past several years, the push for "evidence-based care" has meant that everyone must keep up with the latest research on the various subjects within their area of practice.  Much of what is done in obstetrics has been and still is based on custom, not evidence.  Now, research is changing our understanding of pregnancy, labour, birth and babies - of what makes pregnancy healthy, of how to manage labour and birth, and of how best to care for babies.  

It is wise to remember that it can sometimes take quite a while before new research and evidence is actually reflected in practice - large systems and institutions like hospitals tend to change change slowly!  

Keep in mind that you have the right to request what you want for yourself and your baby, and to decline any treatments or procedures that you believe are not helpful or beneficial.  And you have a right to expect that your wishes will be respected.



The Microbiome: Optimizing Your Baby's Health Before, During and After Birth
The "microbiome" is the collection of bacteria, fungi and other organisms that live in and on all of our bodies.  A healthy microbiome is critical to overall good health, and in particular to a healthy and effective immune system.  We know that the pregnant woman's microbiome changes during pregnancy to prepare for the sharing of 'good' bacteria with her baby.  This starts happening as soon as her waters break, and continues to happen as the baby passes through the birth canal, is placed skin-to-skin with its mother, and breastfeeds.  We are now beginning to understand that some of the interventions we use, including C-section deliveries, separation of mothers and babies after birth, formula feeding, and the administration of antibiotics can all interfere with the healthy transfer of the mother's microbiome to the baby.  To understand more about this and what you can do to ensure your baby gets the best start possible, check out this website:

Group B Strep: prevention using probiotics lactobacillus rhamnosus GR-1 and lactobacillus reuters RC-14? 
Group B Strep, or GBS, is a common bacteria present in the digestive and reproductive system of around 30% of women.  Unless it causes a bladder infection, it may go undetected as it often causes no problems.  But... it can cause problems for newborns.  This can occur during labour, when the bacteria has an opportunity to multiply in the amniotic fluid, and then get into the baby's body before it is born.  Most babies, like most adults, won't get sick.  But some will - some will get very sick.  A very few will die.  Because of this risk, all women are offered testing to see if they have GBS when they are around 35-37 weeks pregnant.  Women who test 'positive' are offered IV antibiotics in labour to prevent the bacteria from multiplying and getting into the baby's system.  A recent study suggests that by taking two specific probiotics - lactobacillus rhamnosus GR-1 and lactobacillus reuters RC-14 - women can reduce their risk of having GBS by around 40%.  Here's a link to the study for anyone who wants to consider taking these lactobacilli.  Best time to start is in the second trimester.  Good luck!


Group B Streptococcus (GBS)
GBS and the recommended treatment for women who have it are still controversial.  Here's a link to a good article about it:  https://evidencebasedbirth.com/groupbstrep/


Zika Virus
Here is some new information about Zika that anyone who is pregnant, or planning a pregnancy, should know:
March 6, 2017  CTV news
This is a quote from the article:
"Zika virus infections in Canadian travellers returning from the Caribbean and south and central America were both more common and their effects more severe than researchers had expected, a new study has found. The study published Monday in the Canadian Medical Association Journal, looked at Canadian travellers who had visited Canadian Travel Medicine Network (CanTravNet) clinics for suspected travel-related illnesses after trips down south. Of the 1,118 travellers studied between October 2015 and September 2016, 3.7 per cent, or 41 travellers, had a Zika infection. That was equal to the number diagnosed with dengue, the fastest-growing mosquito-borne illness. But unlike the dengue patients, many of the Zika patients developed serious problems from their infections. Ten per cent of the 41 patients with Zika developed severe complications. They ranged in age from 13 to 70.Two travellers developed the neurological disorder Guillain–Barré Syndrome, or GBS-like syndrome, a condition that has been linked Zika virus by previous research. Also, among three pregnant women infected with Zika, two transmitted the virus to their unborn babies."


Is there a connection between maternal intake of folic acid and baby's tongue tie:
There has been speculation for some time about an association between maternal consumption of folic acid and baby's tongue-tie. This article is written by a lay person, and could be way off base - or she could be on to something. Worth considering....and maybe eating more folate-rich foods (eggs, lentils and legumes, spinach, broccoli  brussels sprouts, asparagus, and cantaloupe) or looking for a folate supplement, or a multi-vitamin with folate rather than folic acid.  (See below about pre-natal vitamins!)


Why you don't need to take pre-natal vitamins
Although everyone takes them, the benefits of taking pre-natal vitamins is not clear.  What you do need to take is folic acid (1 mg) and possibly iron (depending on your iron status).  Take a look at this article for more on pre-natal vitamins.  www.theguardian.com/society/2016/jul/11/pregnant-women-waste-money-vitamin-supplements-study-says


More fruit in pregnancy linked to babies with higher IQs???
At the same time, it's important to remember that fruits are also packed with sugar, so eat your veggies too!


New guideline for Eye Medications for Babies
At long last there is a new guideline (2015) from the Canadian Pediatric Society regarding eye medications for newborns.  In a nutshell, eye medications have been recommended to prevent infection from gonorrhea and chlamydia.  However, most women do not have these infections, so most babies are not at risk.  Furthermore, the eye medications being used (erythromycin ointment) are not effective against chlamydia.  And the eye medications can be irritating to babies' eyes. The new guideline suggests that women be tested in pregnancy for gonorrhea and chlamydia, and if negative then eye medications do not need to be given.  Here's a link to the guideline:  http://www.cps.ca/en/documents/position/ophthalmia-neonatorum


Skin-to-Skin Care for ALL Babies
No matter how or where you birth, ALL babies - and mothers and fathers! - benefit from skin-to-skin contact.  The research on the benefits for babies is clear.  Even premature babies and babies in the neonatal intensive care unit - in fact ESPECIALLY these babies - do better with skin-to-skin care than with care in an incubator.  Demand skin-to-skin care. 
A good website for more information on skin-to-skin is:  http://www.kangaroomothercare.com/birth-kmc.aspx


The Politics of Birth - and being a woman 
This is one of the most thought-provoking articles I've read on birth - the decisions we face and the choices we make - and on being a woman in an age of technology and super-medicine.      www.newstatesman.com/politics/feminism/2016/05/birth-wars-politics-childbirth


Peace on earth begins with birth 
A different perspective on the majesty and wonder of birth      http://www.birthintobeing.com/


Freedom for Birth 
An international movement to reclaim birth as a human right     http://www.freedomforbirth.com/


Fathers and babies 
A great look at how dad's interactions with baby cause changes in dad's brain!   http://greatergood.berkeley.edu/article/item/the_daddy_brain


What to reject when you're expecting 
Some of the best advice to prospective parents I've seen in a long time!


Co-sleeping with your baby 
30 years of research supporting co-sleeping and how to co-sleep safely with your baby
http://www.naturalchild.org/james_mckenna/    and   http://cosleeping.nd.edu/frequently-asked-questions/


Comments