Historical Evidence and Current Concepts of Neonatal Transition
Dawes and other researchers of his time gathered considerable data on changes in circulation
through the heart and lungs that must take place at birth.  Respiratory function is transferred
from the placenta to the infant's lungs, but how quickly?  Clamping of the umbilical cord is a
human invention, and current protocol mandates clamping the cord as soon as possible after
birth.  Transition from placental to pulmonary respiration is thus assumed to take place within
seconds of birth.  Most infants breathe immediately at birth, but those who do not must rely on
neonatologists to quickly establish inflation and function of the lungs.
Data from research going back at least to 1878 exists on blood volume left in the placenta, and
weight gained by the neonate when placental circulation is allowed to continue for up to 20
minutes or more following birth.  Some studies were based on comparing the effects of
immediate versus late clamping of the umbilical cord, but the conclusion of most, up through the
1930s and 40s, was that waiting for pulsations of the cord to cease was healthiest.
The effects of bilirubin on the infant brain have been the focus of research going back at least
to 1875, with highpoint in the 1960s of RhoGAM (anti-D) treatment for Rh-negative mothers.  
Association of placental transfusion with polycythemia and hyperbilirubinemia in the 1970s
appears to have been a major incentive for the current protocol to clamp the umbilical cord as
soon as possible after birth.
Ranck and Windle in 1959 observed ischemic brainstem damage in newborn monkeys
subjected to asphyxia, by preventing onset of pulmonary respiration (delivering the infant head
into a saline-filled sac) and clamping the umbilical cord.  Damage was most severe in the
midbrain auditory pathway, which in human children would be an impediment to speech
development.  The current protocol for clamping the umbilical cord immediately at birth should
be reviewed in light of much historical evidence that this may be unsafe.  It should be
considered as possibly responsible for recent increases in autism and other developmental
disorders.  More at
1     2     3     4     5     6     7     8     9    10    11    12   13    14    15    16
Poster 2
FNPS 2006