DiversityNursing Blog

Gay men who've abstained from sex for one year would be able to donate blood in 2015, ending a lifetime ban for the gay community, under a proposed FDA policy change unveiled Tuesday.

The current lifetime ban by U.S. Food and Drug Administration states dates back to 1983 and forbids men who have had sex with men from becoming blood donors because the group is "at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion," the FDA has ruled.

But the FDA is now seeking a change in that policy and would allow such blood donations based on an independent expert advisory panel's recommendation, the agency said.

The proposed change would align the one-year deferral period "with that of other men and women at increased risk for HIV infection," the FDA said.

The agency will be gathering public comments on the proposed change.

"We encourage all stakeholders to take this opportunity to provide any information the agency should consider, and look forward to receiving and reviewing these comments," FDA Commissioner Margaret A. Hamburg said in a statement.

The National Heart Lung and Blood Institute and the FDA would monitor a national blood surveillance system to see any effects of the proposed policy change and to ensure the continued safety of the blood supply, Hamburg said.

"A history of male-to-male sex is associated with an increased risk for exposure to and transmission of certain infectious diseases, including HIV, the virus that causes AIDS," the FDA said. Men who have had sex with other men represent approximately 2% of the U.S. population, yet are the population most severely affected by HIV, according to the FDA.

In 2010, male-to-male sex accounted for at least 61% of all new HIV infections in the United States, and "an estimated 77% of diagnosed HIV infections among males were attributed to male-to-male sexual contact," the FDA said.

Source: www.cnn.com

By Rebecca Riffkin

In 2014, Americans say nurses have the highest honesty and ethical standards. Members of Congress and car salespeople were given the worst ratings among the 11 professions included in this year's poll. Eighty percent of Americans say nurses have "very high" or "high" standards of honesty and ethics, compared with a 7% rating for members of Congress and 8% for car salespeople.

Americans have been asked to rate the honesty and ethics of various professions annually since 1990, and periodically since 1976. Nurses have topped the list each year since they were first included in 1999, with the exception of 2001 when firefighters were included in response to their work during and after the 9/11 attacks. Since 2005, at least 80% of Americans have said nurses have high ethics and honesty. Two other medical professions -- medical doctors and pharmacists -- tie this year for second place at 65%, with police officers and clergy approaching 50%.

Historically, honesty and ethics ratings for members of Congress have generally not been positive, with the highest rating reaching 25% in 2001. Since 2009, Congress has ranked at or near the bottom of the list, usually tied with other poorly viewed professions like car salespeople and -- when they have been included -- lobbyists, telemarketers, HMO managers, stockbrokers and advertising practitioners.

Although members of Congress and car salespeople have similar percentages rating their honesty and ethics as "very high" or "high," members of Congress are much more likely to receive "low" or "very low" ratings (61%), compared with 45% for car salespeople. Last year, 66% of Americans rated Congress' honesty and ethics "low" or "very low," the worst Gallup has measured for any profession historically.

Other relatively poorly rated professions, including advertising practitioners, lawyers, business executives and bankers are more likely to receive "average" than "low" honesty and ethical ratings. So while several of these professions rank about as low as members of Congress in terms of having high ethics, they are less likely than members of Congress to be viewed as having low ethics.

No Professions Improved in Ratings of High Honesty, Ethics Since 2013

Since 2013, all professions either dropped or stayed the same in the percentage of Americans who said they have high honesty and ethics. The only profession to show a small increase was lawyers, and this rise was small (one percentage point) and within the margin of error. The largest drops were among police officers, pharmacists and business executives. But medical doctors, bankers and advertising practitioners also saw drops.

Honesty and ethics ratings of police dropped six percentage points since last year, driven down by many fewer nonwhite Americans saying the police have high honesty and ethical standards. The clergy's 47% rating last year marked the first year that less than 50% of Americans said the clergy had high ethical and honesty standards -- and the current 46% rating is, by one percentage point, the lowest Gallup has measured for that profession to date.

Bottom Line

Americans continue to rate those in medical professions as having higher honesty and ethical standards than those in most other professions. Nurses have consistently been the top-rated profession -- although doctors and pharmacists also receive high ratings, despite the drops since 2013 in the percentage of Americans who say they have high ethics. The high ratings of medical professions this year is significant after the Ebola outbreak which infected a number of medical professionals both in the U.S. and in West Africa.

At the other end of the spectrum, in recent years, members of Congress have sunk to the same depths as car salespeople and advertising practitioners. However, in one respect, Congress is even worse, given the historically high percentages rating its members' honesty and ethics as being "low" or "very low." And although November's midterm elections did produce a significant change in membership for the new Congress that begins in January, there were also major shakeups in the 2006 and 2010 midterm elections with little improvement in the way Americans viewed the members who serve in that institution.

Previously in 2014, Gallup found that Americans continue to have low confidence in banks, and while Americans continue to have confidence in small businesses, big businesses do not earn a lot of confidence. This may be the result of Americans' views that bankers and business executives do not have high honesty and ethical standards, and the fact that their ratings dropped since last year.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted Dec. 8-11, 2014, with a random sample of 805 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error is ±4 percentage points at the 95% confidence level.

Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods.

Source: www.gallup.com

By KELLI DUNHAM

I'm a proud nurse from a proud family of nurses, yet I would never claim that a layperson would enjoy watching mainstream medical dramas with us. We end up yelling at the screen: "There is nothing about that sexy get-up that remotely resembles a nursing uniform," and "Doctors don't fire nurses, nurse managers fire nurses," and "No emergency room nurse would ever have to be told by a doctor to start CPR!"

So when the Baymax, the nurse/robot in the hit Disney movie Big Hero Six turned out to be reasonable, competent and not dressed in fishnet stockings, I was thrilled.

You know your profession has an image problem when you point to a balloonish animated robot doll and say, "Yes, that's good. That accurately reflects what I do on a daily basis. More representations like that, please."

Baymax might not look like any nurses you know, but unlike most nurse characters in the media he actually provides nursing care. He assesses the health condition of his charge, the boy-genius Hiro, makes recommendations related to his health and teaches him about his neurochemical processes.

Once Hiro reprograms Baymax with fighting capabilities, Baymax becomes Hiro's terrifying defender. If you've ever heard a nurse on the phone with an insurance company insisting that a patient get needed care paid for, you know this is not a misplaced metaphor.

Contrast this with the Nurse Dawn character in the HBO comedy Getting On. She has sex with a new nurse manager within hours of meeting him; doesn't seem to notice when a patient dies; cowers submissively in front of even the most incompetent doctors and never seems to provide any actual nursing care because she is too busy with self-created drama and paperwork.

Or the Nurse Beverly character in Fox's comedy The Mindy Project. She is fired from an office medical practice for incompetence, breaks a doctor's nose in angry response, and when she is rehired in a clerical position expresses relief that she finally has a job where she doesn't have to wash her hands.

Or the nurses in the Fox medical drama House. Rather than being sexually inappropriate or incompetent, these nurses all seem to be on a series-long coffee break. It is the doctors who are shown providing nursing care: starting IVs, doing patient teaching, negotiating complicated family dynamics at the bedside.

Even when nurses are shown to be competent, compassionate patient-focused experts like Jackie Peyton, the main character in Showtime's Nurse Jackie, the creators aren't satisfied with the life-and-death drama of a high-level trauma center in a huge city. The nurse character has to be an unethical, lying, stealing, not quite-in-recovery drug addict as well.

The argument could be made that it's the job of Hollywood to create fiction of all the professions, and that popular culture gets everything about health care wrong.

Certainly examples of this exist: the new Fox teen drama Red Band Society is populated by exceedingly healthy looking, extremely attractive gravely ill teenagers who live for months in hospital rooms the size of two-bedroom apartments for no other apparent reason than to make it more convenient for them to kiss each other.

Any scenes in which the dying but randy teens are portrayed interacting with medical care (one patient is shown receiving dialysis for liver failure) are so ludicrous that it makes you wonder if the procedure for the show's writers is to ask their medical adviser how something might accurately be conveyed and then write the exact opposite.

But even though this is just entertainment, the stakes for the future of nursing are high. Research has repeatedly demonstrated that Americans believe what TV shows say about medical care and health policy.

For 13 years the non-profit advocacy organization Truth About Nursing has been researching and documenting nurse representations in popular culture and has come to the conclusion that "the vast gap between what skilled nurses really do and what the public thinks they do is a fundamental factor underlying most of the more immediate apparent causes of the [nursing] shortage [including], understaffing, poor work conditions, [and] inadequate resources for nursing research and education."

This is bad news for nurses, but worse news for patients. Nurses make the difference in good health care; increased RN staffing decreases the overall patient death rate as well as the rate of hospital acquired pneumonia, falls, pressure ulcers and blood clots after surgery. When nurses show more signs of burnout related to understaffing, postsurgical infections increase.

And there's the hard-to-quantify but essential benefit of being cared for. When I was in the hospital this past January after a life-threatening complication of knee-replacement surgery, I woke up one night in pain and unable to figure out how to move within the many drains, tubes and wires attached to, or inserted in, my body. I muttered an expletive and from around the corner a nurse appeared.

"I'm right here," she said. Even before she started to untangle my IV and troubleshoot better pain management, my panic was instantly calmed.

Baymax's programming won't allow him to disengage until the patient has answered, "Are you satisfied with your care?" in the affirmative. This is inconvenient for the characters in an action adventure movie, but it's a good question to ask in a hospital. If you're satisfied with your care, you may well have a nurse to thank.

Source: www.npr.org

What do all nurses want for this holiday season? We asked the nursing community on Facebook and reddit and we discovered that yes, it’s not necessarily a pair of scrubs. Here are their answers:

1. Better staffing and better nursing jobs

   Top of the list are these answers that we think go hand-in-hand:

   “A job. Going 2 months strong being unemployed (currently living the dream of being a stay at home wife). When I was working: Adequate staffing.” – mogris, from reddit

   “I second the ‘adequate staffing’. I'm a little worried that my Christmas night will be crushingly busy.” – CrossP, from reddit

   “I'm in the same unemployment boat as you. It is not a fun ride. I just want to be someone's nurse again.” – OkieDokieArtichokee, from reddit

   “Better nurse to patient ratio!” – Lisa B., from Facebook

   “Low census and adequate staffing” – nocturnalnurse, from reddit

   When hospitals and other healthcare facilities don’t want to hire more nurses, then obviously there are fewer nursing jobs created. Meanwhile, the existing staff will have to bear a heavier workload.

2. The right to die with dignity

   “Legalized euthanasia.” – Vilalintine, from reddit

   After all, death shouldn’t be something to be afraid of. Controversial as this may sound, sometimes it is the better option for the patient.

3. The company of family and friends, at home or even at work

   All nurses want for Christmas is “to spend it with their families.” – Leslie C., from Facebook

   “To not be pulled to another unit. I'm already away from my home family, don't take me away from my work family too!” – FunkeeBananas, from reddit

   “Word. Worst Christmas ever involved me and another nurse getting pulled to another unit, that nurse crying, my pod mate being a total bitch, and my two being patients sad, sad trainwrecks. Ugh.” – abermanlebt, from reddit

   Who doesn’t want to feel at home this Christmas, even at work?

4. The ability to not get tired

   “Feet that don't hurt after 12hrs.” –Hottiemcgee, from reddit

5. A break during their shift or sometimes a break from nursing itself.

   “A break…” – Nancy G., from Facebook

   “Nonnursey gifts. ;) seriously, get me a new game or help with the gaming PC I'm building and I will love you forever. Or blankets. My husband keeps this apartment freezing! Same there's only do many layers and blankets I can cover up in before it impedes my gaming.” – thackworth, from reddit

   “Steam gift cards and a matched pair of GeForce GTX 980s. ...or is that just me?” – auraseer, from reddit

   Everyone does need a break from nursing once in a while—and that break takes different forms. For some of our nurses, it’s a day of playing their favorite video games. So before you go shopping to get some gifts for nurses, you may want to consider this fact. (Hint: if your nurse friends aren’t gamers, a day of pampering is always nice.)

6. And of course, all nurses want the best for their patient.

   “For the NICU babies to go home with their family.” – kitty-cat-meow, from reddit

   “An empty waiting room.” – A_guy_in_scrubs, from reddit

   No patients means no one’s sick, and hence, no problem!

We’ll end this post with a Christmas carol from rninnj, posted on reddit:

12 filled meds from pharmacy

11 family members leaving

10 toes on a diabetic

9 days off

8 beds ready, no new admissions

7 cups of coffee

6 smiling patients

5 sleeping patients

4 extra staff members

3 patent lines

2 uninterrupted breaks

1 partridge in a pear tree

Wishing all nurses a happy holiday season!

Source: www.nursetogether.com

By David McNamee

Between 1990 and 2013, global life expectancy increased by nearly 5.8 years in men and 6.6 years in women, according to a new analysis of the Global Burden of Disease Study 2013 published in The Lancet.

"The progress we are seeing against a variety of illnesses and injuries is good, even remarkable, but we can and must do even better," says lead author Dr. Christopher Murray, professor of Global Health at the University of Washington. 

"The huge increase in collective action and funding given to the major infectious diseases such as diarrhea, measles, tuberculosis, HIV/AIDS and malaria has had a real impact," he says. 

"However, this study shows that some major chronic diseases have been largely neglected but are rising in importance, particularly drug disorders, liver cirrhosis, diabetes and chronic kidney disease."

The analysis suggests that life expectancies in high-income regions have been increased due to falling death rates from most cancers - which are down by 15% - and cardiovascular diseases - which are down by 22%.

In low-income countries, rapidly declining death rates for diarrhea, lower respiratory tract infections and neonatal disorders have boosted life expectancy.

Despite the increases in global life expectancy by nearly 5.8 years in men and 6.6 years in women, some causes of death have seen increased rates of death since 1990.

These increased causes of death include:

• Liver cancer caused by hepatitis C (up by 125%)
• Atrial fibrillation and flutter (serious disorders of heart rhythm; up by 100%)
• Drug use disorders (up by 63%)
• Chronic kidney disease (up by 37%)
• Sickle cell disorders (up by 29%)
• Diabetes (up by 9%)
• Pancreatic cancer (up by 7%).

HIV/AIDS has 'erased years of life expectancy' in sub-Saharan Africa

The report also points to one notable global region where life expectancy is not increasing. Deaths from HIV/AIDS have erased more than 5 years of life expectancy in sub-Saharan Africa, say the authors. HIV/AIDS remains the greatest cause of premature death in 20 of the 48 sub-Saharan countries.

Since 1990, years of life worldwide lost due to HIV/AIDS is reported as having increased by 334%.

In Syria, war is the leading cause of premature death - the conflict caused an estimated 29,947 deaths in 2013, and up to 54,903 and 21,422 deaths in each of the preceding 2 years.

Countries that the authors consider to have made "exceptional gains in life expectancy" over the past 23 years include Nepal, Rwanda, Ethiopia, Niger, Maldives, Timor-Leste and Iran - where, for both sexes, life expectancy has increased by more than 12 years.

Life expectancy at birth in India increased from 57.3 years for men and 58.2 years for women in 1990 to 64.2 years and 68.5 years, respectively, in 2013. The authors say that India has made "remarkable progress" in reducing deaths, with the death rates for children dropping 1.3% per year for adults and 3.7% per year for children.

The report also welcomes dramatic drops in child deaths worldwide over the study period. In 1990, 7.6 million children aged 1-59 months died, but this death rate was down to 3.7 million by 2013.

Igor Rudan and Kit Yee Chan, from the Centre for Population Health Sciences and Global Health Academy at the University of Edinburgh Medical School in the UK, write in a linked comment:

"Estimates of the causes of the global burden of disease, disability, and death are important because they guide investment decisions that, in turn, save lives across the world.

Although WHO's team of experts have been doing fine technical work for many years, its monopoly in this field had removed incentives to invest more time and resources in continuous improvement [...] the competition between WHO and the GBD [Global Burden of Disease Study] has benefited the entire global health community, leading to converging estimates of the global causes of death that everyone can trust."

 

Source: www.medicalnewstoday.com

NAHN is pleased to present the NAHN National Certification for Bilingual Healthcare Providers Medical Spanish Course & Exam in partnership with Canopy Apps, a health tech company that is improving access to information across language barriers to improve healthcare.

In line with NAHN’s dedication to the professionalism and advancement of Hispanic nurses, the NAHN Medical Spanish Certification offers access to improved provider competencies in Hispanic culture and language. Healthcare providers- both on the individual and organizational level - benefit from increased proficiency in medical Spanish, resulting in the ability to reach individuals who are unable or afraid to get assistance because of linguistic barriers. The acceptance of this credentialing in the provider community on a wide-spread basis has broad-reaching potential, including reduced risk of medication and treatment non-adherence in a growing Hispanic American population with increasing medical needs. 

The NAHN Medical Spanish Course is a comprehensive, self-paced online course covering the essentials of patient-provider communication in Spanish. The medical Spanish knowledge provided in the three-level program results in a provider who can communicate with and provide appropriate care to Hispanic patients. Following the program, the NAHN Medical Spanish Certification exam assesses the ability for an individual to communicate directly with Hispanic patients in a clinical setting without the use of an interpreter. The program offers 18 Continuing Nurse Education (CNE) hours for completion of the course. 

NAHN members receive a discount on both the course and the exam. When registering for the course and/or the exam, please login using the email address from which you received this email to receive your discount. 

Source: http://www.nahnnet.org

By DENNIS THOMPSON

Chickenpox befell Angelina Jolie this week, preventing the actress-turned-director from attending the premiere of her new film.

Meanwhile, an outbreak of mumps has hit the National Hockey League, sidelining more than a dozen players and two referees.

These are considered kids' diseases. Most adults have vivid, fretful childhood memories of standing in line to get vaccinations that they expected to provide lifetime protection.

Why, then, are these prominent adults -- and scores of others -- coming down with these infections?

Mainly, it comes down to two factors, experts say.

Vaccination rates have declined among children in some parts of the United States, increasing everyone's risk of exposure to virulent diseases like chickenpox, measles, mumps and whooping cough, said Dr. Aaron Glatt, a spokesman for the Infectious Diseases Society of America.

"These vaccines are not perfect," said Glatt, who's also executive vice president of Mercy Medical Center in Rockville Centre, N.Y. "If you don't have a perfect vaccine and you couple that with a less-than-ideal number of people getting it, then if one person gets it then it's more likely to spread to others."

On top of that, even adults who got their shots as kids are at risk of contracting these diseases once exposed to them, because the protection provided by childhood vaccinations can fade over time.

"You can be vaccinated for something and have antibodies that wane over time or disappear entirely," said Dr. Len Horovitz, an internist and lung specialist at Lenox Hill Hospital in New York City. "You can have intermittent immunity, or no immunity."

America's public health defense against infectious diseases is built on a concept called "herd immunity," Glatt explained. If enough people are vaccinated against diseases like chickenpox, influenza, mumps and whooping cough, then even those who aren't vaccinated benefit because those who are immune can't spread the disease.

Skepticism over the effectiveness and safety of vaccines has caused vaccine rates to decline in some parts of the country, Horovitz and Glatt said. In those locations, adults with waning or imperfect immunity could fall prey to childhood infectious diseases, particularly if there's an outbreak.

"There is less vaccination going on than there was previously," Glatt said. "These childhood diseases have not gone away, and there is a strong anti-vaccine lobby that plays a role in people's decision to have their children vaccinated."

Since the early 1980s, there has been an overall increasing trend of whooping cough in the United States, said Angela Jiles, a spokeswoman for the federal Centers for Disease Control and Prevention.

Between Jan. 1 and Aug. 16 of this year, the CDC received reports of 17,325 cases of whooping cough, a 30 percent increase from the same time period in 2013 and the most cases seen in six decades, Jiles said.

California is experiencing its worst outbreak of whooping cough in seven decades.

There also have been more reported mumps cases in the United States this year, due to some larger outbreaks, according to the CDC. A reported 1,078 people have contracted mumps in 2014, compared with 438 the year before. In 2006 -- the worst year in recent history -- there were 6,584 cases of mumps, largely due to outbreaks on college campuses, according to the CDC.

No one has said how Jolie might have contracted chickenpox, but many of the NHL players appear to have gotten mumps from each other, despite efforts by the hockey league to get players vaccinated.

A single dose of mumps vaccine is about 80 percent effective, and two doses is about 90 percent effective, Amy Parker Fiebelkorn, an epidemiologist with the CDC's measles, mumps, rubella and polio team, told The New York Times.

"There is no vaccine that's 100 percent effective," Fiebelkorn said. "There is some margin for fully vaccinated individuals to still be infected with mumps if they're exposed to the virus."

Unfortunately, adults who contract these diseases are in for a rougher ride than children. They are more likely to develop serious complications, and are at higher risk of death, Glatt and Horovitz said.

These viruses also can increase a person's risk of future illness. For example, chickenpox patients like Jolie have a lifetime risk of shingles, a disease that can cause terrible rashes and intense nerve pain. The chickenpox virus hides in deep reservoirs inside the human body, and then emerges later in life to cause shingles.

Concerned adults can ask their doctor for a blood test that will check their antibodies and see if they remain immune to these infectious diseases, Horovitz said.

"It's something that could be done in the course of your annual exam. It takes no more than an extra tube or two of blood," the same as regular checks for blood sugar and cholesterol, he said. "It would be particularly important for people with chronic medical conditions or who do a lot of foreign travel where these diseases are running rampant."

People also can talk with their doctor about vaccinations that are recommended for adults. For example, the CDC recommends that adults get a booster shot every 10 years for tetanus, diphtheria and whooping cough, as well as an annual flu shot.

Source: www.cbsnews.com

A paralysed woman who controlled a robotic arm using just her thoughts has taken another step towards restoring her natural movements by controlling the arm with a range of complex hand movements.

Thanks to researchers at the University of Pittsburgh, Jan Scheuermann, who has longstanding quadriplegia and has been taking part in the study for over two years, has gone from giving "high fives" to the "thumbs-up" after increasing the manoeuvrability of the robotic arm from seven dimensions (7D) to 10 dimensions (10D).

The extra dimensions come from four hand movements--finger abduction, a scoop, thumb extension and a pinch--and have enabled Jan to pick up, grasp and move a range of objects much more precisely than with the previous 7D control.

It is hoped that these latest results, which have been published today, 17 December, in IOP Publishing's Journal of Neural Engineering, can build on previous demonstrations and eventually allow robotic arms to restore natural arm and hand movements in people with upper limb paralysis.

Jan Scheuermann, 55, from Pittsburgh, PA had been paralysed from the neck down since 2003 due to a neurodegenerative condition. After her eligibility for a research study was confirmed in 2012, Jan underwent surgery to be fitted with two quarter-inch electrode grids, each fitted with 96 tiny contact points, in the regions of Jan's brain that were responsible for right arm and hand movements.

After the electrode grids in Jan's brain were connected to a computer, creating a brain-machine interface (BMI), the 96 individual contact points picked up pulses of electricity that were fired between the neurons in Jan's brain.

Computer algorithms were used to decode these firing signals and identify the patterns associated with a particular arm movement, such as raising the arm or turning the wrist.

By simply thinking of controlling her arm movements, Jan was then able to make the robotic arm reach out to objects, as well as move it in a number of directions and flex and rotate the wrist. It also enabled Jan to "high five" the researchers and feed herself dark chocolate.

Two years on from the initial results, the researchers at the University of Pittsburgh have now shown that Jan can successfully manoeuvre the robotic arm in a further four dimensions through a number of hand movements, allowing for more detailed interaction with objects.

The researchers used a virtual reality computer program to calibrate Jan's control over the robotic arm, and discovered that it is crucial to include virtual objects in this training period in order to allow reliable, real-time interaction with objects.

Co-author of the study Dr Jennifer Collinger said: "10D control allowed Jan to interact with objects in different ways, just as people use their hands to pick up objects depending on their shapes and what they intend to do with them. We hope to repeat this level of control with additional participants and to make the system more robust, so that people who might benefit from it will one day be able to use brain-machine interfaces in daily life.

"We also plan to study whether the incorporation of sensory feedback, such as the touch and feel of an object, can improve neuroprosthetic control."

Commenting on the latest results, Jan Scheuermann said: ""This has been a fantastic, thrilling, wild ride, and I am so glad I've done this."

"This study has enriched my life, given me new friends and co-workers, helped me contribute to research and taken my breath away. For the rest of my life, I will thank God every day for getting to be part of this team."

Source: www.sciencedaily.com

At birth, a newborn baby is still attached to its mother through the umbilical cord, which is either cut very early - within the first 60 seconds - or later, with some women opting to wait until after the cord has stopped pulsating. Though the right timing for cutting the cord - also referred to as clamping - is widely debated, a new study suggests delaying cord clamping by 2 minutes results in better development for the newborn during the first days of life.

What do you think about it? Do you think the 2 minutes makes a difference? Perhaps you can share a personal and/or professional experience about this.

The research, carried out by scientists from the University of Granada and the San Cecilio Clinical Hospital in Spain, is published in the journal Pediatrics, the official journal of the American Academy of Pediatrics (AAP).

According to the American Congress of Obstetricians and Gynecologists (ACOG), the reason that cord clamping timing is so controversial is that a previous series of studies into blood volume changes after birth concluded that in healthy term infants, more than 90% of blood volume was attained within the first few breaths he or she took after birth.

As a result of these findings, as well as a lack of other recommendations regarding optimal timing, the amount of time between birth and umbilical cord clamping was widely shortened; in most cases, cord clamping occurs within 15-20 seconds after birth.

However, before these studies, in the mid-1950s, cord clamping within 1 minute of birth was defined as "early clamping," and "late clamping" was defined as more than 5 minutes after birth. And the ACOG have stated that "the ideal timing for umbilical cord clamping has yet to be established."

Meanwhile, the World Health Organization (WHO) advocate for late cord clamping (between 1-3 minutes after birth), as it "allows blood flow between the placenta and neonate to continue, which may improve iron status in the infant for up to 6 months after birth."

Waiting 2 minutes increased antioxidant capacity

To provide further evidence in the debate of early versus late cord clamping, the researchers from this latest study, led by Prof. Julio José Ochoa Herrera of the University of Granada, assessed newborn outcomes for infants born to 64 healthy pregnant women to determine the impact of clamping timing on oxidative stress and the inflammatory signal produced during delivery.

All of these women had a normal pregnancy and spontaneous vaginal delivery. However, half of the women's newborns had their umbilical cord cut 10 seconds after delivery and half had it cut after 2 minutes.

Results revealed beneficial effects of late cord clamping; there was an increase in antioxidant capacity and moderation of inflammatory effects in the newborns.

Commenting further, Prof. Ochoa says:


"Our study demonstrates that late clamping of the umbilical cord has a beneficial effect upon the antioxidant capacity and reduces the inflammatory signal induced during labor, which could improve the development of the newborn during his or her first days of life."

He adds that umbilical cord clamping is one of the most frequent surgical interventions practiced in humans, with proof of the practice dating back centuries. 

Early clamping 'not advised unless newborn needs resuscitation'

With evidence of benefits for delayed cord clamping, however, why are most newborns separated from the placenta within 15-20 seconds after birth? According to the ACOG, there are concerns over universally adopting delayed clamping because it could "jeopardize timely resuscitation efforts, if needed, especially in preterm infants."

"However," the organization states, "because the placenta continues to perform gas exchange after delivery, sick and preterm infants are likely to benefit most from additional blood volume derived from a delay in umbilical cord clamping."

There are also other concerns regarding delayed cord clamping, including an increased potential for "excessive placental transfusion, which can lead to neonatal polycythemia" - an abnormally high level of red blood cells. This is especially of concern in the presence of risk factors including maternal diabetes, intrauterine grown restriction and high altitude.

Another concern stated by the ACOG is that delayed umbilical cord clamping "may be technically difficult in some circumstances."

Still, the WHO say late cord clamping is recommended for all births, and the improved iron status associated with it "may be particularly relevant for infants living in low-resource settings with reduced access to iron-rich foods."

The organization clearly states that early cord clamping - less than 1 minute after birth - is not advised unless the newborn is asphyxiated and needs to be moved for resuscitation.

Source: www.medicalnewstoday.com