Birth dates

One of the bits of information I found when I was researching all things labour and birth in my last pregnancy, was that eating dates may help you have a natural, shorter labour.

A study carried out by researchers at Jordan University was published in the Journal of Obstetrics and Gynaecology investigated the effect of eating dates on labour and delivery outcomes.

The sample size was 69 women who ate 6 dates each day for 4 weeks before their estimated due date compared with a control group of 45 women who ate no dates.

The research team found that women who ate the dates had a significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005). They also had a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007).

Of the women who ate dates, 96% of those went into spontaneous labour, compared with 79% women in the non date  consumers (p = 0.024). Only 28% of the women in the date eating group needed prostin/oxytocin (for inducing/augmenting labour), which was significantly lower than the 47% who needed induction in the control group (p = 0.036). On average too, the latent phase of the first stage of labour was shorter in women who consumed date fruit compared with the non-date fruit consumers (510 min vs 906 min, p = 0.044).

The researchers concluded that date fruit consumption “in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomised controlled trial.”

The sample size was small, and the researchers stated that the research findings indicate the need for a randomised control trial (RCT) as RCT’s are widely recognised as the best study design.

Even if it makes no difference to your labour, there’s no harm in eating them and just 6 a day could make a difference. While they are high in sugar, they have a GI of just 42,  because of the high fibre content, and therefore release their sugars at a slow steady pace.* They are  super-high in vitamin B6 and provide good amounts of potassium (which is needed for good muscle contraction). They also contribute small amounts of calcium, iron and B vitamins to the diet.

*For this reason too (and also because of the potassium) they make a great snack to have during labour.

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How to boost your baby’s iron stores at birth

If you’re making plans for your birth, hopefully you’ve heard about delayed cord clamping. If you’re not making birth plans this may not be the post for you.

I did lots of research to prepare for the birth of my daughter earlier in the year. We are  lucky to have access to so much information and evidence on birth and pregnancy. Researching all options, means we can make fully informed decisions on the birth we want, whatever happens, because as anyone who has had a baby knows, it doesn’t always go to plan.

Delayed cord clamping

Through my research I came across this TEDx by Dr Alan Greene. In it he describes how the standard practice of clamping the umblical cord, immediately after birth, can result in your baby missing out on about 30% of his/her blood supply, which is effectively outside the body in the cord and placenta.

When your baby is first born, the cord continues to pulse: pumping blood from cord and placenta into your baby’s circulatory system. By delaying cord clamping by just 90 seconds you are ensuring baby starts life with optimal levels of iron rich red blood cells, immune boosting white blood cells and stem cells.

Dr Greene rightly calls it Optimal cord clamping. He explains it all much better than I can …

If you watch the film you can see optimal cord clamping makes so much sense that it seems bizarre that it is not standard practice in the NHS, or indeed Worldwide.

Also, if for any reason baby’s having problems breathing initially – keeping the cord intact means they are getting their oxygen supply from the placenta.

What the evidence says

The UK government’s Scientific Advisory Committee on Nutrition (SACN) published their report on Iron and Health in 2010. In it they drew on research indicating that babies who underwent delayed clamping had, on average, 32% more blood (Nelle et al, 1995) and therefore higher iron levels (30-50mg) (Pisacane, 1996).

They also reported on a Mexican study (Chaparro et al, 2006) where researchers found little difference in haemoglobin (made from iron – a constituent of red blood cells needed to transport oxygen) levels in babies who underwent immediate cord clamping compared to delaying the clamping. However, babies whose cords remained intact for longer at birth had higher  serum ferritin* concentrations. The World Health Organisation  (2007) considered this evidence to be of low quality however, they did recommend delaying clamping by up to 3 minutes.

A review by Cochrane (McDonald and Middleton, 2008) found that delayed cord clamping was associated with significantly higher haemoglobin concentrations at birth. While these levels were not maintained at 6 months,  serum ferritin concentrations were significantly higher at 3 and 6 months. They also found that significantly fewer babies undergoing immediate cord clamping had to undergo phototherapy for jaundice compared with optimal cord clamping.

So in summary they stated that “Delaying clamping cord at delivery is associated with higher systemic iron depots in the first 6 months of life; however, it might also increase the risk of jaundice requiring phototherapy.” They  recommend that further studies are needed to research the benefits, risks and long term effects associated with delayed cord clamping.

Calls to action

  • Dr Alan Greene wants optimal cord clamping to become standard practice, Worldwide. He has started a campaign called Ticc Tocc, the aim is to spread the word about optimal cord clamping.
  • There is also a petition calling for the National Institute of Clinical Excellence (NICE) to change their guidance to recommend delayed cord clamping as standard practice in the UK : http://www.change.org/petitions/national-institute-of-clinical-excellence-implement-delayed-cord-clamping-immediately
  • And if you’re writing your birth plan, remember to include delayed cord clamping.**

* Serum ferritin levels indicate the levels of iron stored in tissue.

**If you have a planned caesarian, you can still plan to have delay cord clamping and skin to skin contact. Search online for “natural caesarian” for more information.

This post is for Claire (you probably already know about this) – good luck.  And Holly and Sarah too.