Post-publication Peer Reviews to:
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Reuben Zimmerman, Physician Assistant Private General Practice in upstate NY
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reubenz{at}bruderhof.com Reuben Zimmerman
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This is the kind of article that really makes a splash. This issue certainly has been contentious at the institutions where I deliver babies, and so it's nice to have some solid scientific evidence to back up what we've always done in practice: save intubation and suctioning for floppy babies, but hold your breath and pray for the ones that seem vigorous. My old OB mentor in NY used to say that one of the most important interventions in obstetrics is to sit on your hands. Your article shows that this may be true not only for the breech, but also for the vigorous meconium-stained infant. Thank you for an excellent study. This is what evidence-based medicine is all about! |
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Claire L Winstone, Infant Mental Health Specialist Santa Barbara Graduate Institute
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claire{at}speaking4baby.com Claire L Winstone
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"Complications of intubation are infrequent and short-lived." While I applaud this study and its welcome findings, I am curious as to how the authors determined that complications of intubation are generally short-lived, what complications were measured, and for what duration. Lactation consultants, midwives and birth psychologists have all commented on the oral aversion they find even in some infants only suctioned on the perineum, let alone subjected to intubatation. Since breast-feeding currently receives minimal support in this culture and formula-feeding has become a regrettable norm, it may go unnoticed by many that suctioned and/or intubated infants may show increased reluctance to accept the breast (or bottle, for that matter) and that this frequently results in breastfeeding failure. Given the well- known long-, as well as short-term, benefits of breastfeeding vs. formula- feeding, such an outcome would hardly be short-lived. A s for frequency, I don't know if anyone has studied the relationship between intubation and breastfeeding failure, or if any correlation between the two has yet been made empirically. Certainly this would be worthy of study and may eventually disprove the present authors' conclusions regarding the "short-lived" consequences of intubation. |
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