eLetters to:

ARTICLE: Thomas E. Wiswell, Catherine M. Gannon, Jack Jacob, Leonard Goldsmith, Edgardo Szyld, Kerry Weiss, David Schutzman, Gerard M. Cleary, Panayot Filipov, Isabel Kurlat, Carlos L. Caballero, Soraya Abassi, Daniel Sprague, Charles Oltorf, and Michael Padula Delivery Room Management of the Apparently Vigorous Meconium-stained Neonate: Results of the Multicenter, International Collaborative Trial Pediatrics 2000; 105: 1-7 [Abstract] [Full text] [PDF]

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Important contribution

Reuben Zimmerman   (16 February 2000)

Are Complications of Intubation Really Short-lived?

Claire L Winstone   (18 August 2003)

Important contribution 16 February 2000
Reuben Zimmerman, Physician Assistant Private General Practice in upstate NY Send letter to journal: Re: Important contribution reubenz{at}bruderhof.com Reuben Zimmerman	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!
Are Complications of Intubation Really Short-lived? 18 August 2003
Claire L Winstone, Infant Mental Health Specialist Santa Barbara Graduate Institute Send letter to journal: Re: Are Complications of Intubation Really Short-lived? claire{at}speaking4baby.com Claire L Winstone	"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.