Delaying newborn's first bath increases exclusive breastfeeding rate

A new Cleveland Clinic study has shown that delaying the first baby bath after delivery increases the breastfeeding rate by 8%, with 49% increased odds of exclusive breastfeeding while in the hospital. These mothers also continued breastfeeding their babies after discharge from the hospital. The odds further increased to 60% if the mother had a vaginal birth versus cesarean birth. 

The researchers at Cleveland clinic looked at data from about 1000 mother-newborn couplets in this retrospective, two-group, pre- and postintervention design study. In the intervention group, the first bath was delayed for at least 12 hours vs. following the routine hospital practice of bathing the baby in a couple of hours after birth in the control group.

The demographics were comparable in both the groups. After multivariate regression analysis, it was observed that there was a significant increase in exclusively breastfeeding rates in the study group in whom the bath was delayed for 12 hours.

Why delaying the bath increases the breastfeeding rate is unclear, but researchers behind the study speculate that similarity between the smell of breast and amniotic fluid may better help the baby to latch.

The study adds support to the initiative of establishing immediate skin-to-skin (STS) contact between mother and baby. STS contact has been promoted internationally through the Baby-Friendly Hospital Initiative (BFHI) as a means to improve breastfeeding initiation, exclusivity, and duration after hospital discharge.

“Human touch is vital to the parent and the baby. You need to have that human touch. I think that by not washing the baby (so soon), encouraging skin-to-skin contact and breastfeeding, you’re improving that human touch. So, you’re now looking at a long-term health benefit,” explains Heather DiCioccio, DNP, RNC-MNN, who led the study. The study was published ahead of print in Journal for Obstetrics, Gynecologic, and Neonatal Nursing.

Those babies who received bath after 12 hours were also able to maintain their temperature better as compared to early bathers.

Research has also shown that increased rates of breastfeeding have a wealth of benefits for mother and child in years to come. Risk of childhood and maternal illnesses decrease considerably potentially decreasing the lifetime healthcare costs.

Here is a beautiful video by Cleveland Clinic explaining the findings

Press release

Full Text

Ob/Gyn Updated Facebook page

NAMS video series 2019: Understanding the etiology and mechanism of vasomotor symptoms

The North American Menopause Society (NAMS) regularly posts comprehensive videos for clinicians about important midlife health topics. All interviews in the series are hosted by NAMS Board of Trustees Member and Past-President Dr. Marla Shapiro, a Canadian physician who led this exciting initiative. Dr. Shapiro is also a medical consultant for CTV News.

In this first video of 2019, Dr. Rebecca Thurston, Director of the Women’s Biobehavioral Health Laboratory and Professor of Psychiatry, Psychology, Epidemiology, and Clinical and Translational Science at the University of Pittsburgh throws some light on the why and how about vasomotor symptoms (VMS).

The natural history of vasomotor symptoms is still evolving. It is estimated that about 75% of women experiencing menopause will have hot flashes. A substantial number of women seen in everyday gynecological practice or specialty menopause clinic report VMS well past the age of 60 and some well into the 80s.

Hot flashes considerably reduce the quality of life and hamper the day to day activities. Prevalence of VMS is generally associated with increased risk of CVD due to endothelial dysfunction. Hence, women with VMS could be screened for CVD risk factor and offered lifestyle modifications and frequent screening for early diagnosis and prevention.

Ob/Gyn Updated Facebook page

Osteoporosis drug Romosozumab receives marketing approval in Japan

Monoclonal antibody romosozumab gains first-ever marketing approval in Japan for the treatment of osteoporosis in patients at high risk of fracture announced Amgen and UCB in a joint press release. The drug will be known as Evenity in Japan and would be developed by Amgen Astellas BioPharma K.K.–a joint venture between Amgen and Astellas Pharma Inc., headquartered in Tokyo.

Romosozumab has a dual effect on the bone– it works by binding and inhibiting the activity of the protein sclerostin which increases bone formation and decreases bone breakdown.

Japanese people have the longest life expectancy in the world and with that comes the burden of osteoporotic fractures. In Japan, the osteoporotic fracture is the leading cause of disability that requires long term nursing home care.

"The approval of EVENITY in Japan is a significant milestone that reinforces our commitment to bringing effective treatments to the millions of patients who suffer from osteoporosis," said David M. Reese, M.D., executive vice president of Research and Development at Amgen in a news release.

"A patient with a prior osteoporotic fracture is twice as likely to suffer another fracture if left undiagnosed and without appropriate treatment. With this approval, physicians in Japan now have a new medicine to help patients reduce their risk of fracture."

The approval is based on results of two phase 3 clinical trials– FRAME and BRIDGE. The FRActure study in postmenopausal woMen with ostEoporosis (FRAME), included 7,180 postmenopausal women with osteoporosis. The women received romosozumab 210 mg s.c. or placebo once monthly for 12 months, followed by denosumab 60 mg s.c. once every 6 months in both groups for 12 months. The drug significantly increased spine and hip BMD and reduced vertebral and clinical fracture risk.

The BRIDGE study (placeBo-contRolled study evaluating the efficacy anD safety of romosozumab in treatinG mEn with osteoporosis) involved 245 men with osteoporosis (163 romosozumab, 82 placebo) randomized 2:1 to receive either 210 mg romosozumab or placebo subcutaneously once monthly for 12 months. Men on Romosozumab showed a significant bone mineral density (BMD) gains at the lumbar spine, total hip and femoral neck compared to placebo at six and 12 months.

The approval is also significant because FDA rejected Amgen’s initial marketing application for Romosozumab in the US because of cardiovascular side effects of the drug in ARCH trial. The drug is also under regulatory review in Europe.

The Japanese Pharmaceuticals and Medical Devices Agency undertook a thorough review of the safety profile of EVENITY, including the cardiovascular safety findings in the ARCH trial.

Toshio Matsumoto, M.D., Ph.D., emeritus professor of Tokushima University and the advisor of the university's Fujii Memorial Institute of Medical Sciences said in the press release, "Physicians have been waiting for a new therapeutic option. I have great hope that the approval of EVENITY will help reduce the fracture risk for patients in Japan."

"Patients with a prior fracture face the risk of having another fracture and particularly stand to benefit from the option of a new bone-forming agent," he further added.

Meanwhile, During the second review cycle, the US Food and Drug Administration (FDA) Bone, Reproductive, and Urologic Drugs Advisory Committee (BRUDAC) recently voted in favor of approving Amgen and UCB’s romosozumab (EVENITY) In the US for the treatment of postmenopausal women with osteoporosis at high risk for fracture. The committee indicated that the drug benefits for treatment of postmenopausal osteoporosis outweigh its risk.

Press release