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Sunday, September 16, 2012

Midwives in Gauteng

Midwives are integral to ensuring that we take quality care of our mothers and babies at all times. Midwives midwives are involved in every aspect of a pregnant woman's health, from pregnancy screening to post-delivery care and the provision of family planning and pap-smears to detect cervical cancer. Midwives are classified as nurses in South Africa so there are no figures on their numbers, Nurses and Midwives also comprise the largest group of health care providers in South Africa. Independent Midwives work in both public and private hospitals. In the past, midwives helped women give birth at home, but there are no longer enough of them for this to be possible.

IN SOUTH AFRICA INDEPENDENT MIDWIVES OFFER:
Antenatal and Postnatal Care
Home birth
Waterbirth
Hospital Birth
Birth in Birth Centre
Caesarian section attendance
Ntombi Mchunu ,
Little Arrivals Private Midwife Services
Address: Linkwood Hospital 24 12th Avenue Linksfield West,
 Orange Grove, Gauteng 2192
Tel: (07) 2949 6058
Fax: (08) 6504 1808
http://www.littlearrivals.co.za

Home Visiting Midwife
Address: Roodepoort, Gauteng 1724
Tel: 071 6367692
lgvanderw@gmail.com

Hettie Grove: Carmi Clinic: Springs

RN, RCN, RM, BACurEdAdmin, advanced midwife, IBCLC, Internationally certified childbirth educator, Happiest kid on the block educator, Evergreen parent facilitator. PR 8806926
TeL 011 815 2129
083 492 5861
Childbirth education, postnatal classes, well baby clinic, home phototherapy, lactation education & consultation 492 5861



Sunday, September 9, 2012

Birth & Midwifery Groups Western Cape

There are two main options open to a pregnant woman when having a baby in Cape Town: midwife or ginaecologist. Whichever the woman choose, the midwife or gynaecologist will remain the person in charge of her care throughout the pregnancy and will be present at the birth so there is very reassuring continuity of care. Here are some contacts for private midwives. Please feel free to add to the list and give your recommendations. Most of the private hospitals in Cape Town offer antenatal classes which  must be paid.

Central
Cape TownBirthworks
Karen Clark
Registered nurse & midwife
PR No. 0092444
We hire birth pools, birth stools, Tens machines & birth balls nationwide
(021) 785-5670 / 082 776 3622 / www.birthworks.co.za 
Mouille Point
Thula Baby Centre
Heather Wood
Registered nurse & midwife
PR No. 0192031
Antenatal preparation classes, well baby clinic, home visits
(021) 434-2614 / 072 548 8506
Sea Point
Bella-Mia
Tania Wener
Perinatal instructor ICEA
PR No.
Birth preparation, nutrition, postnatal rehab, pelvic floor strengthening, core
083 408 8868
info@bellamiax.co.za 
Gardens
Ruth Katzman

BSc Physiotherapy, IBCLC
PR No. 7222742
Physiotherapy for breastfeeding problems, hiring of Tens machine, pelvic floor rehabilitation
082 864 8232

Pinelands Joann Lugt Childbirth Education
Joann Lugt
Registered nurse & midwife
PR No. 0880000032395
Antenatal classes, baby sign language workshops, postnatal visits
(021) 531-5422 / 084 879 8511

Northern suburbs
Milnerton Be Prepared For Life
Devorah Gruss
Registered nurse & midwife
PR No. 8804559
Childbirth education classes for couples
(021) 552-5872 / 083 463 8114

Milnerton
Sr Lyns Baby Clinic at Milnerton Medi-Clinic
Lyn Smit
Registered nurse and midwife
PR No. 0016985
Well baby clinic offering immunisations, breastfeeding, weight & observation of newborns
(021) 529-9195 / (021) 552-8126

MilnertonThe Lactation Consultancy
Jean Ridler
RN, RM, international board certified lactation consultant
PR No. 8809068
Breastfeeding classes for parents-to-be, home consultations for breastfeeding problems, breastpump hire
(021) 556-9162 / 082 668 1082

Milnerton
Paula Pedersen
Qualified labour doula
PR No.
Certified childbirth companion for all births (home, hospital, water, vbac), breastfeeding support
083 334 2253 / www.paula.co.za / paula@paula.co.za

TableviewTenfold Baby Clinic
Jackie Butler

BCur Hons, registered midwife
PR No. 0880000056170
Antenatal classes, well baby clinic, breastfeeding support, immunisations, postnatal home visits
(021) 557-6066 / 082 297 2742

Table View Robin Buck Physiotherapy
Angela Buck

BSc Physio
PR No. 0159263
Treatment of engorged breasts, cracked nipples, breastfeeding advice & infant massage
084 981 0232

Sunningdale
Blaauwberg Hospital
Delene Cloete
Registered nurse
PR No. 0880000018082
Antenatal classes
(021) 556-8027 / 072 470 0435

Sunningdale Storks Nest Netcare Blaauwberg Hospital
Barbara Chambers
Registered nurse & midwife
PR No. 0880000003379
Antenatal classes, breastfeeding advice, well baby clinic, immunisations, milestones & development
(021) 554-9388/9

Melkbos
Marcha Izatt
RN, RM, RPN
PR No. 0880000087580
Postnatal care, breastfeeding counselling, home phototherapy
078 138 2040

PanoramaPanorama Breastfeeding Clinic
Justine Geiger

BSc Nursing, RN, RM, RCHN
PR No. 8853088
Antenatal classes, breastfeeding advisors, all baby & child immunisations till preschool
(021) 939-9720 / (021) 930-8397 / after hours helpline 083 703 7711

Panorama Panorama Antenatal Classes
Danelia Kok

Reg midwife, comm health, nursing education & admin
PR No. 0880000118532
We offer Afrikaans and English antenatal classes at Panorama Medi-Clinic
(021) 938-2153

Goodwood Storks Nest Clinic
Ronel Nortje
Registered nurse & midwife
PR No. 0880000161764
Antenatal classes, well baby clinic, breastfeeding support, vaccinations, baby massage
(021) 590-4196/1

Bellville Jeanne Roux / Tucker Physiotherapy
Jeanne Roux
Registered midwife
PR No. 0880000093416
Antenatal & postnatal education, exercise, delivery & back care
(021) 957-6283 / (021) 948-1553

Bellville Birth, Baby & Beyond
Rosemary Gauld
Registered nurse & midwife, internationally certified childbirth educator, international board certified lactation consultant
PR No. 8812608
Antenatal classes, breastfeeding private home consultations
(021) 910-0606 / 082 372 3348

Bellville
Sr Jenny’s Pregnancy Centre
Jenny Visser
RN, RM
PR No. 0024252
Antenatal classes, home & hospital births, postnatal & breastfeeding support
(021) 919-9000 / 082 508 5842

Durbanville Baby and U
Merle Townsend
Registered nurse & midwife, internationally certified childbirth educator
PR No. 0080010078921
Antenatal classes – childbirth education – relaxed and informative classes
(021) 976-5740 / 072 266 8864

Durbanville
Durbanville Family Care Centre Breastfeeding Clinic
Jessica Commaille
RN, RM
PR No. 0880000157139
Fun childbirth education for moms and dads, well baby clinic, immunisations
(021) 975-3634 / 073 235 2869

Durbanville All About Babies
Darol Wilmot
RN, RM, ICCE, CIMI
PR No. 8809747
Antenatal classes, all follow-up help birth – 6 years including feeding & immunisations
083 335 4653

Durbanville Magical Mums Clinic
Riana Stander
Registered nurse & midwife
PR No. 8847398
Antenatal classes, well baby clinic, breastfeeding consultant
(021) 976-6477 / 082 771 4253

Durbanville
Proselect Mother & Baby Clinic
Rika Hoffman
Registered nurse & midwife
PR No. 0217743
Infant massage, immunisations, breastfeeding consultant, antenatal classes, family planning
(021) 979-1970 / 082 575 3918

Welgedacht
Welmed Breastfeeding Clinic
Suzette Viljoen & Alma Strever
RN, RM, BACur admin, comm health
PR No. 883870401
Antenatal classes, breastfeeding advice & weighing of baby, immunisations, baby massage, phototherapy
(021) 913-7024 / 082 674 1077

Kuils RiverStorks Nest
Christine Swart RN, RM, RCHN, RPN, CNP
PR No.
Childbirth education, well baby clinic, breastfeeding, diabetes clinic, immunisations
(021) 900-6250
Brackenfell
Susan de Wet

BCur, RN, RM, IAIM
PR No. 0880000226963
Presenting condensed antenatal classes (1 day) & specialising in multiple pregnancies
082 785 7770 / susandw@mweb.co.za

Brackenfell
Clicks Pharmacy Fairbridge
Silke Schmidt-Dumont
BCur
PR No. 8841810
Well baby clinic, breastfeeding advice, immunisations, family planning
(021) 981-1144

Malmesbury
Natalie Hanekom Privaat Baba Kliniek
Natalie Hanekom
Registered nurse and midwife
PR No. 0880000129186
Voorgeboorte klasse, fetalehart monitering, weeg van babas, immunisasies, borsvoedingskliniek, babamassering ens
(022) 487-2567 / 082 714 3276

Malmesbury
Mediese Sentrum
Jeannine Bruwer

GV, GVV, GGV, PGS
PR No. 1582607
Immunisasie kliniek & weeg van babas
(022) 482-4589

Piketberg
Sujalet
Suzanne Burger

Geveg verpleeg in verloskunde, algemene, psigiatrisie en vermeenskapverpleeging
PR No. 880013013
Voorgeborrte klasse en nageboorte hulp, wat bosvoeding insluit en immunisering
076 703 2803

SaldanhaBaby Basics
Julia Slabber

BSocSc Nursing
PR No. 0880008806187
Antenatal exercise & education classes
(022) 714-1427
Southern suburbs
Claremont Kingsbury Hospital
Pauleen Nelson
Registered nurse & midwife, international board certified lactation consultant
PR No. 0880000066389
Breastfeeding education and support, antenatal & postnatal private home consultations
(021) 696-5791 / 084 082 9104 
Claremont
Cindy Homewood
Registered nurse & midwife
PR No. 0880000098302
Breastfeeding counselling, infant & child nutrition advice, home visits
082 960 5940

Claremont
Lady Buxton Clinic
Registered nurse & midwives
PR No.
Mon – Fri: 9am – 12 noon / Tues: 2:30 – 5:30pm
Support and advice to parents on babyhood & childhood, immunisations, family planning
(021) 674-3110

Plumstead Birth Options
Kate Christie

BSc Nursing
PR No. 8840873
Independent midwives, home & hospital births, antenatal care, antenatal classes, postnatal care, breastfeeding advice
(021) 761-9623 / 082 785 3877

Plumstead Birth Options
Glynnis Garrod
Prof nurse & midwife
PR No. 8846502
Midwifery practice including home and hospital births, antenatal classes and postnatal care
(021) 761-9623 / 082 894 5934

Plumstead Incredible Babies Clinic
Ceredwin Thomsen
Registered nurse & midwife & community health science
Well baby clinic, parenting support, breastfeeding weighing, immunisations, nutrition, home visits
083 303 5552 / (021) 761-9623

Rondebosch Well Mother & Child Clinic
Louise Naude
Registered nurse & midwife
PR No. 8826277
Well baby clinic, breastfeeding care, immunisations, weighing, developmental screening, maternal support
(021) 689-6930 / 082 829 9788

Constantia Constantia Antenatal & Baby Clinic
Lynne Heydenrych

BSc Nursing & midwifery, internationally certified childbirth educator, international board certified lactation consultant
PR No. 8814422
Internationally certified childbirth educator specialising in antenatal classes, breastfeeding baby clinic
(021) 715-2539w / (021) 715-2262h / 082 425 1151 
Constantia
Kathryn Sutton
BSc Nursing, lactation consultant
PR No. 8813779
Breastfeeding consultations & home visits, well baby clinic
082 728 6629
Constantia
Healthwise
Suzanne Leighton
Aromatherapy, reflexology, reiki, yoga
PR No. 1060000216224
Baby & pregnancy massage, postnatal depression & bi-polar disorder
(021) 794-2738

Kenilworth Perfectly Pregnant
Jill Mathew
Registered nurse & midwife
PR No. 8809224
Preparing for childbirth & parenting courses, paediatric CPR, antenatal & postnatal exercises
(021) 683-1404w / (021) 671-5294h / 072 329 0281

Tokai McLeod & Orpen-Lyall Physiotherapy
Wendy Orpen-Lyall

BSc Physiotherapy
PR No. 0087483
Women’s health physiotherapy (pregnancy aches and pains and incontinence)
(021) 713-3766

Marina da Gama Midwives Inc
Sandy Standish

CPN, registered midwife
PR No. 8814368
Antenatal and postnatal care, home and hospital deliveries
083 653 7794 / (021) 788-7199

Fish Hoek Carol’s Clinic
Carol Martin
Registered nurse, midwife, childbirth educator
PR No.
Antenatal & postnatal education & support, family planning, breastfeeding support
(021) 782-2124
084 989 0055

Fish Hoek
Labours of Love
Jennifer Skillen

BSc D.Phil, NCT childbirth educator
PR No.
Preparing for a natural birth in a high tech society
(021) 788-7867

Noordhoek
Noordhoek Baby Clinic
Sarah Philbrick

RGN,RM, BScHons
PR No. 0880000114561
Antenatal classes, breastfeeding support, baby care & advice, immunisations, postnatal home visits, weighing
083 437 7358
 
 Southern suburbs
Southern suburbs
Sue Lees
Registered nurse & midwife
PR No. 8818096
Antenatal care, home & hospital births, postnatal care
(021) 788-5997

Southern suburbs
Lalilu Doula Care
Lana Petersen
PR No.
Childbirth companion for home, hospital and vbac, support at home
(021) 703-4291 / 073 514 9754 / lalilu@sybaweb.co.za

Southern suburbsTums2Tots
Kerry Pienaar

Doula / Mom
PR No.
Doula – labour, birth, breastfeeding assistance, postnatal care, labour & birth kits
(021) 785-3694 / 082 475 7776
Boland
Stellenbosch
Swanger Familie Konsultasie
Leana Habeck

BCur, RN,RM,RPN,CHN,dip peri ed, UNICEF breastfeeding counsellor
PR No. 0880000026174
Antenatal classes for couples and singles, Afrikaans or English, breastfeeding support
(021) 855-4657 / 083 415 4657

Paarl
Paarl Medi-Clinic
Annelise Nel

BACur
PR No. 0880000087815
Antenatal classes, breastfeeding clinic, well baby clinic, massage consultant
(021) 807-8129 / 807-8130

Paarl
Mariana Symington

BACur
PR No. 8824460
Well baby clinic with immunisations, all midwifery services, antenatal classes
082 807 5887 / (021) 872-5106

WorcesterWorcester Medi-Clinic
Heidi Jonker
Registered nurse & midwife
PR No.
Antenatal & postnatal classes, well baby clinic, immunisations
(023) 348-1500 / (023) 348-1570

RobertsonMulti-Med Kliniek
Karien Orton

BCur Hons midwifery & neonatal
PR No. 8850186
Voorgeboorte klasse, gesonde baba kliniek, tuis bevallings, water geboortes
(023) 626-2022 / 082 334 3474

VredendalMiracle Babies Kliniek
Estelle Bornman

BCur, midwife, OHS
PR No. 88000177636
Antenatal classes, postnatal care & support, breastfeeding care & support
084 548 6841 / (027) 213-5323
Helderberg
Somerset WestIrene Bouquin Childbirth Parenting Course
Irene Bourquin
Registered nurse & midwife, ICCE, ICPNE
PR No. 0880008801878
Childbirth & parenting classes for teens, single mums, couples and grandparents
(021) 852-3040

Somerset West The Cape Midwife
Natasha Stadler
Registered midwife & nursing sister
PR No. 0202584
Qualified personal care for you and your family, pregnancy, birth, early parenting
082 538 7707
Stellenbosch
Swanger Familie Konsultasie 
Leana Habeck
BCur, RN,RM,RPN,CHN,dip peri ed, UNICEF breastfeeding counsellor
PR No. 0880000026174
Antenatal classes for couples and singles, Afrikaans or English, breastfeeding support
(021) 855-4657 / 083 415 4657

Stellenberg Helping Hands at Stellenberg Pharmacy
Elaine van Zyl
RN, midwife, community health
PR No.
Breastfeeding advice, weighing, immunisations, postnatal advice
083 225 8880
Southern Cape
Hermanus – OnrusrivierAnita’s Mom and Baby Clinic
Anita Rust
Dip general & obstet, BCur, primary health care
PR No. 0880000168394
Prenatal education, lactation consultation, well women clinic, baby vaccination, screening
(028) 316-1717 / 082 929 4460

Hermanus & StandfordMarie’s Antenatal Care
Marie du Plessis
Registered nurse & midwife, psychiatry
PR No.
Antenatal classes
082 821 7144 / (028) 313-8138 / (028) 341-0643

Riversdal
Riversdal Gesonde Baba Kliniek
Rina Kapp

Geredestreerde verpleegkundige
PR No. 8830711
Voorgeboorte klasse
082 921 4415 / (028) 713-2500

George
George Medi-Clinic
Registered nurses of labour ward
PR No.
Antenatal classes Mondays at 18h00, postnatal groups every second Thursday at 10h00 at the baby clinic
(044) 803-2312 
George
Elon Clinic
Maureen BarnardRegistered nurse & midwife, community health, operating theatre science, primary clinical care, nursing of patients with diabetes
PR No. 8829357
Well baby clinic, immunisations, lactation consultant, diabetes educator
(044) 874-6769 / 082 494
For those who cant afford care visit the government clinics: http://www.westerncape.gov.za/eng/directories/facilities/6439

 

Breastfeeding is hard

Breastfeeding is beautiful and natural. But breastfeeding is hard, and it hurts. Yes it is hard and it is not a picnic. It is not always “natural.” Initiating breastfeeding is often painful. Cracked and bleeding nipples are every bit as unpleasant as it sounds. Many women will tell you there babies latched poorly, they bled, had cracked nipples, got mastitis not once but three times. Some of them are in pain during breastfeeding, breasts are swollen, making them miserable. For many new moms the experience was not comfortable or natural or easy at all.

There are times they want to give up. One problem is that many of new mom or even nursing staff have never seen a nursing mother and baby or grew up in a breastfeeding culture. This can make it difficult to learn the art and techniques associated with good nursing techniques like the proper latch and breastfeeding positions. By using good positioning with breastfeeding you can help avoid nipple pain and other breastfeeding problems.

If you feel I've missed important links for lactation experts, have a more up-to-date link for any of them or find any other problem, please find the following links:
La Leche League International (LLLI) www.lalecheleague.org/
Lamaze International  www.lamaze-childbirth.com/
Int’l Society for Research in Human Milk & Lactation nutrition.hhdev.psu.edu/ISRHML/MW4/noframes/default.htm

For more basic practical breastfeeding information, I highly recommend that you check out Dr. Jack Newman's articles which are great resources to help you know more about breastfeeding. Also be sure to check out "Gee Whiz" Lactation Facts for some surprising facts about breasfeeding. Breastfeeding is a learned behavior. It is not instinctual on the part of the mother and although a baby has the instinct to suckle, latching on properly and actually getting milk requires practice. A new mother and a new baby may get frustrated very quickly when things do not proceed smoothly. This is a comprehensive site regarding Breastfeeding, Birthing Centres, Breastfeeding Consultants, Midwives


Addtional breastfedding articles and links:
Fenugreek
Reglan
Reverse Pressure Softening

I found this article very interesting and worth sharing. It is so sad that breast feeding is looked at as almost impossible before even trying. Our bodies were made for this!

www.thealphaparent.com/2012/06/news...

How Weaning Happens
http://astore.amazon.com/peacefparent-20/detail/0912500549

Breastfeeding Older Children
http://astore.amazon.com/peacefparent-20/detail/1853439398

Adventures in Tandem Nursing
http://astore.amazon.com/peacefparent-20/detail/0912500972

Tuesday, August 7, 2012

Baby Friendly Hospital Initiative

The Baby-friendly Hospital Initiative (BFHI) was launched by WHO and UNICEF in 1991, following the Innocenti Declaration of 1990.  The Innocenti Declaration is a document that outlines the optimal feeding of babies and children. Part of this declaration was a recommendation that all governments should develop national breastfeeding policies and implement systems to protect, promote, and support breastfeeding. The initiative is a global effort to implement practices that protect, promote and support breastfeeding.

So we know now that The BFHI was established to encourage maternity hospitals to implement the Ten Steps to Successful Breastfeeding and to practise in accordance with the International Code of Marketing of Breastmilk Substitutes.

The Baby Friendly Initiative works with the health-care system to ensure a high standard of care in relation to infant feeding for pregnant women and mothers and babies. Support is provided for health-care facilities that are seeking to implement best practice, and an assessment and accreditation process recognises those that have achieved the required standard.

Since its launching BFHI has grown, with more than 152 countries around the world implementing the initiative. The initiative has measurable and proven impact, increasing the likelihood of babies being exclusively breastfed for the first six months. Since the beginning of the BFHI, over 22,000 hospitals worldwide have become designated “Baby Friendly.  However, the vast majority of hospitals in the world have failed to implement the Baby Friendly Hospital Initiative in the 20 years since this agreement was signed.

In South Africa, the BFHI was launched in 1994 and St Monica's Maternity Hospital in Cape Town was the first hospital to be accredited Baby-Friendly. The Western Cape has 74 public and private hospitals with maternity wards, of which only 19 boasts the BFHI accreditation. 17 of the 19 are public hospitals. So we know now that nineteen hospitals in the Western Cape Province have received this accreditation. Alan Blyth Hospital celebrated its international Baby-Friendly Hospital Initiative (BFHI) accreditation by hosting a ceremony on Monday, 13 February 2012.

Nurses and midwives should take action. Advocate for Baby Friendly accreditation at your local hospitals.  Join breastfeeding organizations such as La Leche. If you are not already a member, I urge you to attend a La Leche League Group regularly and become a member. or become a member of International Baby Food Action Network.  Write letters to your local hospital administration, health minister, head of obstetrics, maternity ward, public health unit (health units can earn Baby Friendly accreditation as well), and health authority, advocating for a push to improve infant and maternal health via the Baby Friendly Hospital Initiative. Change the world, improve health, support women! One hospital at a time…

World Breastfeeding Week

World Breastfeeding Week is celebrated every year from 1 to 7 August in more than 170 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.The World Alliance for Breastfeeding Action (WABA) was formed in 1991 to act on the Innocenti Declaration (1990) to protect, promote and support breastfeeding. As part of its action plan to facilitate and strengthen social mobilisation for breastfeeding, WABA envisioned a glabal unifying breastfeeding promotion strategy. A day dedicated to breastfeeding was suggested to be markedin the calender of international events. The idea of a day's celebration was turned into a week.

The World Health Organization recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond. This has become to be known as World Breastfeeding Week (WBW) celebrated every 1-7 August commemorate the Innocenti Declaration. WBW was first celebrated in 1992. Now it involves over 170 countries and is endorsed by UNICEF, WHO, FAO and IPA.

Please read the WBW 2012 Calendar Announcement at www.worldbreastfeedingweek.org for more information.

Source: www.who.int/features/factfiles/breastfeeding/facts/en/index.html
http://www.rnjournal.com/journal_of_nursing/the_importance_of_supporting_mothers_who_breastfeed.htm

Monday, August 6, 2012

Umbillical Cord Knots

The umbilical cord is about 30 to 60 cm in length at term. So at 36, 37 weeks it really is quite long. The important thing about it is, not only is it long, but it’s really thick. So it’s up to 2, sometimes 2 ½ cm thick, and not only does it contain two arteries and one vein. But it also contains a lot of jelly-like substance called Wharton’s Jelly that protects the blood vessels. So it really is encased in quite a thick covering and then the blood vessels have jelly around them. So that stops them getting twisted or occluded in any way.

Umbilical knots do happen occasionally when a foetus swims through a loop in the cord, but the structure of the cord makes it difficult for this to have any adverse effects.  Babies jump up and down, they turn over from head down to bottom down sometimes. There has to be a great deal of tension in order for the knot to compress the cord with any significance, and therefore, impede blood flow.

Here is a good review article on cord knots.

http://www.pediatricperinatalpathology.com/id27.html

Apparently, in some cases a cord knot is detected via ultrasound (but not all knots are found with prenatal exams). However, there are no specific treatments. Most of the time, a knot is not a problem, but a “true knot” can actually be so tight that it compromises blood flow through the umbilical cord to the baby. Probably what most people worry about when it comes to umbilical cords is that they will be wrapped around the baby’s neck. This is called a “nuchal” cord (from the Latin word for “neck”). This is much more common, occurring in up to 20% of all births, but only rarely causes problems. I've seen about a dozen true knots, none have been in babies with any problems.

Saturday, August 4, 2012

Umbillical Cord

The Purpose of the Umbilical Cord

The umbilical cord is one of the most important things in an unborn baby's environment. The umbilical cord begins to form between four and six weeks as the embryonic disc takes a cylindrical shape. The proximal portion of the umbilical cord is in the lower third of the embryo, and begins to form and develops a sac. The proximal portion houses the guts until the tenth week of gestation. At this time the umbilical cord is short, usually shorter than the than the head-to-tail length of the embryo. By ten weeks the intestines leave the proximal cord and return to the stomach, the elongation of the cord begins and the location of the umbilicus positions in the middle third of the embryo.
 
Features
 
The umbilical cord is a unique tissue covered by a mucoid connective tissue called Wharton's jelly and a thin mucous membrane. The umbilical cord develops from two separate foetal origins. The yolk sack and the allantoses both compromise the umbilical cords. As a result both are formed from the foetal tissue and can be thought to be part of the foetus. The cord is usually 1-2 cm in diameter and 60 cm long according to Percy Malpas, a British obstetrician who studied cord length in the 1960s.

Wharton.s jelly is a specialized tissue serving many purposes for the developing fetus. Its specialized cells contain gelatin-like mucus that encases fibers. These properties give it elastic and cushion effect, which can tolerate the vibration, bending, stretching and twisting of an active fetus. In addition, it holds the vessels together, may regulate blood flow, plays a role in providing nutrition to the fetus, stores chemistry for the onset of labor, and protects the supply line. Umbilical cords without much Wharton’s jelly are more prone to compression, and complete absence is usually associated with fetal death. If an umbilical cord is twisted or knotted, it is more likely to tighten where there is less resistance, such as an area low in Wharton.s jelly. It is believed that males have more Wharton.s jelly content than do females and that good nutrition increases the amount. Wharton.s jelly tends to reduce with gestational age and can disappear when pregnancies go beyond 40 weeks.

Function
The umbilical cord contains three vessels and two arteries. About 1% of all infants are born with a cord that contains only a single vein and artery. A 15% of these infants are found to have accompanying congenital anomalies, particularly of the kidney and heart.

The umbilical cord has three functions: serves as a blood resource for the foetus, serves as a source of nutrients (calories, proteins, fats and vitamins) and transfers waste products. The umbilical cord carries blood in the opposite direction, from the baby to the placenta. This blood has been emptied of nutrients and oxygen and now carries the fetus' waste products back to the mother's bloodstream where she can dispose of them through her system. The blood in the arteries contains waste products, such as carbon dioxide, from the baby’s metabolism. Carbon dioxide is transferred across the placenta to the bloodstream and then into the lungs where it is breathed out. Oxygen is transported from the red blood cells in the circulation across the placenta to the baby in the umbilical vein. In addition to oxygen the umbilical cord transports nutrients from the placenta to the baby.

Umbilical cord problems can be extremely scary to a pregnant woman. According to Dr. Jason H. Collins at The Pregnancy Institute, umbilical cord accidents leading to stillbirth occur in 1.5 of every 1000 births. An otherwise healthy fetus may suddenly develop a problem with the umbilical cord that needs to be carefully watched to make sure it doesn’t develop into an umbilical cord accident.

 Source: http://www.med.yale.edu/obgyn/kliman/placenta/articles/EOR_UC/Umbilical_Cord.html
              https://apps.who.int/rht/documents/MSM98-4/MSM-98-4.htm#IMPORTANCE
             
              http://www.pediatricperinatalpathology.com/id27.html