Tuesday, August 22, 2017

Vaginal seeding after Caesarean 'risky', warn doctors

New mothers should not embrace the trend of "seeding" their babies with vaginal bacteria, say doctors.

It exposes children born by Caesarean section to bacteria that could have coated their bodies if they had been born vaginally.
The idea is bacteria help train the immune system and lower the risk of allergies and asthma.
But doctors in Denmark and the UK said there was too little evidence and it may be doing more harm than good.
Being born by Caesarean section is linked to a higher risk of some immune-based diseases.
And there is growing medical interest in the role of the microbiome - the microorganisms that call our bodies home - in preventing disease.
Swabs
Seeding involves taking a swab of vaginal fluid and rubbing it into the newborn's face, skin and eyes.
A report, published in BJOG: An International Journal of Obstetrics and Gynaecology, said more than 90% of Danish obstetricians (pregnancy and birth doctors) had said they had been asked about vaginal seeding.
It said there was no evidence of any benefit to seeding as there was only one proper study of the technique and it involved just four babies.

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However, it warned of clear risks to the baby, including infections such as group-B streptococcus, E. coli and a range of sexually transmitted infections.
Dr Tine Clausen, the report author and a consultant at Nordsjaellands Hospital in Denmark, said: "We know that women and their partners are increasingly speaking to their doctors about vaginal seeding."
She told the BBC News website: "I really understand, it's a fascinating thought that you're able to mimic nature by doing the seeding, but it's based on some theoretical thoughts and we don't have evidence to support it."
Dr Clausen said a swab may not contain the same bacteria as those transferred during a vaginal birth and any bacteria were more diluted because of blood and amniotic fluid in the vaginal tract during labour.
Her advice to women is to "avoid unnecessary [Caesarean] sections, aim for breast feeding for at least half a year and to have early skin-to-skin contact".
Each of which does have a beneficial impact on a child's microbiome.
In the UK, about a quarter of babies are born via Caesarean section
Dr Patrick O'Brien, from the Royal College of Obstetricians and Gynaecologists, said: "There is no robust evidence to suggest that vaginal seeding has any associated benefits.
"We would therefore not recommend it until more definitive research shows that it is not harmful and can in fact improve a child's digestive and/or immune system."

Thursday, January 5, 2017

Don't cotton swabs to clean your ears, It's very Dangerous.

The docs' advice hasn't changed much, however it is nevertheless so unsatisfying: you ought to not use cotton swabs to easy your ears.
Up to date clinical suggestions published tuesday within the journal otolaryngology-head and neck surgical treatment say they are not suitable for earwax elimination. In reality, information for patients within the guidelines say no to setting some thing "smaller than your elbow in your ear."
Don't cotton swabs to clean your ears, It's very Dangerous.

Regardless, most folks hoard a stash of the gentle-tipped paper sticks; they seem so perfectly suited to that dirty task.
So the authors of the suggestions -- an advisory panel of the yankee academy of otolaryngology-head and neck surgery -- have injected a bit little bit of freshness into the usual recommendation, giving more rationalization as to "why not?" they even "we sincerely have come to realize that clinicians are not the handiest users of (the tips), that patients are absolutely inquisitive about their very own care and those are clearly taking possession of their own care," stated dr. Seth schwartz, chairman of the guideline update organization for the academy.
Study extra
Here's why now not: cotton swabs, hair pins, residence keys and toothpicks -- the many smaller-than-our-elbow-items we adore to install our ears -- can cause cuts in our ear canals, perforate our eardrums and dislocate our hearing bones. And any of this stuff should cause listening to loss, dizziness, ringing or different signs and symptoms of ear harm.
Alternatively, the general public can just permit nature do its activity. Our our bodies produce earwax to keep our ears lubricated, clean and guarded: dirt, dirt and something else that might enter our ears receives stuck to the wax, which continues such a debris from transferring farther into the ear canal. Our normal jaw motions from talking and chewing, in conjunction with skin increase within the canal, normally allows flow vintage earwax from inside to the outside the ear, wherein it is washed off throughout bathing. The pointers published in 2008 have been overdue for an update. Whilst new randomized trials were included, "not anything very dramatic" has modified, apart from an improvement within the technique itself, said schwartz: "the procedure has turn out to be a touch extra transparent in the way we without a doubt write the pointers now. We're extra clean about why the choices we made are made and what statistics there is to aid it."
Patient are apparently interested by the nitty-gritty of ear care: more than 50,000 humans downloaded the antique guideline, schwartz stated.
"it is sort of brilliant how many humans were interested by studying that," he stated.

The do's and don'ts

To be "a little bit extra affected person-friendly," the tips now consist of lists of "do's and do not's" for everyone and a listing for people who have had troubles with cerumen impaction, the reliable term for earwax buildup, a circumstance that is extra common a few of the elderly, in step with dr. James battey, director of the country wide institute on deafness and other communication disorders.
Impaction can occur whilst the ear's self-cleaning method would not work very well. The resulting waxy buildup blocks the ear canal, causing trouble hearing. For people with impacted ear wax, the usage of cotton-tipped swabs can also push the earwax deeper into the ear canal and harm the eardrum," battey stated. He introduced that "about 2% of adults with impacted earwax may match the health practitioner with listening to loss as their symptom."
"impacted earwax is nice addressed via a health care expert," he said.
Within the all-essential "don't" section, you may find warnings against "overcleaning" your ears. Excessive cleansing may additionally boom earwax impaction, in step with the authors.
"it's cultural" to want clear ears, schwartz said, however "wiping away any extra wax in relation to the out of doors of the ear is enough to keep it easy."
Any other warning within the new hints: do no longer use ear candles. Now not best can they cause "critical damage" for your eardrum, "there is no proof that they eliminate impacted cerumen," wrote the authors.
"domestic treatments are pretty effective," schwartz said, including that the "whole host" of over-the-counter wax-softening drops in addition to home-use irrigators are effective and safe. "even drops of water inside the ear can be powerful to soften the wax," he added.
Still, some of the items on the "do" listing is to ask your health care issuer approximately a way to treat earwax impaction at home, seeing that "you can have sure medical or ear conditions which could make some alternatives dangerous."
"it is no longer a terrible component to have wax in your ears. Anybody does and need to. It is extra of an problem when it will become too much," schwartz said. The rule definition of "an excessive amount of" is an operational one: if you have signs and symptoms -- inclusive of pain, drainage, bleeding or hearing loss -- then you definitely have a problem.
"if it's causing symptoms, sincerely go to your physician," schwartz said, repeating what is likely the maximum essential "do" listing recommendation. Nonetheless, a few people attribute their symptoms to wax buildup while it's simply not the case.
Amongst older humans, "listening to loss will become very, very not unusual," stated schwartz.
In fact, getting older, together with infections and exposure to loud noise, is one of the maximum common reasons of obtained hearing loss, consistent with battey.
Yet many humans can not imagine that they've started to lose their listening to, and due to this disbelief, schwartz stated, "a patient has wax cleared, and then their doctor desires to look deeper."