Jean says,
<< If the mom is getting Pit, so is the baby.>
<< Is this evidence based, Jan? What about half-life, and transfer across
the placenta? How much gets through? Does anyone know if there have been
any studies, for instance, on cord blood of babies born with and without
pitocin in labor? Does it come back out through the placenta for mom to
get rid of like some drugs do if given long enough before delivery so
that the baby doesn't have to break them down?>>
Those are excellent questions, Jean, and I don't know if anyone has studied
them. I do know (according to a reference I cannot currently put my fingers
on since I'm in Charlotte at a 6 day course and not at home) that Pitocin
competes for albumin binding sites in the infant and can increase the
bilirubin levels. Since the baby isn't getting Pitocin after it is born, I
have to presume that it goes through the placenta and into the baby. Is the
pediatric half life as short as the adult half life (3 to 5 minutes), or is
it longer? Since the Pitocin is most often given almost up to the point of
delivery, does the mother excrete it for the baby (assuming it does cross the
placenta), or is there so much Pitocin given to the mother that the baby has
a lot on board when it is born?
<If it is an antidiuretic in a mom, it is in baby too. If it holds fluid
in the mother's system, it does in the baby too.> Is that a hypothesis
derived from any such studies as above, or a logical deduction?>>
Logical deduction not to mention clinical experience. Not sure why it would
act differently in adults than in infants in regards to its antidiuretic
properties. By the way, one of the side effects of Pitocin is water
intoxication.
<For the most part, babies don't have
"dependent extremities" so the edema would be all over.>
I'll grant you that. Nor do they have pendulous breasts!
<<What makes you "suspect" this and why? What about premature babies where
the kidneys might still be immature?>>
Actually, renal glomerular filtration in babies doesn't mature for about 3-4
months, if I remember it correctly. But I question why babies don't seem to
be edematous after 3 or 4 days, and mothers still are. But I don't have any
research to back it up. Who bothers to do any research on something that is
universally used and seemingly so innocuous? Who cares (besides us) if
babies lose up to 10% of birth weight? Who cares if babies are edematous
after birth? Who cares enough to do a research project on it? Besides us, I
mean??
<< I think I remember hearing that
babies of diabetic mothers seem to have some generalized edema. I wonder
if anyone has ever taken a look to see if those mothers received Pitocin
in labor?>>
I don't know. But why are babies of diabetic mothers more edematous? Is it
Pitocin, or is it something else? I remember this back before Pit was in
generalized use....
<(we know that it can take up to 12 days for the mother to get rid of all
the edema)>
No reference for that either -- have heard physicians tell mothers that it
will take at least that long for the edema to go away, and I've seen it
clinically.
Part of the problem with demanding that everything be backed up by research
instead of using logic is that until we have enough researchers in the field
with enough money to do the research, our hands are tied. Leaps of logic
are, I realize, not acceptable in this venue. But leaps of logic and
experience-based practice are what drives research. I'm begging for people
to do it! And for people to learn to think outside the box.
Jan Barger, RN, MA, IBCLC
Wheaton Illinois
Lactation Education Consultants
www.lactationeducationconsultants.com
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