EYE OINTMENT , 2015
Health November 30, 2015 5:20 pm Updated: December 1, 2015 12:29 am ‘Ineffective, outdated and unethical’ – the case against antibiotic eye drops for newborns By Allison Vuchnich Network Correspondent Global News WATCH ABOVE: In many provinces, newborns receive antibiotics eye drops, in Ontario midwives are asking the government to change the mandatory practice. A A + When Laura and Curtis Hardy’s son, Phoenix, was born, antibiotic drops were put in his eyes. “We were informed…that [it was] just going to happen,” said new mother Laura Hardy. “It doesn’t seem to make sense that it is a mandatory requirement.” The practice has been around since the late 1800s, when silver nitrate drops were used to greatly reduce the incidence of blindness in infants whose mothers had chlamydia or gonorrhea. More than 120 years later the practice still exists. Now, within an hour of a baby being born, antibiotic eye drops or ointment is put into its eyes. In Canada erythromycin is administered. The prophylaxis drops are a preventative treatment and is still mandatory in some provinces – Alberta, Ontario, British Columbia, Prince Edward Island and Quebec. Pediatricians and midwives want the practice to be changed. “The research shows this practice is ineffective, outdated and unethical,” said midwife Liza van de Hoef. READ MORE: Meant to save your life, now overuse of antibiotics may endanger it: study Now there are better ways to screen pregnant women for sexually transmitted infections (STIs), and if the baby is infected there are more effective treatment options, and certain gonorrhea strains are now resistant to antibiotics – making the treatment ineffective and unnecessary – according to pediatricians and midwives. As well, gonorrhea can result in a serious eye infection, but is responsible for less than one per cent of infant eye infection, say researchers. “The risk of an individual baby suffering longterm consequences from an eye infection is extremely low, so again, mandatory eye prophylaxis cannot be justified based on our need to protect individual babies,” said Liz Darling, PhD and midwife researcher. In some provinces, like Ontario, health care providers who do not follow the law are subject to fines, and parents who refuse can be visited by child protective services. In British Columbia the practice is under review. There is also a concern of antibiotics being administered when they are not needed that could lead to increased antibiotic resistance, a growing global problem
Hope we will make safe decisions.
Something we knew all along.
Science tells us that when babies cry alone and unattended, they experience panic and anxiety. Their bodies and brains are flooded with adrenaline and cortisol stress hormones. Science has also found that when developing brain tissue is exposed to these hormones for prolonged periods these nerves won’t form connections to other nerves and will degenerate. Is it therefore possible that infants who endure many nights or weeks of crying-it-out alone are actually suffering harmful neurological effects that may have permanent implications on the development of sections of their brain? Here is how science answers this alarming question:
Chemical and hormonal imbalances in the brain
Research has shown that infants who are routinely separated from parents in a stressful way have abnormally high levels of the stress hormone cortisol, as well as lower growth hormone levels. These imbalances inhibit the development of nerve tissue in the brain, suppress growth, and depress the immune system. 5, 9, 11, 16
Researchers at Yale University and Harvard Medical School found that intense stress early in life can alter the brain’s neurotransmitter systems and cause structural and functional changes in regions of the brain similar to those seen in adults with depression. 17
One study showed infants who experienced persistent crying episodes were 10 times more likely to have ADHD as a child, along with poor school performance and antisocial behavior. The researchers concluded these findings may be due to the lack of responsive attitude of the parents toward their babies. 14.
Dr. Bruce Perry’s research at Baylor University may explain this finding. He found when chronic stress over-stimulates an infant’s brain stem (the part of the brain that controls adrenaline release), and the portions of the brain that thrive on physical and emotional input are neglected (such as when a baby is repeatedly left to cry alone), the child will grow up with an over-active adrenaline system. Such a child will display increased aggression, impulsivity, and violence later in life because the brain stem floods the body with adrenaline and other stress hormones at inappropriate and frequent times. 6
Dr. Allan Schore of the UCLA School of Medicine has demonstrated that the stress hormone cortisol (which floods the brain during intense crying and other stressful events) actually destroys nerve connections in critical portions of an infant’s developing brain. In addition, when the portions of the brain responsible for attachment and emotional control are not stimulated during infancy (as may occur when a baby is repeatedly neglected) these sections of the brain will not develop. The result – a violent, impulsive, emotionally unattached child. He concludes that the sensitivity and responsiveness of a parent stimulates and shapes the nerve connections in key sections of the brain responsible for attachment and emotional well-being. 7, 8
Decreased intellectual, emotional, and social development
Infant developmental specialist Dr. Michael Lewis presented research findings at an American Academy of Pediatrics meeting, concluding that “the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.”
Researchers have found babies whose cries are usually ignored will not develop healthy intellectual and social skills. 19
Dr. Rao and colleagues at the National Institutes of Health showed that infants with prolonged crying (but not due to colic) in the first 3 months of life had an average IQ 9 points lower at 5 years of age. They also showed poor fine motor development. (2)
Researchers at Pennsylvania State and Arizona State Universities found that infants with excessive crying during the early months showed more difficulty controlling their emotions and became even fussier when parents tried to consol them at 10 months. 15
Other research has shown that these babies have a more annoying quality to their cry, are more clingy during the day, and take longer to become independent as children 1.
Harmful physiologic changes
Animal and human research has shown when separated from parents, infants and children show unstable temperatures, heart arrhythmias, and decreased REM sleep (the stage of sleep that promotes brain development). 10 12, 13
Dr. Brazy at Duke University and Ludington-Hoe and colleagues at Case Western University showed in 2 separate studies how prolonged crying in infants causes increased blood pressure in the brain, elevates stress hormones, obstructs blood from draining out of the brain, and decreases oxygenation to the brain. They concluded that caregivers should answer cries swiftly, consistently, and comprehensively. (3) and (4)
- P. Heron, “Non-Reactive Cosleeping and Child Behavior: Getting a Good Night’s Sleep All Night, Every Night,” Master’s thesis, Department of Psychology, University of Bristol, 1994.
- M R Rao, et al; Long Term Cognitive Development in Children with Prolonged Crying, National Institutes of Health, Archives of Disease in Childhood 2004; 89:989-992.
- J pediatrics 1988 Brazy, J E. Mar 112 (3): 457-61. Duke University
- Ludington-Hoe SM, Case Western U, Neonatal Network 2002 Mar; 21(2): 29-36
- Butler, S R, et al. Maternal Behavior as a Regulator of Polyamine Biosynthesis in Brain and Heart of Developing Rat Pups. Science 1978, 199:445-447.
- Perry, B. (1997), “Incubated in Terror: Neurodevelopmental Factors in the Cycle of Violence,” Children in a Violent Society, Guilford Press, New York.
- Schore, A.N. (1996), “The Experience-Dependent Maturation of a Regulatory System in the Orbital Prefrontal Cortex and the Origen of Developmental Psychopathology,” Development and Psychopathology 8: 59 – 87.
- Karr-Morse, R, Wiley, M. Interview With Dr. Allan Schore, Ghosts From the Nursery, 1997, pg 200.
- Kuhn, C M, et al. Selective Depression of Serum Growth Hormone During Maternal Deprivation in Rat Pups. Science 1978, 201:1035-1036.
- Hollenbeck, A R, et al. Children with Serious Illness: Behavioral Correlates of Separation and Solution. Child Psychiatry and Human Development 1980, 11:3-11.
- Coe, C L, et al. Endocrine and Immune Responses to Separation and Maternal Loss in Non-Human Primates. The Psychology of Attachment and Separation, ed. M Reite and T Fields, 1985. Pg. 163-199. New York: Academic Press.
- Rosenblum and Moltz, The Mother-Infant Interaction as a Regulator of Infant Physiology and Behavior. In Symbiosis in Parent-Offspring Interactions, New York: Plenum, 1983.
- Hofer, M and H. Shair, Control of Sleep-Wake States in the Infant Rat by Features of the Mother-Infant Relationship. Developmental Psychobiology, 1982, 15:229-243.
- Wolke, D, et al, Persistent Infant Crying and Hyperactivity Problems in Middle Childhood, Pediatrics, 2002; 109:1054-1060.
- Stifter and Spinrad, The Effect of Excessive Crying on the Development of Emotion Regulation, Infancy, 2002; 3(2), 133-152.
- Ahnert L, et al, Transition to Child Care: Associations with Infant-mother Attachment, Infant Negative Emotion, and Cortisol Elevations, Child Development, 2004, May-June; 75(3):649-650.
- Kaufman J, Charney D. Effects of Early Stress on Brain Structure and Function: Implications for Understanding the Relationship Between Child Maltreatment and Depression, Developmental Psychopathology, 2001 Summer; 13(3):451-471.
- Teicher MH et al, The Neurobiological Consequences of Early Stress and Childhood Maltreatment, Neuroscience Biobehavior Review 2003, Jan-Mar; 27(1-2):33-44.
- Leiberman, A. F., & Zeanah, H., Disorders of Attachment in Infancy, Infant Psychiatry 1995, 4:571-587.