Don’t wash the baby!

July 7, 2009

 Vernix, that cheesy, white substance found on newborn humans and immediatley washed off during “baby’s first bath” in the hospital,  has been found to contain AWESOME bactieria fighting properties!! Just read the article to see how you can protect your newborn from hospital-borne infections and disease. Vernix has also been shown to contain GBS-killing antimicrobial components! Think twice about dousing your baby in Johnson’s soap!

Vernix caseosa as a multi-component defence system based on polypeptides, lipids, and their interactions.

Full study found here: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2315785

Vernix caseosais a white cream-like substance that covers the skin of the foetus and the newborn baby. Recently, we discovered antimicrobial peptides/proteins such as LL-37 in vernix, suggesting host defence functions of vernix. In a proteomic approach, we have continued to characterize proteins in vernix and have identified 20 proteins, plus additional variant forms. The novel proteins identified, considered to be involved in host defence, are cystatin A, UGRP-1, and calgranulin A, B and C. These proteins add protective functions to vernix such as antifungal activity, opsonizing capacity, protease inhibition, and parasite inactivation. The composition of the lipids in vernix has also been characterized and among these compounds the free fatty acids were found to exhibit antimicrobial activity. Interestingly, the vernix lipids enhance the antimicrobial activity of LL-37 in vitro, indicating interactions between lipids and antimicrobial peptides in vernix. In conclusion, vernix is a balanced cream of compounds involved in host defence, protecting the foetus and newborn against infection.

Discussion:

In previous studies, we have characterized antimicrobial peptides and polypeptides in vernix [7, 8]. In the present study we demonstrate the presence of many more proteins of immunological importance in vernix. Among the most abundant proteins now characterized are cystatin A, calgranulin A, ubiquitin, and UGRP-1, which are all implicated in innate immunity of humans. Vernix lipids were now also characterized in which antimicrobial activity was detected, in particular for free fatty acids. In addition, our results indicate that lipids may contribute to a favourable microenvironment in vernix by interacting with antimicrobial components such as LL-37. Our characterization of proteins, lipids and their interactions suggest that vernix is a complex innate defence barrier, protecting the foetus and the newborn from infectious microbes, in an apparently crucial manner, since the adaptive immunity of newborns is immature. The antimicrobial property of vernix may also act to facilitate colonization by the normal flora following birth and to block the colonization of unwanted microbes or pathogens. For example psoriasin, which is identified in vernix, directly kills E. coli but not Staphylococcus aureus [33, 34]. The shedding of the vernix in late pregnancy may suggest that the level of protection has to be adjusted to allow proper colonization of the normal flora.
Several proteins now identified are expressed in skin such as cystatin A, profilaggrin, psoriasin and calgranulin C. Due to the close contact of vernix and amniotic fluid, they share some of the same components. This is now shown regarding calgranulin A and B, proteins previously known to be present in amniotic fluid [35]. The origin of UGRP-1 may be the lungs, and a transfer of this protein to vernix may occur via the amniotic fluid. Blood may be another source of the identified proteins in vernix. Using mass fingerprinting, we identified not only α- and β- haemoglobin but also γ-haemoglobin. During the last two trimesters of pregnancy the foetus produces γ-haemoglobin, which is replaced by β-haemoglobin after birth, enabling an efficient transfer of oxygen from the blood of the mother to the foetus. Thus, the γ-haemoglobin detected in vernix originates from the foetus.
Calgranulin A, B, and C, and psoriasin all belong to the S100 family of calcium binding proteins. The S-100 family of proteins has 2 calcium binding motifs of the EF-hand type [36]. These proteins have been shown to exhibit chemotactic properties and may play a role in the pathogenesis of epidermal diseases [36]. Notably, an N-terminal fragment of profilaggrin, with sequence similarity to the two EF-hands [37], was also identified in vernix.
Calprotectin is an antifungal and antibacterial complex consisting of a heterodimer of calgranulin A and calgranulin B [38]. Both subunits were identified, revealing that the active holoprotein is present in vernix. Accordingly, the crude peptide/protein extract of vernix exhibited good antifungal activity. However, after separation of the protein extract by RP-HPLC we could not detect any antifungal activity in the collected fractions (data not shown). Our interpretation of this difference is that the two subunits of calprotectin have been separated upon HPLC, leading to loss of activity. Calprotectin is suggested to kill microbes by chelating zinc, thereby depriving microbes of an essential metal ion [39]. This mode of action has also been described for lactoferrin and psoriasin, the latter being a major E. coli-killing compound in human skin [33].
Calgranulin C was first identified on the surface of onchoceral worms in human subcutaneous nodules [40]. It is proposed to be released by activated neutrophils and thereby attack and kill nematodes [40]. Thus, the presence of calgranulin C in vernix contributes to the protective role of vernix.
Cystatin A is a protease inhibitor that is mainly expressed by epithelial and polymorphonuclear cells [41, 42]. Cystatin A is also a minor cross-linking component of the cornified cell envelope [43] and a part of the mechanical barrier of the skin. Unlike cystatin C, cystatin A has not been shown to possess any direct antimicrobial effect. However, cystatin A has been suggested to be a first line protector against cysteine proteases released from infectious micro-organisms and parasites [44]. Thus, cystatin A could have a dual role in the innate defence of the foetus.
Our results reveal that UGRP-1 (HIN-2/SCGBA2) is one of the major proteins in vernix, whereas UGRP-2 (HIN-1 /SCGBA1) is not as abundant. These proteins are both expressed at high levels in neonatal lungs by different subsets of secretory cells within the surface and glandular epithelia [45]. UGRP-1 has been shown to bind bacteria and to the macrophage scavenger receptor MARCO [46], indicating opsonizing properties. In the lungs of mice the expression of UGRP-1 is upregulated by IL-10 [47], while it is downregulated by IL-5 [48], suggesting that UGRP-1 is a target of anti-inflammatory pathways. In vernix, we have characterised three novel forms of UGRP-1, which are N-terminally differently processed. These forms may have altered binding affinities to bacteria, leading to enhancement of the opsonizing spectra.
Vitamin A has been detected at high levels in vernix [49] and is proposed to serve as a nutritional depot of vitamin A. Vitamin A is secreted from the amniotic epithelium into the amniotic fluid, and is taken up by vernix [49]. Our results show that transthyretin is present in vernix, a protein that binds to the retinol binding protein, which in turn binds vitamin A.
Like lipids previously isolated from human stratum corneum and sebum [50, 51], our results demonstrate inhibitory effects of the free fatty acids in vernix against the Gram-positive bacterium B. megaterium. We also demonstrate that palmitoleic acid (C16:1) and linoleic acid (C18:2), known to exhibit potent antimicrobial activity [14, 52], are a considerable part of the total free fatty acids. The long-chain unsaturated fatty acids found in vernix (C20 to C22 in table 2 ) are also antimicrobial and the activity is enhanced with an increase of the number of double bonds [15]. Like antimicrobial peptides [53], fatty acids and monoacylglycerols disintegrate the lipid envelope of viruses [15] and bacterial plasma membranes [12, 16].
Considering the high lipid content of vernix (10%) [3], it seems possible that lipids influence the function of other components of vernix. It has been demonstrated that other factors such as salts and pH, influence the conformation of the human cathelicidin LL-37 [23]. Therefore we speculate that the lipid fraction of vernix can exhibit similar functions. Under our experimental conditions, lipids isolated from vernix enhanced the antimicrobial potency of LL-37. Thus, LL-37 can be active in a lipid-rich environment.
When studying the antimicrobial activity in peptide/protein extracts of vernix, we found a high antimicrobial activity against bacteria and fungi. The most active antibacterial compound against E. coliand GBS in these samples was isolated and identified as chlorhexidine. Chlorhexidine is a microbicidal substance of vaginal cream used as a lubricant during vaginal examination prior to delivery. For this reason, some of the vernix samples were found to contain chlorhexidine. We noted that the samples with E. coli activity.
In conclusion, we have characterized proteins and lipids that add novel protective functions to vernix, such as antifungal properties, opsonizing features, protease inhibiton, and parasite inactivation. In addition, the antimicrobial action of LL-37 can be potentiated by the lipids in vernix in vitro, stressing the importance of the microenvironment for the function of antimicrobial components.
 
 
Acknowledgements:
This work was supported by grants from The Icelandic Research Fund for Graduate Students, The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), and The Swedish Research Council (no. 11217, 13X-3532). We thank Ella Cederlund, Carina Palmberg, Marie Ståhlberg, Gunvor Alvelius, and Monica Lindh for excellent assistance. We also thank Milan Chromek and Annelie Brauner, for the GBS strain.

LOCAL PREGNANCY FAIR

March 7, 2009

Who wants to meet me? Who needs to interview 6-10 doulas in the same day at the same place?

The perfect place to meet all the local birth professionals in one place! There will be massage therapists, midwives, Child Birth Educators and Doulas and other associated vendors.

Saturday, March 14 11-2pm
Baby Depot at the Citadel Mall.

THIS IS A FREE EVENT

Find a variety of Resources for Expectant Parents! Information on your New baby, pregnancy, Labor, Birth and more!!

Free Resource Guide: Birth and Beyond 2009 Provided by Colorado Springs Birth Newtwork

Enter to Win a prize courtesy of Baby Depot!

I’m giving away an asian style carrier:

xxsling


Consumer Reports On Maternity Care

March 3, 2009

Back to basics for safer childbirth
Too many doctors and hospitals are overusing high-tech procedures

http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/overview/maternity-care.htm

Noninvasive measures can mean better outcomes for baby and Mom.When it’s time to bring a new baby into the world, there’s a lot to be said for letting nature take the lead. The normal, hormone-driven changes in the body that naturally occur during delivery can optimize infant health and encourage the easy establishment and continuation of breastfeeding and mother-baby attachment. Childbirth without technical intervention can succeed in leading to a good outcome for mother and child, according to a new report. (Take our maternity-care quiz to test your knowledge.)
“Evidence-Based Maternity Care: What It Is and What It Can Achieve,” co-authored by Carol Sakala and Maureen P. Corry of the nonprofit Childbirth Connection analyzed hundreds of the most recent studies and systematic reviews of maternity care. The 70-page report was issued collaboratively by Childbirth Connection, the Reforming States Group (a voluntary association of state-level health policymakers), and Milbank Memorial Fund, and released on Oct. 8, 2008.

Overuse of high-tech measures

The report found that, in the U.S., too many healthy women with low-risk pregnancies are being routinely subjected to high-tech or invasive interventions that should be reserved for higher-risk pregnancies. Such measures include:

Inducing labor. The percentage of women whose labor was induced more than doubled between 1990 and 2005
Use of epidural painkillers, which might cause adverse effects, including rapid fetal heart rate and poor performance on newborn assessment tests
Delivery by Caesarean section, which is estimated to account for one-third of all U.S births in 2008, will far exceed the World Health Organization’s recommended national rate of 5 to 10 percent
Electronic fetal monitoring, unnecessarily adding to delivery costs
Rupturing membranes (“breaking the waters”), intending to hasten onset of labor
Episiotomy, which is often unnecessary
In fact, the current style of maternity care is so procedure-intensive that 6 of the 15 most common hospital procedures used in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give birth in U.S. hospitals have high rates of use of complex interventions, with risks of adverse effects.

The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth.

Convenience for health care workers and patients might be another factor. Naturally occurring labor is not limited to typical working hours. Evidence also shows that a disproportionate amount of tech-driven interventions like Caesarean sections occur during weekday “business hours,” rather than at night, on weekends, or on holidays.

Underuse of high-touch, noninvasive measures

Many practices that have been proven effective and do little to no harm are underused in today’s maternity care for healthy low-risk women. They include:

Prenatal vitamins
Use of midwife or family physician
Continuous presence of a companion for the mother during labor
Upright and side-lying positions during labor and delivery, which are associated with less severe pain than lying down on one’s back
Vaginal birth (VBAC) for most women who have had a previous Caesarean section
Early mother-baby skin-to-skin contact
The study suggests that those and other low-cost, beneficial practices are not routinely practiced for several reasons, including limited scope for economic gain, lack of national standards to measure providers’ performance, and a medical tradition that doesn’t prioritize the measurement of adverse effects, or take them into account.


Childbirth Refresher Course

November 29, 2008

I’m cutting the price of my Labor Skills Workshop, due to the Holidays (and celebrating my Shingles recovery and ability to work around pregnant woman and infants again)!

One Night Childbirth Refresher $30
7-9pm Sat. December 13th, 2008
634-2928
by Carrie Anderson, CCE, LD

This two hour  fast-paced workshop was created for women and their partners. You will learn the how, what, where, when and why of providing comfort during labor. Get  hands on practice, practical knowledge, reference guide to positions and LOTS of useful BTDT advice. Holiday price includes workbook and refreshments.

www.Birthteacher.com