Newly released data from the Centers for Disease Control and Prevention show that 6.71 infants per 1,000 births died in 2006, a rate that’s down slightly from the 2005 rate of 6.86 per 1,000, but not enough to indicate improvement, reports the CDC. The rate hasn’t really budged since the year 2000, reports the L.A. Times: “Premature birth and low birth weight are by far the biggest causes of infant death.” And while it’s true that more women are giving birth to twins and triplets resulting from fertility treatment, and these babies are more likely to be born premature, “even accounting for those trends, premature births are increasing.” In an editorial today, the New York Times writes that the causes of infant mortality are complex: “Some researchers blame an increase in premature births, many by Caesarean section. The chief lesson we draw is that the American health care system, despite the highest expenditures in the world, is badly in need of an overhaul.” Among industrialized countries, the U.S. ranks 29th in infant survival.

Optimal childbirth leads to optimal conditions for breastfeeding (which provides optimal nutrition and immunity for newborns): babies who are born awake and alert, who didn’t have a suction tube put down their throat, who were not induced or scheduled and therefore are breathing with lungs that are fully mature, whose lungs reaped the physiological benefits of vaginal birth, who get immediate skin-to-skin contact with their mother, who are not routinely separated from their mother, and who are born to mothers in relatively good shape (i.e. not recovering from surgery) — these mother-baby pairs are more likely to breastfeed, and breastfeed exclusively. They’re also more likely to breastfeed if their hospital doesn’t give out pacifiers, supplement with formula, or send mom home with freebie formula samples.

But according to a first-of-its-kind survey by the Centers for Disease Control and Prevention, the majority of U.S. hospitals are failing. Nearly 2,700 hospitals and birth centers were surveyed on labor & delivery care, postpartum care, and follow-up care. Hospitals received a mean score of 62 – that would be an ‘F’ in grade school — and birth centers came away with a solid ‘B,’ at 86.

“The findings indicate substantial prevalences of maternity practices that are not evidence-based and are known to interfere with breastfeeding,” says the CDC.

• Nearly one-quarter (24%) of birth facilities reported supplementing the majority of healthy, full-term, breastfed newborns with “something other than breast milk…a practice shown to be unnecessary and detrimental to breastfeeding.”
• 65% told mothers to limit the duration of suckling
• 45% gave pacifiers to the majority of infants
• 70% gave breastfeeding moms “gift bags” with formula samples.

The CDC concludes: “Facilities should consider discontinuing these practices to provide more positive influences on both breastfeeding initiation and duration.” Read the full report here. Want to know more about breastfeeding? Pop into the Breastfeeding Cafe.

Here’s a “due date” calculator worth endorsing. It gives you what it calls a “safe range” for the baby to be born, and explains why thinking in terms of a due date isn’t very helpful — or healthy:

A due date does not mean there is only one safe day for your baby to be born. It is meant to establish a range of time that your baby is mature and safe to be born. Because modern obstetrics narrows this to a specific day, unnecessary interventions, like inducing labor, come into practice.

Indeed, a baby is considered “term” (or fully cooked) between 38 and 42 weeks gestation. The due date is simply the estimate of 40 weeks (the midpoint in that 4 week stretch). So if we think of being “due” as a period of time rather than a specific date, then a woman is not “overdue” once the due date has passed — she has just simply reached the halfway mark in her due month!

The calculator is courtesy of the new web site Mothers Naturally (mothersnaturally.org), which was launched by the Midwives Alliance of North America. If you’re looking to give birth with minimal intervention and maximum support, you’ll find great information and resources at this site.

An editorial in the British Medical Journal suggests that docs and midwives end the practice of immediately clamping and cutting a baby’s umbilical cord after he or she is born. This is because blood continues to flow from the placenta even after birth, as evidenced by higher iron stores in babies whose cords are left intact for a few minutes. “Placental transfer of oxygenated blood, nutrients and stem cells continues for several minutes after birth. Physiologic principles suggest that the optimal transition to life outside the womb depends on this transfer,” says a 2006 study from the journal Pediatrics.

So why do we cut? Because once upon a time cutting was thought to prevent hemorrhage in the mother. It was also thought to prevent jaundice in the baby. But editorial author Andrew Weeks, MD, says both of these assumptions turn out to be false. “There is now considerable evidence that early cord clamping does not benefit mothers or babies and may even be harmful.” Weeks recommends holding off for three minutes.

He’s of course not the first to suggest it. Also calling for a delay (a big one) are the lotus birthers, who pack up the placenta like a pillow next to the baby and wait for the cord to fall off naturally.

It being Sunday, let’s indulge in a little celebrity gossip, shall we? The tremendous actor Naomi Watts, who gave birth to a baby boy this summer (the father is the also tremendous actor Liev Schreiber), plays a biker midwife in the forthcoming David Cronenberg film Eastern Promises. Watts found out she was pregnant while filming, and told Good Morning America that the professional education served her personally as well. “I was doing all this research of midwifery and turning up at hospitals and watching live births…And there I was, pregnant all that time!” (Watch the clip here). She hasn’t gone public with too much detail, but it sounds like she had a physiological birth: “…the whole birth thing is such a physical and dramatic experience. You’re so in your body that it’s almost an out-of-body experience,” she told Canwest News Service. “I keep replaying the birth in my mind because it was so powerful.”

Women often need prescription meds to cope with the pain following a cesarean section or even an episiotomy. But the U.S. Food and Drug Administration is now warning nursing moms about codeine, which the body metabolizes into morphine. “Ultra rapid” metabolizers can pass on deadly amounts to the baby via breast milk. “The morphine is excreted into breast milk in amounts that can cause limpness, excessive sleepiness, feeding difficulties and breathing problems in newborns,” according to this article in the Washington Post. Last year, a 13-day old Toronto infant died of a morphine overdose that was traced to his mother’s codeine.

Did he weigh a stone? This one did — 14 lb 7 oz — and his mother pushed him out with the help of four midwives. “Shaune is still less than a week old and is already the size of a six-month-old,” says this article, titled “Boyzilla!” Why not “Superwoman?”