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Lisa Black

The American Academy of Pediatrics reviews alternative birth practices to help pediatricians counsel expectant parents and assess for risks of infection in an exposed newborn. The new clinical report, “Risks of Infectious Diseases in Newborns Exposed to Alternative Perinatal Practices,” is published in the February 2022 Pediatrics (published online Jan. 24). As alternative birthing practices have emerged in recent years, pediatricians may be asked about them during prenatal counseling or after a practice has already occurred. The report describes seven alternative birth practices. These include water immersion for labor and delivery, which has been shown to improve maternal comfort in the first stage of labor, but may cause a rare but serious infection in the newborn from water-associated bacteria. Some parents ask to defer the hepatitis B vaccination, which is a critical safety net for prevention of hepatitis B and thus the deferral should be discouraged. Other alternative birth practices that are discussed include vaginal seeding (the practice of inoculating an infant born by cesarean section with a sampling of fluid from the mother’s vagina); umbilical cord nonseverance; placentophagy (placental consumption); deferral of ocular prophylaxis (eye drops to protect against infection), and delayed bathing. The report, written by the AAP Committee on Infectious Diseases and Committee on Fetus and Newborn, should not serve as an endorsement of alternative birth practices, unless endorsement has been given in other AAP policies. For a copy of the clinical report or an interview with an author, contact AAP Public Affairs.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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