The lungs of most newborn infants begin to work exactly on schedule. But among some babies, particularly the premature, the lungs fail to expand properly. The chest sags, breathing is rapid and the child turns blue. Many deaths during the first week after birth are attributable to this condition, which doctors describe as the "respiratory distress syndrome."

Obstetricians have long noted that babies suffering from such troubles either were delivered by Caesarean section, or were premature infants, or born of diabetic mothers. But in the A.M.A. Journal, a group of pediatricians* from the University of California suggests that the most important factor is the time at which the obstetrician clamps and cuts the infant's umbilical cord.

The California pediatricians base their theory on a study of 129 infants. Among 41 whose umbilical cords were clamped before they took their second breath, 21 showed moderate to severe respiratory distress. In another group of 52 infants whose umbilicals had been clamped some time after the second breath, only six suffered the same symptoms. The condition of the infants who retained their umbilical cords longest was by far the best.

There are sound reasons, say the doctors, for a slowdown in cutting the umbilical cord. Delay allows a gradual change from fetal to regular circulation without putting stress on blood vessels in the lungs and elsewhere in the body. The carefree manner in which the newly born infant is "disconnected" from his mother, concludes the report, "is in sharp contrast to the meticulous care with which the thoracic surgeon separates his patient from the heart-lung machine."

* Drs. Arthur J. Moss, Edward Duffle Jr. and Leonard M. Pagan of Los Angeles.



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