"One of the most difficult cases we have treated": Home births almost ended in disaster

At the Hadassah Mount Scopus Hospital in Jerusalem, two infants have been hospitalized in serious condition over the last two weeks. The toddlers arrived at the emergency room shortly after being born in planned home births. The medical staff at the Jerusalem hospital provided them with life-saving treatment. Both infants were born and hospitalized around the same time, but in different incidents.

In the first case, the infant was evacuated to the hospital about an hour after his birth, which took place at home. The newborn arrived at the emergency room suffering from asphyxia (lack of blood supply to the brain). The parents noticed that the child was in severe medical distress and consequently called Magen David Adom, who evacuated him to the hospital.

Thanks to the alertness of the staff in the pediatric emergency department, respiratory distress was diagnosed in the infant, combined with a bluish skin color and an abnormal neurological state. In the neonatal intensive care unit, the infant was connected to a brain wave monitoring device, which indicated a seizure. As a result, it was decided to cool the infant's body to prevent secondary brain damage. As of today, the infant's condition has stabilized and he is still being treated in the NICU.

Director of the Neonatology Department at Hadassah, Prof. Smadar Even-Tov, emphasized that if the infant had been born in the hospital, he would have received immediate assessment and rapid resuscitation treatments, thus preventing further brain damage.

Severe bleeding in the diaper

The second incident occurred about ten days ago, in which the life of a three-day-old baby girl was saved after she was also born in a planned home birth. She was brought to the hospital by her parents after they reported severe bleeding seen in her diaper. As a result, they were urgently referred for treatment in the emergency room.

Pediatricians in the emergency department quickly identified that the baby girl was in a state of shock and suffering from severe acidosis. In addition, due to the toddler's low hemoglobin, she was in a life-threatening situation and the medical staff began immediate treatment. The treatment included the administration of vitamin K and blood products and led to a significant improvement in clotting functions until the bleeding stopped.

The staff also emphasized that this was one of the most difficult cases they have treated due to a vitamin K deficiency, but fortunately for everyone, the baby girl is out of danger and was discharged home upon completion of treatment.

By decision of the Director of the Neonatology Division at Hadassah, the baby girl was transferred for continued treatment in the neonatal intensive care unit. Tests performed indicated a deficiency in vitamin K, an essential component for preventing bleeding, which was not given to the baby due to the parents' decision. It should be emphasized that this is a vitamin given in Israel and around the world in recent decades to every infant immediately upon birth, in order to prevent extremely dangerous bleeding conditions.

Importance of hospital birth

According to the Ministry of Health, infants are born with low levels of vitamin K, which is essential for normal blood clotting in the body and for the production of blood clotting factors in the liver. In us adults, the vitamin comes through the food we eat, and it is created in a process that occurs by intestinal bacteria.

When the fetus is in the womb, it receives a supply of the vitamin from the umbilical blood, but at a very low level. When the baby comes out into the world, they arrive from a sterile environment (without bacteria) and they do not have the bacteria in the intestine necessary to produce the vitamin. In addition, the amount they receive from breast milk (if there is breastfeeding) is less and not enough to stop bleeding. In the event that bleeding does occur, their clotting system is not yet mature enough to deal with it.