Neonatal Omphalitis After Lotus Birth

Abstract

Lotus birth, or umbilical nonseverance, is the practice wherein the umbilical cord is not separated from the placenta after birth, but allowed instead to dry and fall off on its own. Lotus birth may result in neonatal omphalitis. This article describes the history and rationale for lotus birth as well as the etiology, incidence, clinical presentation, and management of neonatal omphalitis. Recommendations for educating families how to perform lotus birth safely are presented. Additionally, signs and symptoms that warrant newborn assessment and treatment are reviewed.

“Do not detach the placenta from my baby's cord” - Lotus birth case series from Tanzania tertiary hospital

“…However, LOTUS was new, and despite the whole process being uneventful, it is indispensable for all cadres that deal with delivering mothers to be aware for better outcomes. It has been noted that, the risk for neonatal infection increases with this practice [3] , hence clear information needs to be acquired on the preparation of post-delivery care by the mother and family at home while waiting for the natural detachment.…”

“…Such reasons include less stress to a newborn baby while facilitating induction of immunity as well as bonding with the mother [1] , [4] , spiritual motivation has also been reported to favor this process [2] . There are several risks to newborn relating to the practice especially infection, while in some other areas it poses difficulties when histological examinations of the placenta are needed [1] , [3] .…”

Assessing risks of leaving the umbilical cord uncut: A case–control study

“…1 The benefits have not been demonstrated, but the risks can include systemic infections, as the tissue becomes colonised by multiple bacteria. 1 Some case reports have documented omphalitis, bacteraemia, urinary tract infections and hepatitis, [1][2][3][4] but the study designs did not enable causal associations to be established. This prospective, multicentre, case-control study compared infection rates in infants delivered with or without lotus births in six neonatal units in Emilia-Romagna, Italy, from 1 June 2016 to 31 October 2021.…”

“…The benefits have not been demonstrated, but the risks can include systemic infections, as the tissue becomes colonised by multiple bacteria 1 . Some case reports have documented omphalitis, bacteraemia, urinary tract infections and hepatitis, 1–4 but the study designs did not enable causal associations to be established.…”

Advances in paediatrics in 2019: current practices and challenges in allergy, endocrinology, gastroenterology, public health, neonatology, nutrition, nephrology, neurology, respiratory diseases and rheumatic diseases

“…In a recent case report series, no infections occurred after lotus birth and mothers expressed interest in repeat lotus birth in the future [62]. However, the dead tissue attached to the newborn may be affected by bacteria and possible complications related to this practice such as omphalitis or other infections have been described [63]. From the medicolegal side, the question arises whether placenta belongs to the mother or to the baby and no clear statement assess the juridical availability of placenta.…”