I received a wonderful comment about the hypothesis that early umbilical cord clamping might contribute to the risk of origin of autism from a wonderful former colleague, Dr. David Blake, a researcher in the Department of Neurology at the Medical College of Georgia. His observations:
Fraternal twins typically have different placentas, whereas identical twins share a placenta but have different cords. The blood supply, and pre-clamping susceptibility to anoxia, would surely be different.
There are plenty of reviews associating prenatal or perinatal anoxia with autism already (as well as advanced maternal and/or paternal age). Given that early cord clamping clearly impacts perinatal anoxia, and has been recommended against, it would seem prudent to just change practice and see where that leads in a few years. The evidence that would lead one to think that early cord clamping is a bad idea is elaborate and complex (and amazingly compelling with respect to autism), but changing practice, immediately, is not.
As for the idea that one could statistically detect whether cord clamping is the problem, we can! Amish people do not clamp the cord until placental delivery, and they have no autism rate. The same is true in Somalia, but Somalian immigrants to westernized medical countries have high rates. Try to systematically find out autism rates and immediate cord clamping rates, on a country by country, or region by region basis. It is a task someone should get on immediately, but it will take a lot of effort.
An interesting discussion of the “Amish anomaly” re autism incidence has been provided by Dan Olmsted, who went to Amish Country to find the 150 or so individuals there who could be expected to be severely autistic. They aren’t there. He seems pre-disposed to believe that the difference lies with their non-vaccination. Many studies now show that this is unlikely. As David Blake points out, there is another difference in this population: In Amish birthing, by tradition, the cord is not clamped prior to placenta delivery.
The picture with autism in Somali children is a little murkier. It turns out that the incidence of autism is very high in children of Somali origin who were born in the US (several times higher than normal), while it appears to be very low in Somali children born in their native country. Again, vaccination has been identified as the likely cause by Somali parents and by many observers — but again, clamping follows placental delivery in Somalia, while the cord has been clamped without delay as a general practice in Minnesota, where a high incidence of autism in these children of Somali immigrants was first discovered.
I agree with David. These observations strengthen the arguments that early cord clamping could be a contributing cause of higher AD incidence. We should get our act together and determine, ASAP, the facts of the matter.
Perhaps this IS just another case of outwitting ourselves, as we attempt to outwit that clever old woman, Mother Nature. For the sake of all of the havoc that just might be attributed to this factor, let’s not let another year go by without having these answers.
An afterword: In reading a Huffington Post discussion of the “Minnesota Somali Autism” issues written by David Kirby, it was a sad thing to read the responses of a Somali woman whose family had suffered from this “American disease”. “Some autism families have returned to Somalia (because) they were angry and disgusted with the United States. The nation that offered them refuge was the same nation that made their children so sick. They think that, by returning home, maybe they can make their children better.” To view Somalia as a place in the world where children can escape from a great American miasma seems to this observer to be a rather surprising state of affairs!
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Great site. I just found it.
Perhaps it is the lack of vitamin d from the sun in Minnesota for the Somali immigrants?? Dr. Cannell makes a pretty good case of examining this link as well: http://www.vitamindcouncil.org/health/autism/
I live much farther south than Minnesota where I’m outisde w/ my children for 2-3 hours every day (in the summer) and I’m caucasian, so better absorption of vit d. I just got my vit d levels tested and I’m extremely low.
Another thought is the possibility of a link between pitocin use and autism. Pitocin is the synthetic oxytocin, which is a hormone related to contractions in labor. Oxytocin is a bonding hormone. If a mother is given pitocin during labor, maybe her own bonding hormones don’t release. Autistic children have trouble bonding. Homebirthers only use pitocin in very rare cases. Just a thought.
What about dietary free glutamate and aspartate? Oxygen deprivation may be one cause but the rise in flavor enhancers in the diet cannot be over looked. If a mother is pregnant couldn’t the over saturation of the developing fetus’s brain by dietary free glutamate make the child more sensitive to glutamate? Isn’t this why we see many autistic children respond very well to low glutamate diets?
I know the Amish eat foods low in dietary free glutamate.
This may be a long post. I’ve been doing a lot more research on perinatal indicators and autism and anoxia and anemia. I’d like to make the case for iron deficiency being the cause of autism (and possibly also ADD). Here is the logic.
There is a brilliant paper done at Harvard in 1955 (look for Duncan E. Reid as last author, Clement A. Smith as first). They injected pregnant women with radioactive iron. It hardly seems ethical today, but times change. The babies were born, and the authors tracked iron in these babies. Specifically, they looked at the fraction of heme iron that was radioactive. They also looked at the fraction of the blood that was red blood cells, or the hematocrit. What they found was that infants CANNOT incorporate dietary iron into their hemoglobin iron for the first six months of life! This is an incredible finding! Most infants use their red blood cells as a source of iron. They double in size in six months, and the loss of hematocrit donates iron for other body parts (like the brain). So the natural course of action is to burn through your iron for six months, at which time you can regulate its absorption in the GI tract. Of course, this means babies, at birth, have a higher iron-blood requirement than most other people.
On to my second brilliant study. This one was performed by a graduate student nutritionist at UC Davis named Camilla Chaparro, and published in 2006 in Lancet. They went to a Mexican hospital, and randomized normal full-term births. One group had the umbilical cord clamped at 15 seconds after the shoulder passed. The other had the umbilical cord clamped after a few minutes. The significance of this is that in normal full-term babies, the umbilical cord pumps an extra 50% blood volume into a newborn over the first few minutes. When Camilla and colleagues did blood work on these newborns at 6 months, they found that 4% of the infants were IRON DEFICIENT ANEMIC – but only in the early cord clamping group. The other group had none.
What is the significance of iron deficiency anemia? Well, the two biggest brain-related pathways involved are production of “myelin basic protein”, and “dopamine”. The former is a basic building block that every developing brain needs, and there are a number of well-described issues in brain myelination in autism, and in antibody responses specifically to myelin basic protein. The dopamine pathway you may recognize from its role in treating ADD. The ADD child gets a dopamine “booster”, and it normalizes their behavior. A side effect of the dopamine metabolic abnormality with iron deficiency anemia is urinary noradrenaline – this is also found in autistics. Another interesting finding is that iron supplementation helps autistics. But critically, if there is a significant insult to development at such an early age, there will be a limit to how much “catch-up” you can do. The brain is programmed to develop in sequence, and screwing up one step in the sequence can have enduring consequences.
I mentioned this to a very smart friend of mine (another Duke alumnus) who works in pediatric medicine. He said that malaria should cause autism, because it causes severe anemia. In fact, there is a paper out of Tanzania in which the doctor-authors are wondering why they are seeing infants with severe malaria get autism…perhaps the malaria causes the anemia, which includes iron deficiency, and then autism symptomologies set in.
You cannot supplement an infant in the first six months of life with iron, because the infant cannot absorb iron yet. Studies that have tried to treat early anemia with dietary iron fail miserably when evaluated at six months. There are many unanswered questions left by this line of inquiry. Do ADD and autism have the same cause and different genetic susceptibility? What, exactly, is the iron status of babies at six months who later become autistic (insurance companies only pay for blood work at 9 or 12 months, and this blood work is not suitable for addressing iron status except indirectly). I think enough of this line of thinking that I am organizing a line of my own work to pursue the latter question – if you had a group of autistic kids, and you could go back in time to when they were 6 months old, would they all be iron deficient? Any bets?
I think Baron-Cohen’s hypersystemising thesis is the key for some – and such false systemising can be switched off by some; see unlearningasperger.blogspot.com
Dear Dr Mike Merzenich, I also find the anxity-reduction thesis below works.
Anxiety; what is happening?
A non-conscious part of the mind is considering what is going on, and may send ‘this matches, send physical symptoms to get conscious attention’ (i.e. an emotion – e.g. see discussion in Mapping The Mind by Rita Carter, work by Ledoux etc) messages to amygdala.
Why do some people suffer particularly?
Some amygdala’s become hyper-potentiated; ‘conditioned’ – perhaps partly due to genetic predisposition, partly due to extreme experiences (e.g. perhaps imprints received as a young child). Such amygdala’s ‘over-do’ the physical symptoms, creating ‘amygdala hijacks’.
Can the amygdala be un-conditioned?
No, research and experience indicate that the amygdala will remain potentiated, once it has become so.
However
The medial prefrontal cortex can reduce the excitability of the amygdala central nucleus by stimulating the amygdala infralimbic
cortex, to which it is connected.
See http://www.iac-usnc.org/Lectures/Symposium1/Quirk/Quirk1.html#picture
See slide 29 in particular.
How?
To do so the medial prefrontal cortex needs new fear extinction memories (old memories do not work).
See slides 9-10 of the above presentation.
How can one continually create new fear extinction memories?
One effective approach is to use REBT (Albert Ellis rational emotive behavioural therapy):
- hunt out, go after and eliminate irrational beliefs, involving ‘must’ or ‘should’. E.g. ‘I must be the best person in the world at my job’; no, it would be nice if I was, but it is not the end of the world if I am not.
- hunt out, go after and eliminate ‘awfulizing’; instead rationally consider possible outcomes of a worrisome situation. E.g. ‘it would be awful if I crashed the car’; no, it would involve some repair work and an insurance claim; people do this all the time.
- use humour, and particularly ridiculousness, in this. E.g. ‘Think about it; it’s ridiculous to demand of yourself you be the best ever
person in the whole history of the world at your job!’
—–
Very interesting article. Thank you!!!
Could it possibly be so that only the children who had their cord cut immediatley develop autism from vaccinations?
Here are som interesting links on cord clamping
http://www.autism-end-it-now.org/
http://www.youtube.com/watch?v=CgAyQvOMrTM
http://www.youtube.com/watch?v=RoHg-Vg95pg
Hello, my name is Camila Cuevas, I am a student of medicine at the Catholic University of Maule, Talca, Chile.
I really think that the brain is the organ most amazing, mysterious and important. I found this very interesting article that talks about anoxia and autism, because we know that the brain is very sensitive to the lack of oxygen, and this can lead to various diseases globally to patients. I think it’s very important new discovery about early cord clamping and its effects on the newborn and I think there are excellent doctors who are motivated to further investigate this, I think this blog provides important information for people like me which we want to be aware of new discoveries about the causes of diseases that are becoming increasingly common in our times. I sincerely appreciate your motivation. I would ask and I hope I could answer, is there a possibility that this discovery will radically change current techniques for cutting the umbilical cord?
Thanks for your time.
Hello there,
My name is Shamsudin ABIKAR, originally from Somalia and since 2004 I have been working in Bristol (UK) primary schools as learning support and as a High Level Teaching Assistant. Couple of months ago I have submitted my MA Ed (Bilingualism).
Part of my job involves me assessing and supporting the English as Additional Language (EAL) pupils. This experience rouse my interest in Special Educational Needs (SEN) which in turn led me to interest in how the brain works.
I found the forum really interesting especially the title: Autism and early oxygen deprivation. From last year to months back, I have been working with a Somali Autism child. To establish some of reasons I sought advice from the child’s mother. She elaborated two aspects: she was anaemic during pregnancy and prior to the delivery and that the child was heavy and born much later than anticipated.