The First Breath and the Immune Reaction

After the first breath, the lungs changes stronger as any other organ. Before birth, the lungs do not have any function; this is similar between humans and mice. Though they are trained by various movements of muscles, which the unborn performs, they are filled by liquid and get their blood supply directly from the placenta, while the vascular system bypasses this organ. In the first breath, which is often connected with a strong scream, the liquid gets absorbed by the body. The lungs unfold and are fully supplied with blood from now on. In the next three weeks, the lungs develop to become what their task is for the rest of the life is: the central breathing organ. By the sudden stretching of the lungs and by the first scream, certain mediators get released, among them a cytokine, interleukin 33, which then exerts a strong influence on other immune cells.

In the maternal body, the lungs still are free of microbes. Yet after that, the lungs need a well working immune defense, for with every breath noxious substances and bacteria stream into the lungs. This immune system gets activated with the first breath in a chain reaction. IL33 is released and activates IL2-cells, special white blood cells, which invade the lungs. This leads to the activation of the most important immune cells in the breath ways, the alveola-macrophages.

The IL2-cells are important for keeping up a balance: on the one hand, pollutants should be rejected, on the other hand, over-reactions should be avoided. The IL2-cells reduce the activity of the immune system, which has the disadvantage as bacteria have a better chance to spread in the body.
The first breath can work more or less well. Labor plays and important role, but also the shock in temperature is an important trigger factor. Not all babies have the same preconditions for the kick-off of the lungs, Cesarean babies are disadvantaged.

This is the translation of a radio broadcast featuring the research work of Silvia Knapp from the Medical University of Vienna, from March 3rd, 2017 with the title: “The first breath and the immune system”, transcribed and translated by me.

Commentary:

Also this context demonstrates the negative consequences of Cesarean birth for the health of the babies. It is an artificial disruption of a process, which has its inner natural logics, here presented in the connection of the development of the immune system of the lungs. When this process cannot take place, important components are missing, which the child has to build up by itself in a different way later on in life.

The article seduces to enforce a well-known prejudice in one point: The stronger the scream of a baby after birth, the better for its health and robustness. On my enquiry about this point, I got this answer from the ORF redactor: “Mrs Ronzheimer has reported about the actual research project of Silvia Knapp. As far as she knows, the first breath and the scream connected with it is crucial for the development of the immune system of the lungs. According to Silvia Knapp, the immune system also develops normally in the case of a Cesarean birth, which is not under ideal conditions, and not as well as in the case of natural birth. Whether the scream is decisive, cannot be confirmed by Mrs Ronzheimer – the theme is the first breath, which is naturally deeper with a scream.”

Or course, a scream requires a deeper breath. Yet many experts on birth have the opinion that the scream is caused by an abrupt transection of the umbilical cord. Babies, whose cord stays attached up to the end of pulsation, usually start to breath slowly and gently, without a scream. Thus they do not suffer from the placenta trauma, which could be the emotional cause of the scream in the other case.

See the lecture of Susanna Hinnawi on "Lotus Birth" at the Global Inspiration Conference on August 5, 2017 in Hirschwang/Austria and the workshop on "Healing the Placenta Trauma" facillitated by Wilfried Ehrmann at the same event.