Explaining Delayed Cord Clamping
Generally speaking, “early” or “immediate” cord clamping is within the first 10-30 seconds after birth, and delayed cord clamping is more than 30 seconds after birth. (4, 5)
Depending on individual preferences and cultural practices, the cord can be left attached from a few minutes (usually until after the umbilical cord stops pulsating) to a few hours or even a few days. (1)
OB/GYNs are starting to take a second look at what midwives have been practicing for years.
Benefits of Delayed Cord Clamping (DCC)
The reason for delaying the cutting of the umbilical cord has to do with the high iron content of the blood still in the placenta. (4)
Studies conducted by the World Health Organization have shown that waiting to cut the umbilical cord can allow the newborn to receive between 40 and 50 mg/kg of iron, and a 32 percent increase in blood supply.
With iron deficiency and iron deficiency anemia being associated with poor brain development worldwide, this initial increase in blood supply and iron could have a huge effect on newborns.
To read more about how DCC benefits iron levels in infants, refer to any of the sources cited at the end of this article.
Other benefits may include:
• Reduced incidence of bleeding of the brain (intraventricular hemorrhage) and late on-set infections particularly in very preterm infants (1)
• Increased tissue oxygenation levels in newborns (1)
• Increased total body iron levels and iron stores (1)
• Decreased lower blood lead levels in lead-exposed infants (1)
Addressing Fears Regarding Delayed Cord Clamping
The primary concerns associated with the increase in blood supply and iron were about increased incidence of jaundice and too many red blood cells in DCC babies.
Polycythemia occurs when there is an increase in circulating red blood cells in the body. In infants, this may happen due to the increased blood the baby receives from the placenta.
Babies with polycythemia may not feed well, experience low blood sugar and difficulty breathing. This condition is usually not treated and allowed to resolve naturally as the baby’s system settles in the days after birth. (4, 7).
A more recent, more thorough study of DCC in Sweden showed no significant increase in risk of polycythemia in DCC infants. (4)
Jaundice is caused by high levels of bilirubin in the blood which is supposed to be flushed out of the body by the liver after the body has destroyed old red blood cells.
The increase in red blood cells and iron levels in DCC infants could increase the amount of bilirubin the liver has to process, resulting in jaundice. Treatment isn’t usually needed because the baby’s liver will catch up and clear out the excess fluid in the days following birth. (5)
As you prepare for the birth of your baby, it is important to consider and discuss with your family doctor, gynecologist or midwife, the effects of delayed cord clamping instead of the traditional obstetric practices.
Sources:
1) “Delayed Cord Clamping should be Standard Practice in Obstetrics” Fogelson, Nicholas. Academic OB/GYN. Web. Nov 6, 2012.
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics
2) Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. World Health Organization. Web. Nov 6, 2012.
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd004074_abalose_com/en/index.html
3) Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomized controlled trial. British Medical Journal. BMJ 2011;343:d7157. Web. Nov 6, 2012.
http://www.bmj.com/content/343/bmj.d7157
4) “Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials” Hutton, Eileen & Hassan, Eman. Journal of the American Medical Association. JAMA. 2007;297(11):1241-1252. doi: 10.1001/jama.297.11.1241. Web. Nov 6, 2012.
http://jama.ama-assn.org/content/297/11/1241.full
5) “Immediate versus Delayed Umbilical Cord Clamping in Premature Neonates Born <35 Weeks: A Prospective, Randomized, Controlled Study” Kugelman, Amir et al. American Journal of Perinatology. AJP Vol 24 Number 5 (2007). Web. Nov 6, 2012.
http://www2.cfpc.ca/local/user/files/%7B5D4E4E2E-FC40-408D-ABE0-541D9AB34047%7D/Cord%20Clamping%20in%20premies.pdf
6) “Jaundice” Marks, Jay. Medicinenet.com. Web. Nov 6, 2012.
http://www.medicinenet.com/jaundice/article.htm
7) Polycythemia. Group Health Centre. Web. Nov 6, 2012.
http://ghc.mediresource.com/disease_detail.asp?disease_id=280
Reviewed November 7, 2012
by Michele Blacksberg RN
Keywords:
Description: Discussion about the evidence supporting the benefits of delayed cord clamping for newborns, as well as address some of the concerns.
Page Title: Delayed Cord Clamping can Prevent Iron Deficiency in Infants