Delayed Cord Clamping: Disadvantages

Assumption: There are advantages to immediate cord clamping.

TRUE
Yesterday I said I would try to find out of there was any particular *advantage* to immediate cord clamping.  It seems there must have at some time been some advantage or it would not be such a widespread practice, right?  The studies analyzed here show that delayed clamping/ cutting does not lead to more maternal hemmorages (as previously theorized) and it does help babies’ iron stores.  BUT, the babies whose cords were clamped 2 minutes or more after birth did tend to develop more jaundice.

http://www2.cochrane.org/reviews/en/ab004074.html

My Views:
First, although low iron and jaundice can contribute to the risk of brain damage, I think that iron levels are more important since jaundice can be remedied in very non-invasive ways (frequent breastfeeding and exposure to sunlight) and is more apparent and easy to detect.  Second, I now wonder if there might be a benefit to some (low-level) jaundice at birth since so many babies experience it.  My personal opinion after reading these studies is that the delayed cord cutting has more benefits than risks and that it should be studied and practiced more.

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Cord Clamping and Iron

Assumption: The umbilical cord should be immediately clamped and cut after birth.

FALSE
This study demonstrated that delaying cord clamping by just 2 minutes had a significant effect on the iron levels in a newborn’s blood and continued to have an effect when checked again at 2 months and 6 months.

http://nutrinet.org/pages/downloads/documetos-HO/Otros%20Documentos/Umbilical_Cord_Clamping_Lancet_Mexico.pdf

My Views:
Yesterday I reviewed studies that showed the benefit of delayed cord cutting on premature newborns.  Then, two friends posted this article on Facebook.  It is lengthy, but basically states that immediate cord cutting can be dangerous to the newborn brain.  This encouraged me to look for more studies about delayed vs. immediate cord clamping (in full-term newborns) and I found this one that supports the findings in the article mentioned above.  If waiting just 2 minutes before clamping and cutting the cord helps a newborn to regulate iron levels in the blood, I am amazed that immediate cutting is still the norm.  Are there downsides to delaying that I am not aware of?  Maybe I’ll look into that for tomorrow’s post. 🙂

Cord Clamping in Premies

Assumption: It is best to clamp and cut the umbilical cord as soon as a baby is born.

FALSE
When cord clamping was delayed by just 30-120 seconds, there were more positive outcomes for premature infants.  Receiving the continued blood-flow through the umbilical cord prevented the need for transfusions and resulted in fewer cases of intraventricular hemorrhage.

http://www2.cochrane.org/reviews/en/ab003248.html

My Views:
A lot about what happens immediately after birth seems rushed to me.  I think that giving the baby time to transition while still attached to the placenta certainly won’t cause harm!  Allowing Mom, Dad and baby to relax and just BE together after the birth without a lot of intervention from staff helps establish a peaceful loving bond. Delaying the clamping of the cord seems natural to me, as does delaying eye treatments, immunizations, baths, and warmers.  Baby against Mom’s skin and no one rushing them to DO anything is a great way to welcome a new life! 🙂  These studies focused on preterm infants, but I think all infants could benefit from this kind of treatment.