When to Cut the Umbilical Cord in Babies?

Snap it Off or Wait for the Clock to Tick Off for a While?

Wow! The baby’s out after hours and hours of labor. Umbilical cord-the magical connection between you and your baby that served as the primary means for exchange of nutrients and oxygen-rich blood is chopped off IMMEDIATELY. Running as a 20-inch long connection from the opening in the baby’s stomach to the placenta in the womb it’s still a fantasy that this cord having just a vein and two arteries helps to keep your baby alive through the pregnancy term and brings her/him into this world! Cutting off the cord from the placenta and from the baby’s belly (after leaving some 3-4 cms) within 10-15 seconds has been in practice since ages unknown. Why don’t we give the mom and baby some more time before cutting the cord when its going to be a better choice in terms of health for the little one?

Biblical Umbilical Cord
Its been shown that a transfer of 80ml of blood from the placenta occurs by 1 minute of birth increasing to 100 ml by 3 minutes. Before 1950s, early clamping was what that happening within 1 minute of birth and late clamping was what happened after 5 minutes of birth. But it was seen that almost 80-100 ml of blood transfer occurred within 3 minutes of birth and up to 90% of blood volume transfer was possible within first few breaths in healthy term infants because of which it became a practice to clamp and cut the cord within 15-20 seconds after birth. But recent developments have argued for delaying umbilical cord clamping by at least a few minutes after birth!

A new study finds that clamping the cord five minutes after birth is advantageous in forming the brain structure of the newborn. The research involved 73 babies that were grouped into two where in the first group of babies the umbilical cord was cut after a five-minute delay and in the other group the cord was clamped within 20 seconds. Four months into this world and each of the baby was subjected to a series of tests-MRI of the brain, a brain development test and a blood test to check their ferratin levels. Ferratin tests are a clear indication of the available iron in the blood as they are the main storage protein for iron in our body. Results showed that babies whose cords were cut after 5 minutes displayed increased levels of ferratin and their brain contained more of a substance called myelin. Myelin serves to protect our ‘grey’ matter and helps nerves communicate in a better manner. Also, more concentrated the amounts of myelin and ferratin are, better is the baby’s cognitive, motor, social and developmental skills as they are directly related to these components. Nourishment of the pregnant mom also plays an integral role in defining the health of the baby. Meeting a nutritionist/dietitian at www.firsteatright.com and getting a diet chart for your pregnancy term goes a long way in ensuring the health of the little one.

Previous studies in pre-term infants showed that delayed cord clamping (between 30 and 180 seconds) was linked to fewer infants needing transfusion to treat anemia, studies of delayed clamping supported decreased occurrence of intraventricular hemorrhage or enterocolitis too and others associated with improved circulation of blood in the infant’s heart and increased volume of red blood cells.

Studies of full-term infants showed that early clamping (within a minute) resulted in lower hemoglobin concentration at birth and also increased the baby’s risk of iron deficiency up to 6 months after birth. Children whose umbilical cords were cut early experienced delayed fine motor skills compared to those children whose cord was clamped later. Though there was a small risk involved due to increase in risk of jaundice in those infants subjected to delayed umbilical cord clamping, the benefits outweighed the risks overall.

Time to Change the Age-old Practice?
The World Health Organization insists that a preterm or full-term baby’s umbilical cord should not be clamped within a minute after birth until the newborn required positive pressure ventilation. While WHO recommends clamping the cord between 1 and 3 minutes after birth the American Academy of Pediatrics recommends clamping it between 30 and 60 seconds after birth.
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Weighing the pros and cons, researchers find it safe to conclude that delaying umbilical cord clamping by 30-60 seconds in preterm and full-term infants is recommended. Maybe parents can put forth their suggestions with the physician and request for a delayed clamping. But none of these should be considered in times of emergency (either with the mom or baby) despite the benefits that go with it. Don’t you think the greatest benefit is to assure full care and health of the patient right away rather than work on something that might be needed for the future?