Cutting the Cord Later

Clamping newborn umbilical cords later may reduce neonatal problems

(RxWiki News) Soon after a baby is born, the umbilical cord is clamped. But just how long those minutes should be, in between birth and clamping, is the subject of some controversy.

New research from Sweden shows that a delay in clamping the cord, by just a few minutes, results in improved iron levels for babies. This can be vital later in life, as iron is crucial for healthy development of the brain and central nervous system.

"Ask your OB about delayed clamping."

Ola Andersson, MD, of Uppsala University, and colleagues conducted a study on 400 full-term infants born in Europe, after low-risk pregnancies. The births were randomized so that some newborns had delayed umbilical cord clamping (180 seconds or more after delivery), and some had early clamping (within 10 seconds of delivery).

For the babies whose clamping was delayed, there were fewer instances of anemia two days after birth. By four months of age they showed a 45 percent higher mean ferritin concentration (the protein that stores and releases iron), and a lower prevalence of iron deficiency than the babies who had been clamped early.

In the early clamping group, researchers noted that the degree of iron deficiency was moderate, rather than mild. All infants, from both groups, had similar weights and lengths as well as similar levels of hemoglobin.

Delayed cord clamping permits additional blood, including iron, to reach the neonate. The controversy comes in, however, because in higher income countries where early clamping is common, later clamping can have a potential for neonatal problems such as respiratory difficulties. It is also thought to help prevent maternal hemorrhage.

It is reassuring to see data on the benefits of delayed cord clamping,” says Catherine Browne, DO, an obstetrician in Austin, Texas, "particularly since the study methodology showed that it is not necessary to wait until the cord stops pulsating, which many obstetricians are reluctant to do."

“Simply waiting a few minutes while you dry and stimulate the baby provides significant health advantage for the baby. My partner and I both practice this way, even at cesarean section."

But due to the results of this research, the Swedish group recommends that delayed clamping should be considered standard OB practice for full term deliveries after uncomplicated pregnancies.

Results were published in the British Medical Journal in November 2011.

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Review Date: 
November 21, 2011