To Delay or Not To Delay: Impacts of Delayed Umbilical Cord Clamping

When giving birth, it is a common practice for doctors/midwives/caregivers to clamp and cut the umbilical cord that connects the mother and the newborn infant. Usually, the cord is cut within ten seconds after giving birth. But recently, the idea of delaying the clamping and cutting of cord blood is spreading across the world, with scientists conducting studies about it and mothers actually giving it a try.

Why are they choosing this over the usual quick clamping and cutting of the umbilical cord?

This article will show you the two sides of delayed umbilical cord clamping and cutting— the advantages and the disadvantages. While this idea seems more beneficial than destructive, there are still dangers to consider when choosing to delay the clamping and cutting of the cord.

 

INSIDE THE CORD

To delay or not to delay— that is the burning question. Before weighing the pros and cons of delayed cord clamping and cutting, you must first understand what the umbilical cord is.

The umbilical cord is the one that joins a fetus (later becoming a fully-developed baby) to its mother. The one end is actually attached to the infant’s stomach (the navel, to be exact— this is why the umbilical cord is also called a “navel string”) while the other end is in the placenta of the mother’s womb.

Now, why is this cord so important to both the mother and the baby?

The cord consists of one vein and two arteries, and all are responsible for carrying oxygen-rich blood and nutrients from the mother to the baby, as well as returning waste products and deoxygenated blood from the baby back to the placenta. The umbilical cord also serves as a medium for the placenta to give antibodies to the baby, so it will be immune from infections for up to three months after birth.

To sum things up, the umbilical cord is a healthy link between the mother and the infant. Whether delaying the clamp-and-cut process will bring more nutrients to the baby takes another batch of facts, though.

 

DELAY AND SUSTAIN

One study suggests that, after giving birth, there might be a good reason to let the umbilical cord linger on the mother and the baby for a while.

According to neonatologist Dr. Heike Rabe of the Brighton& Sussex Medical School in UK, infants benefit from getting an extra supply of blood from the placenta at birth, which is caused by the delayed clamping and cutting of the umbilical cord. Since the cord is still attached to the mother and the baby, all the blood and nutrients (including iron, which is very important in the development of the baby’s brain) flowing through the navel string can still be acquired by the baby, even if it’s already out of the womb.

“The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world,” Rabe stated. Therefore, a few extra minutes is encouraged before completely cutting the umbilical cord.

Swedish infants study

Several studies have been conducted to prove that delaying the umbilical cord clamping has beneficial effects to the baby. Some of these studies have been done in the past, and they have shown positive effects during the later moments of the baby’s infancy. However, few studies (one in particular) have dared to look way past the infancy and into the early years of the baby.

This study was conducted with half of 263 newborn babies in Sweden, which were grouped into two teams: those whose cords were clamped after more than three minutes after birth, and those who had their cords clamped within ten seconds after birth.

Fast forward to four years after that experiment, these children were tested for various skills, such as IQ, social, motor, problem-solving, behavior, and communication. The results showed that those whose cords were clamped a bit late got fairly high scores in fine motor skills and social skills, especially the boys. Rabe speculates that the reason for girls not showing significant improvement in this study is because of their high estrogen levels while in the womb.

More for preemies

While the practice of delaying the clamping and cutting of the umbilical cord can clearly benefit healthy term babies, Rabe believes that pre-term infants (or premature babies) would gain more from this process.

Premature babies, whose cord-clamping were delayed, have shown improvement in various medical aspects. These infants had better blood pressure a few days after birth, required fewer medicines and blood transfusions, had lower chances of a dangerous bowel injury, and experienced less bleeding into their brains.

 

OFF WITH THE CORD— IMMEDIATELY!

It is fairly reasonable to not get your hopes high after reading the advantages of delayed umbilical cord clamping, because along with the pros comes the cons.

The highly-recognized disadvantage of delayed cord clamping is the possible (and higher) risk of jaundice, which is a bilirubin build-up in the blood that results to the yellowing of the infant’s skin and eyes. Because the baby will be getting extra blood with the delay of the cord’s clamping, there could be a chance of a surplus in the infant’s red blood cells— which is possible to result in a normal cell breakdown, causing the bilirubin build-up.

There is another risk in delaying the umbilical cord clamping. According to Dr. Scott Lorch, University of Pennsylvania Perelman School of Medicine’s associate professor of pediatrics, a condition known as polycythemia could also stem from delaying a cord’s clamping. It is a disease caused by a very high count of red blood cells, which could result to blood clots, strokes, or respiratory distress to the baby.

However, these risks have not been fully proven on all types of infants yet, and according to Lorch, “We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay.”

 

WEIGHING THE OPTIONS

Whatever you choose— delaying the cord clamping or immediately having it cut— always note the possible side effects both to you and your future child. If in doubt, remember the World Health Organization’s (WHO) recommendation on cord clamping: not earlier than one minute after birth, for the mother and the baby’s health improvement.

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