It seems unthinkable to deliberately deprive a newborn baby of 30% to 40% of its blood supply but some delivery experts suggest we do exactly that when the umbilical cord is severed within a minute of its birth. A recently published report indicating a wait of just another minute or two delivers immediate benefits to the baby with no added risk to the mother's safety.
The report -- Effect of Timing of Umbilical Cord Clamping of Term Infants on Maternal and Neonatal Outcomes -- was published online on July 11, 2013, by the Cochrane Pregnancy and Childbirth Group. Data was gleaned from 15 clinical trials that involved 3,911 mothers and their newborn babies.
The widespread practice of immediate cord clamping is said to minimize the risk of the mother hemorrhaging but results of the Cochrane report suggest the benefit to the baby outweighs the minimal risk to the mom. Benefits include:
- Improved stores of iron to the baby within the first six months of life
- Higher hemoglobin levels 24 to 48 hours after birth
- Higher birth rate thought to be a result of added blood volume from the mother at birth
- No increased risk of severe hemorrhage
- No increase in maternal blood loss
- No reduction in maternal hemoglobin levels
Concerns to consider:
- 2% increased the risk of jaundice in babies
- Newborn anemia is not common in the US
- Certain medical emergencies require immediate clamping
To counter concerns over jaundice, delayed clamping should be done in medical facilities equipped to deal with the possibility. Because of a mother's increased risk of hemorrhaging during a C-section delivery, delayed clamping should be reserved for vaginal deliveries only.
There are no long-term studies of the effects of delayed clamping but Dr. Tonse Raju, a neonatologist not involved with the study, says theoretically that improved iron stores at birth and in the first few months of life could minimize the risk of cognitive delay and learning difficulties later on. Iron-deficiency anemia has been linked to learning difficulties in children of school age.
Raju describes the delayed clamping as "a good chunk of blood the baby is going to get" that will help fill the baby's lungs. Raju is a medical officer for the National Institute of Child Health and Human Development.
Eileen Hutton describes the study's implications as "huge" and suggests we've deprived babies of a valuable blood supply "just because we've learned a practice that's bad." Hutton, a midwife, teaches obstetrics at Ontario (Canada) McMaster University.