in collaboration with
Gersende Lesage (Midwife)
Essential to the life of the foetus, the umbilical cord is revealed to the parents on the day of delivery. It is often a source of questions: how to clean it, when does it fall… We take stock with a midwife
The umbilical cord: what is it?
Indispensable to the life of the embryo and then of the fetus, the umbilical cord is an organ that joins it (the fetus) to its placenta in the very womb of the mother. Like the diver, the future baby is supplied with oxygen thanks to the cord. “It is in this cord that a circulation of blood vessels takes place (two arteries and a vein) which supply the embryo, then the fetus during pregnancy., explains Gersende Lesage, midwife. The umbilical cord is of variable length. If it is very long, it can wrap around the fetal parts during pregnancy (we speak of a circular cord when it is around the neck or of a suspender cord around the limbs) or form one or even several knots. But its structure, wound on itself like a telephone wire (we are talking about old telephones!), allows these phenomena to be without harmful consequences and without risk for the fetus.
Cutting the umbilical cord at birth
Childbirth is coming to an end, the baby is out and is no longer one with its mother. It therefore no longer needs the placenta, which until the moment of birth served as its lung, intestine and kidney. We can then cut the umbilical cord that still connects the baby to the placenta. In practice, the midwife will put two clamps on the cord between the baby and the placenta (a clamp, we then speak of clamping or clamping) and often offers the dad (or the person present) to cut it with scissors. Otherwise, the midwife will take care of it.
Once the umbilical cord has been cut, a small plastic clip is placed on the cord, 2 cm from the umbilicus which will eventually become the navel. In some maternities, the forceps are replaced by a thread. This poses no risk to the child. The goal in both cases is to prevent the baby from losing blood through the cord. This gesture is part of the care of the newborn, provided at birth by health professionals in the hospital.
Cord clamping: early or late?
Cord clamping, or clamping, is said to be early if it is performed within 10 to 20 seconds after birth. It is late if it occurs beyond these seconds within 2 or 3 minutes, or when the pulsating beating of the cord ceases.
Before the umbilical cord dries up and detaches itself from the infant’s body (between one week and fifteen days after birth), the question of care arises.
On this point, opinions are divided. For her part, Gersende Lesage assures us that “to clean the umbilical cord, there are several ways (it will also depend on the practices of the maternity ward), but one can use saline solution, biseptine, mercurochrome or simply water and soap”. These different options pose no risk to the cord or your baby.
But according to the pediatrician-homeopath, Pierre Popowski and the midwife Nicolas Dutriaux: “The World Health Organization no longer recommends systematic care, although French pediatricians (and parents) find it difficult to put it down. The umbilical cord is cut with sterile instruments and baby is washed in water from the tap… So little risk of tetanus. Indeed, it is especially to guard against it that the care is recommended. Also, the WHO no longer recommends systematic disinfection in developed countries..
When it has just been cut, the umbilical cord has a somewhat viscous consistency and as the days go by, it dries out (you can always get an idea of the appearance of the cord from photos) . At the maternity ward, the childcare assistant will remove the forceps (Barr clamp) from the second day. The cord can be protected from friction with the diaper or clothing by a compress, or left in the open air so that it dries faster.
“When it starts to unhook, the cord can sometimes bleed at the base or have brown colored secretions, which can smell bad. Don’t panic! We clean well at the base. If the cord is half unhooked, especially we don’t shoot it. We’re waiting”advises Gersende Lesage, before adding: “To help accelerate the fall of the cords, some pediatricians recommend, however, to put on a drying lotion.. You can always experiment.
Rest assured, cord fall is completely painless for infants. Indeed, this remnant of the umbilical cord does not contain a nerve, but three blood vessels (two arteries and a vein). After two weeks, the umbilical cord is still there, attached to your baby? Simply continue the care as prescribed by the maternity ward. It will expire later.
Abnormalities during umbilical cord care: professional advice
The umbilical cord folds
Leave it alone and keep cleaning it.
The umbilical cord is torn
Clean and disinfect with a product that does not sting, such as biseptine.
The cord smells bad, bleeds or the umbilicus is red, oozing
In one of these cases, consult your pediatrician, doctor or caregiver at a PMI (maternal child protection) centre. He will check the absence of infection on the umbilicus and will tell you what to do.
What about cord blood samples for the health of your baby?
You have probably heard of the valuable stem cells contained in umbilical cord blood. This is a topical subject that raises questions and is mentioned in “The Big Book of My Pregnancy“, at Editions Eyrolles. In certain maternity wards which have organized themselves with the French Blood Establishment (EFS), you may be offered the option of making an anonymous and free donation of your baby’s cord blood. Such as bone marrow, Cord blood is rich in stem cells that can be used to treat a patient with leukemia (not your child).
You should also know that for-profit commercial companies advise future parents to ask for the collection of 80 ml of cord blood from their child during childbirth. This act will be carried out with a view to freezing, and storing the blood and the stem cells it contains, for several years. These companies play on the precautionary principle concerning the health of your child, by suggesting to the parents that these stem cells could be useful in the future, to the child or the adult that he will become to treat possible diseases. , such as leukemia or even Alzheimer’s disease, Parkinson’s, diabetes…
This is a bet on the progress of medicine, very questionable because:
- These indications are currently completely unknown and hypothetical;
- Research is still unaware of the conservation and life of these stem cells (from bone marrow and umbilical cord blood) beyond 20 years;
- In the case of diseases such as leukemia, cord blood and someone else’s stem cells must be used.
This is why the National College of French Gynecologists and Obstetricians and that of many countries advise against this conservation for your baby himself. However, you can participate in a public and solidarity bank as for the blood of adults: the stored blood will go for a patient.