Umbilical Cord Clamping (from www.thebirthsource.homestead.com )
What’s the difference in cutting the baby’s umbilical cord immediately
after birth as opposed to waiting until pulsating has ceased (10-30 minutes after birth)? When you cut the cord is such a trivial thing….or is it? Read the following findings and decide for yourself.
1. Not all babies breathe right away after birth. This is normal,
common, and generally not an emergency if the cord is still attached. Why? The cord still provides oxygenated blood through the umbilical cord for 10-30 minutes to allow for the transition from cord breathing to lung breathing, thereby reducing the risk of arrest and resuscitation.
2. While over half of newborn experience jaundice and this is normal,
babies who experienced immediate cord clamping had more severe levels
of jaundice requiring hospital intervention (hospital stay, billirubin
lights, IV).
#1 & #2 are adapted excepts from George M. Morely, MB., CH.B, Cord
Closure: Can Hasty Clamping Injure the Newborn? July OBG Management.
3. Autopsies performed on primates who gave birth in captivity and had
early cord clamping showed unusual lesions in the brains of the animals. This prompted human research and when done, these same lesions were also found in the brains of human babies.
#3 is an adapted except from Magical Child by Joseph Chilton Pierce
4. To study the effect of delayed cord clamping on infant iron status,
69 newborn infants were randomly assigned to three groups at time of
delivery:
1. Cord clamping immediately after delivery
2. Cord clamping when the cord stops pulsating, at around one minute after delivery placed at the level of the placenta.
3. Clamping when the cord stopped pulsating, with the infant placed below the level of the placenta.
Two months after delivery groups 2 and 3 had significantly higher-packed cell volume values and hemoglobin concentrations. These infants were less anemic: the % of infants with packed cell volume lower than thirty-three percent was 88% in group 1, 42% in group 2, 55 % in group 3. These findings conclude that for optimal packed cell volume and overall health in infants that babies should be put skin to skin immediately at the mothers chest and cord clamping should be delayed at least until pulsating ceases.
#4 is an adapted excerpt from The Kangaroo, 2nd quarter 1999, a
Supplement to Child Health Dialogue, Issue 15
5. The umbilical cord is comprised of two arteries and one vein, The
vein goes from the placenta to the baby, and the arteries going from the baby to placenta. By cutting the cord before full drainage there is an increased risk that the vein and arteries can become “backed up” and herniate at the newborn’s navel creating a fluid-filled lump that can enlarge to the size of a golf ball and remain there up to a year.
6. It’s interesting that a whole industry has emerged to collect cord
blood for its valuable T-cells that have cancer fighting properties at birth to be used at some time in the future. This is human insanity of the first order.
That blood is designed to go into the child’s body for protection at
birth, not 30 years later!
7. In Rh negative women, many believe it is the clamping of the
pulsing cord that causes the blood of the baby to transfuse into the
bloodstream of the mother, causing sensitization problems.
Conclusion: To achieve an optimal outcome babies should be given to
their mothers immediately after birth and cords should not be cut until
pulsating has ceased and complete drainage has occurred (or not cut at all), especially for newborns who experienced distress and/or meconium
staining. In only rare cases, such as severe nuchal cord or delivery of the first multiple, should cord clamping occur before or immediately after birth.
The Umbilical Cord
Early cord clamping deprives the baby of 54-160 mL of blood, which
represents up to half of a baby's total blood volume at birth.
"Clamping the cord before the infant's first breath results in blood being sacrificed from other organs to establish pulmonary perfusion [blood supply to the lungs].
Fatality may result if the child is already hypovolemic [low in blood
volume]".
- Morley, G. (1998, July). Cord closure: Can hasty clamping injure the
newborn? OBG Mgmnt: 29-36.
Early clamping has been linked with an extra risk of anemia in infancy.
- Grajeda, R. et al. (1997).
Delayed clamping of the umbilical cord improves hematologic status of
Guatemalan infants at 2 mo. of age.
- Am J Clin Nutr 65:425-431.
Premature babies who experienced delayed cord clamping--the delay was
only 30 seconds--showed a reduced need for transfusion, less severe
breathing problems, better oxygen levels, and indications of probable improved long-term outcomes compared with those whose cords were clamped immediately.
- Kinmond, S. et al. (1993). Umbilical cord clamping and preterm
infants: A randomized trial. BMJ 306(6871): 172-175.
Some studies have shown an increased risk of polycythemia (more red
blood cells in the blood) and jaundice when the cord is clamped later.
Polycythemia may be beneficial in that more red cells mean more oxygen
being delivered to the tissues. The risk that polycythemia will cause the blood to become too thick (hyperviscosity syndrome), which is often used as an argument against delayed cord clamping, seems to be negligible in healthy babies.
- Morley, ibid.
Some evidence shows that the practice of clamping the cord, which is
not practiced by indigenous cultures, contributes both to postpartum
hemorrhage and retained placenta by trapping extra blood (about 100 mL) within the placenta. This increases placental bulk, which the uterus cannot contract efficiently against and which is more difficult to expel.
- Walsh, S. (1968, May 11). Maternal effects of early and late clamping
of the umbilical cord. The Lancet: 997.
Clamping the cord, especially at an early stage, may also cause the
extra blood trapped within the placenta to be forced back through the
placenta into the mother's blood supply during the third stage contractions. This feto-maternal transfusion increases the chance of future blood group incompatibility problems, which occur when the current baby's blood enters the mother's bloodstream and causes an immune reaction that can be reactivated in a subsequent pregnancy, destroying the baby's blood cells and causing anemia or even death.
- Doolittle, J. & Moritz, C. (1966). Obstet Gynecol 27:529 and Lapido,
O. (1971, March 18). Management of the third state of labour with
particular reference to reduction of feto-maternal transfusion. BMJ 721-3.
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The above are excerpts from Sarah Buckley's "A Natural Approach to the
Third Stage of Labour," Midwifery Today Issue 59