Another study on Delayed Cord Clamping

Yet another study that proves that delaying the clamping and cutting of a babies umbilical cord has great effect on improving the baby's vital signs and over all health.  This study looks at cord clamping and cutting in preterm infants, but the fact is that the benefits to these fragile infants carries over to full term infants too!!

Dr. Nicholas Fogelson writes about delayed clamping and the shifting of thinking in Obstetrics- one of the slowest medical fields to "change" from ideologies they've carried around for decades.

"..For the majority of my career, I routinely clamped and cut the umbilical cord as soon as it was reasonable. Occasionally a patient would want me to wait to clamp and cut for some arbitrary amount of time, and I would wait, but in my mind this was just humoring the patient and keeping good relations. After all, I had seen all my attendings and upper level residents clamp and cut right away, so it must be the right thing, right?
Later in my career I was exposed to enough other-thinking minds to consider that maybe this practice was not right. And after some research I found that there was some pretty compelling evidence that indeed, early clamping is harmful for the baby. So much evidence in fact, that I am a bit surprised that as a community, OBs in the US have not developed a culture of delayed routine cord clamping for neonatal benefit."

 The latest study on Delayed Cord Clamping, as reported in the BBC news states that preterm babies who's umbilical cords were left intact for a longer amount of time had a positive impact on the health of the infants.

'Delay cord cutting aids babies'

Delaying clamping 'allows babies to adapt to their surroundings'

Waiting up to two minutes to cut the umbilical cord after a premature baby is born could reduce the risk of bleeding on the brain, say researchers. A team from Brighton and Sussex University Hospitals reviewed seven studies of 297 babies.
Around half of units in the UK do wait, but others cut the cord as quickly as 10 or 15 seconds after birth.
The review is published by healthcare information group, the Cochrane Collaboration.
The seven studies which were reviewed measured blood pressure, red blood cell counts, blood volume, bleeding within the brain and the need for transfusions.
Between 60 and 80% of preterm infants less than 32 completed weeks' gestation require transfusion.
But premature babies often have trouble breathing, so doctors aim to move them to special care baby units where they are helped to breathe, which requires the umbilical cord to be clamped and cut quickly.
'A healthier start'
Medical staff ordinarily clamp the umbilical cord in two places after the baby is delivered, then cut the cord between the two clamps.
There are no formal guidelines for when the cord should be cut. The latest evidence showed 47% of units performed delayed cord clamping - anything between 30 seconds and two minutes after birth,
The researchers say reducing the chances of bleeding in the newborn's brain also cuts the need for transfusions.
They found the delay also reduces anaemia and increases blood pressure and blood volume, giving premature infants a healthier start in life.
Dr Heike Rabe, the neonatologist who carried out the review told BBC News Online: "A slight delay in cord clamping of preterm infants is good for their subsequent health.
"It is cheap, leading to no extra cost. The optimal timing is not known yet and needs to be assessed by further studies. Funding needs to be available to perform this clinical research."
She added: "If the cord is left unclamped for a short time after the birth, some of the baby's blood from the placenta passes to the baby to help the flow of blood to the baby's lungs," Rabe explains. "Delaying cord clamping for just a very short time helped the babies to adjust to their new surroundings better."

HERE to read the entire article

Time: Cutting the Cord too soon

Yet another study showing the benefits of delayed umbilical cord clamping, and the very real dangers of clamping the cord too soon.

Obstetrics: Cutting the Cord Too Soon

Time Mag.

The lungs of most newborn infants begin to work exactly on schedule. But among some babies, particularly the premature, the lungs fail to expand properly. The chest sags, breathing is rapid and the child turns blue. Many deaths during the first week after birth are attributable to this condition, which doctors describe as the "respiratory distress syndrome."

Obstetricians have long noted that babies suffering from such troubles either were delivered by Caesarean section, or were premature infants, or born of diabetic mothers. But in the A.M.A. Journal, a group of pediatricians* from the University of California suggests that the most important factor is the time at which the obstetrician clamps and cuts the infant's umbilical cord.

The California pediatricians base their theory on a study of 129 infants. Among 41 whose umbilical cords were clamped before they took their second breath, 21 showed moderate to severe respiratory distress. In another group of 52 infants whose umbilicals had been clamped some time after the second breath, only six suffered the same symptoms. The condition of the infants who retained their umbilical cords longest was by far the best.

There are sound reasons, say the doctors, for a slowdown in cutting the umbilical cord. Delay allows a gradual change from fetal to regular circulation without putting stress on blood vessels in the lungs and elsewhere in the body. The carefree manner in which the newly born infant is "disconnected" from his mother, concludes the report, "is in sharp contrast to the meticulous care with which the thoracic surgeon separates his patient from the heart-lung machine."

* Drs. Arthur J. Moss, Edward Duffle Jr. and Leonard M. Pagan of Los Angeles.

Read more: http://www.time.com/time/magazine/article/0,9171,830142,00.html#ixzz0fpieHgli

"Delayed Cord Clamping Should Be Standard Practice in Obstetrics"

Here is a link to a brilliant blog by Dr. Nicholas Fogelson OB about delayed cord clamping. I know that many of you will feel vindicated by his article and will want to read the numerous links and studies that he posts at the end of his blog.

In the comments at the end of the blog Dr. Fogelson comments thathe might develope this further into a peer-reviewed article. That is an article that I will look forward to reading.

Delayed Cord Clamping Should Be Standard Practice in Obstetrics

Dr. Nicholas Fogelson

There are times in our medical careers where we see a shift in thought that leads to a completely different way of doing things. This happened with episiotomy in the last few decades. Most recently trained physicians cannot imagine doing routine episiotomy with every delivery, yet it was not so long ago that this was common practice. ...

...For the majority of my career, I routinely clamped and cut the umbilical cord as soon as it was reasonable. Occasionally a patient would want me to wait to clamp and cut for some arbitrary amount of time, and I would wait, but in my mind this was just humoring the patient and keeping good relations. After all, I had seen all my attendings and upper level residents clamp and cut right away, so it must be the right thing, right?

Later in my career I was exposed to enough other-thinking minds to consider that maybe this practice was not right. And after some research I found that there was some pretty compelling evidence that indeed, early clamping is harmful for the baby. So much evidence in fact, that I am a bit surprised that as a community, OBs in the US have not developed a culture of delayed routine cord clamping for neonatal benefit.

HERE to read the complete blog and studies