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Let it Pulse: The Clamp Down on A Routine Birth Practice

Mama Glow | August 2, 2019

Awareness about Delayed Cord Clamping is on the rise with a growing number of parents choosing this postnatal care option for their own birth plan. With major news outlets covering it- including NY post, New York Times, and more, the practice is finding it’s way into popular culture and in birth discussions.

Before birth, the baby and placenta share a circulating blood supply, separate from the mother’s. Inside the uterus, the placenta and umbilical cord supply the baby with oxygen, nutrients and clears waste keeping the baby is a sterile and protective environment. During fetal development, the baby’s organs only need a small flow of blood because the placenta performs the role of lungs, kidneys, gut and liver for the baby. This is why a so much of the baby’s total blood volume is in the placenta at any given time. The blood circulating the placenta and cord is not ‘extra’ blood or waste – it belongs to the baby. When we clamp the cord too soon, the baby doesn’t get that blood.

The rate and volume of blood the baby receives during placental transfer with the cord intact is approximately 80 mL of blood by 1 minute after birth, reaching approximately 100 mL at 3 minutes after birth. This additional blood can supply extra iron to the baby, amounting to 40–50 mg/kg of body weight. Combined with the body iron present at birth in a full-term newborn, this may help prevent iron deficiency during the first year of life.

5 Important Questions You Should Ask Before You Clamp The Cord

So, what is delayed cord clamping?

Delayed cord clamping is a birth practice where the umbilical cord is not clamped or cut until after pulsation has ceased, or until after the placenta is delivered. The optimal timing of clamping the umbilical birth is the subject of continuing debate.

What are the benefits to delayed cord clamping?

The timing of clamping the umbilical cord, has a measurable impact on the outcomes for your baby. Research has shown that we delay cord clamping the newborn will receive up to 30% more of the fetal-placental blood volume than it would have with immediate cord clamping. That’s 1/3 of the baby’s blood volume! When your baby is born, the cord and placenta system will contain about one third of your baby’s blood- so, healthy blood volume for the transition to life outside the womb; and a full count of red blood cells, stem cells and immune cells. For mothers the risk for complications in delivering the placenta drastically decrease.

Is there an ideal time the cord should be clamped? 

The ideal timing for cord clamping has yet to be established. In most cases, umbilical cord clamping is performed within 15–20 seconds after birth, with the infant maintained at or below the level of the placenta. It’s been suggested that clamping the umbilical cord in all births should be delayed for at minimum 30–60 seconds, The World Health Organization recommends 1-3 minutes, with the infant maintained at or below the level of the placenta because of the associated benefits to the newborn, including:

  • increased blood volume
  • reduced need for blood transfusion
  • decreased incidence of intracranial hemorrhage in preterm infants
  • lower frequency of iron deficiency/ anemia in full term infants.

What does it mean to “milk the cord”?

To milk the cord blood is when the care provider hold the cord and squeezes it, stripping or “milking” blood towards the baby. This is another way to help modulate the blood flow and volume from placenta to baby. There was a study performed in Japan that reported umbilical cord milking reduced the need for red blood cell transfusions in the newborn period in premature babies. The same study also reported that milking the cord in extremely preterm infants increased infant blood pressure in the first 12 hours of life and urine output in the first 72 hours of life.

Can I still bank my cord blood if I delay cord clamping? 

It is possible to do both. 50 mL of blood is necessary for cord blood storage. If you choose to delay the cord clamping by 1 minute, around 80 mL of this blood is transferred into the infant, leaving more than enough to be stored in a cord blood bank. If you delay clamping by 3 minutes, 100 mL will have transferred to the baby. You would still have enough to collect for banking.

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