Cord Clamping – When, how and why from Dr. Chad Hayes
Chad Hayes, is a physician passionate about providing parents with evidence-based information about children’s health, development, and behavior.
Lately there has been much discussion about when to clamp the cord, and it seems that there is still some debate. Dr. Hayes briefly discusses circulation before and after the baby is born:
The umbilical cord contains three blood vessels that carry blood from the baby to the placenta and back. There is a fascinating transition that occurs immediately after birth, during which the infant’s circulation switches from getting oxygenated blood from the placenta to using his own lungs. Part of this transition is that, as the blood flow is shifted to the lungs, the umbilical arteries contract until the blood flow to the placenta stops. After about 2-3 minutes, this transition has progressed to the point where there is no more blood flow through the cord.
Delayed cord clamping is waiting until the blood stops flowing through the umbilical cord, on average it takes 1-3 minutes. This time allows the blood that is in the cord to flow back into the baby. Research isn’t clear when it comes to healthy term infants, only a few studies have been conducted to know the risks or benefits to the baby. One study does show that children who are 4-6 years old and had delayed cord clamping have improved iron stores which showed improvement in developmental outcomes.
There are, of course, some potential risks of delayed cord clamping. While only slightly, delayed cord clamping can increase the risk of jaundice. Jaundice is caused from an increased amount of bilirubin that comes from the breakdown of red blood cells. If there is more blood from delaying cord clamping, then you will have more bilirubin. Jaundice is routinely tested for and easily treated but is a cause for concern because too much bilirubin can cause neurological problems.
One other concern that Dr. Hayes discusses is polycythemia or too many blood cells. The condition can have severe side effects but none have been recorded in cases of delayed cord clamping. Usually it provides an abnormal lab report.
Studies have shown a definite positive outcome in premature infants, including improved blood pressure and lower risks of severe complications like brain bleeds and bowel injuries. The cord can provide infants with 20%-30% more blood volume which can reduce the need for a transfusions, since iron stores will be higher.
Dr. Hayes says, ” ‘delayed cord clamping’ isn’t really a great term. Maybe we should just call it “cord clamping,” since that’s the way it’s supposed to work. It’s not the delay, but the practice of immediate clamping that is the intervention.”
To read more about cord clamping and cord care check out Dr. Hayes post Stumped by the Cord: delayed cord clamping, dry umbilical care.
Thanks to Dr. Chad Hayes for providing information for this post. Make sure to check out his blog ChadHayesMD.com. We look forward to welcoming him back to the lowcountry in 2016!