Delayed Cord Clamping
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Umbilical Cord is the link that connects the mother’s placenta and the baby in the womb. The cord continues to pulsate and transfer blood, oxygen and stem cells to the baby. A better transition from life in the womb, to the outside world, is possible from the extra blood for the baby; hence delayed cord clamping is the best option for newly born babies. Read on to know more about it.
What Is Delayed Cord Clamping?
Delayed cord clamping (DCC) is the elongation of the time between the delivery of the newborn and the clamping of the umbilical cord. It has been customary for 50 to 60 years to cut the cord immediately after the birth. However, some suggest that it is not good for the baby as it misses out a large amount of blood and other benefits. The World Health Organisation suggests that DCC is safe for full-term as well as premature babies, as long as they do not require breathing assistance; the cord being attached to the baby and the mother can significantly hamper resuscitation efforts.
Is Delayed Umbilical Cord Clamping Common?
In the past few years, the potential benefits of the delayed cord clamping have gained more attention. Although it has no risk for infants and mothers, it should be practised on healthy infants and mothers without complications.
How long Should You Delay Cord Clamping?
The circumstances of mother and baby influence the timing of the clamping of the umbilical cord. An infant receives 30% more foetal-placental blood volume in delaying cord separation than immediate cord clamping. The WHO recommends cord clamping not earlier than 1 minute in both term and preterm babies provided the baby doesn’t require immediate positive pressure ventilation or resuscitation.
Benefits of Delayed Cord Clamping
Before birth, the circulating blood supply is shared by the baby and the placenta. The baby is provided with oxygen and nutrients by the placenta and the umbilical cord. The functions of lungs, liver, gut, and kidneys of the baby are performed by the placenta. So, the baby organs require a small flow of blood. Hence at any time, placenta carries the significant portion of the baby’s blood volume. The blood in the placenta belongs to the baby. After birth, the placenta provides essential oxygen and nutrients and delivers the blood back to the baby. This imperative part of the birth process is called placental transfusion. Placental transfusion provides the baby with red blood cells, stem cells, immune cells and blood volume.
There are multiple benefits of DCC. Here are a few of them:
1. Neurodevelopmental Benefits
Extra minutes attached to the umbilical cord at birth may translate into a small boost in the neurodevelopment of the child several years later. Children with DCC have slightly higher social skills and fine motor skill than ICC children.
2. Decreased Risk of Anaemia
Breastfed children need to be supplemented with iron since breast milk is low in iron, which is needed to prevent anaemia. Infants require iron for rapid brain growth and development, too. A Study found that DCC increases the iron endowment at birth and haemoglobin concentration at two months of age. Delay in cord clamping of 2 minutes could help prevent iron deficiency from developing before six months of age.
3. Increased Blood Volume or Smoother Cardiopulmonary Transition
Approximately one-third of the blood volume resides in the placenta for both premature and full-term babies. This volume of blood is required to suffuse the foetal lungs, kidneys, and liver at birth. Babies whose cords are clamped with 2-3 min delay have adequate iron stores and smoother cardiopulmonary transition. Another potential benefit of this increased blood volume is increased blood platelets required for normal blood clotting.
4. Increased Levels of Stem Cells
Stem cells play an imperative role in the development of immune, respiratory, cardiovascular and central nervous system amid many other functions. It also repairs the brain damage suffered by the baby during a difficult birth. Delayed cord cutting results in an infusion of stem cells.
5. Better Outcomes for Preterm Infants
Premature babies who have DCC tend to have better blood pressure immediately after birth and need fewer drugs to maintain blood pressure. They also need few blood transfusions and less bleeding into the brain. It reduces the risk of critical bowel injury – necrotizing enterocolitis.
There are some risks involved, too, whether it is immediate or delayed cord clamping. We’ve explained the risks below.
Risks of Immediate Cord Clamping
Immediate cord clamping or ICC causes complications for both mother and baby. Here is the list of risks:
- ICC disrupts normal physiology and the birth process – it splits the baby from the still functioning placenta and stops the blood circulation.
- It results in the lower iron stores in the baby, which has an adverse effect on their neurodevelopment.
Risks of Delayed Cord Clamping
Here are some risks related to DCC:
- Polycythemia: Circulation of an excess of blood flow to the newborn may develop blood hyperviscosity, causing polycythemia.
- Hyperbilirubinemia: Due to increased iron stores, DCC babies will have a greater incidence of hyperbilirubinemia because of the high level of bilirubin in the blood. In the womb, the placenta takes care of the excess bilirubin, but a babies’ livers must process the bilirubin. This leads to jaundice and often requires phototherapy.
- Respiratory Distress: Respiratory distress occurs when there is not enough of a liquid coating the lungs after birth to keep the airways and tiny alveoli of the lungs open. This can cause cell damage near the lungs and a build-up of carbon dioxide in the blood. Due to this, babies need to be placed on ventilators.
From the pros and cons, it is clear that the benefits of DCC do outweigh the hypothesised risks. DCC is beneficial to both premature and full-term infants with higher levels of iron in the blood and better oxygenation of brain tissues.
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