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April 29, 2013 by MELANIE JOHNSON
The Rush To Clamp and Cut The Cord: Experts Warn Umbilical Cords Should Not Be Cut For 5 minutes

For nine months, the umbilical cord is a lifeline between mother and baby, sending oxygenated blood to the growing fetus. Once the baby is born, usually within the first minute of birth, that connection is often quickly severed. Mounting evidence suggests that clamping the cord within seconds of the baby's arrival deprives it of vital blood from the placenta -- which can lead to iron deficiency and anemia in later life.

Medical bodies, senior doctors and the National Childbirth Trust (NCT) want maternity staff to instead leave the umbilical cord untouched for anything from 30 seconds to whenever it stops pulsating naturally - usually within two to five minutes.

"The later the better," said Midwife Naomi Karns. "Between four to five minutes is the ideal delay period in cutting the cord to maximize therapeutic potential."

The umbilical cord carries nutrients and oxygen from mom-to-be's placenta to the developing infant's abdomen. (It leaves a life-long impression in the form of the belly button.) When the practice of immediate cord clamping first began about a half century ago, the value of cord blood, especially its stem cells, which can develop into a suite of other cells, was not known. But now we know that stem cells have many therapeutic properties.

A review, which appears in an issue of the Cochrane Collaboration, found that delaying the clamping of the umbilical cord for up to 120 seconds in premature infants can lead to an increased number of red blood cells, the need for fewer transfusions due to anemia or low blood pressure, and a decreased risk of bleeding in the brain.

anemia - a disorder which means you have a less than the normal quantity of hemoglobin in the blood - can later be associated with brain development and can affect cognitive ability.

It is estimated that around 10 per cent of toddlers are iron-deficient.

Hospital policy for the past 50 years has been early clamping the majority of millions of babies born each year using this method.

The reason that waiting to clamp the umbilical cord can make a difference in a baby's health is because the delay allows blood to return from the umbilical cord back to the baby, which can help keep blood pressure normal and keep the red blood cell count up.

"Ob-gyns and parents should think about giving the cord blood to the baby," said researcher Paul Sanberg of the University of South Florida. "It only takes a few minutes."

Medical Colleges recommend 'early clamping and cutting of the cord' to health professionals as a key element of the 'active management' of the third stage of labour, just after the birth.

"It is not just regular blood going is nature's first stem cell transplant," says Sanberg.

After reviewing the majority of research in the field, Sanberg and his colleagues concluded that delaying cord clamping could reduce the infant's risk of many illnesses, including respiratory distress, chronic lung disease, brain hemorrhages, anemia, sepsis and eye disease.

The risk of such problems, and thus the potential benefit of delaying cord clamping, is particularly significant for premature babies and those born malnourished or suffering from other complications.

Women are able to request for the placenta to be cut later or to deliver it naturally, but only if the woman has a low-risk pregnancy.

Dr Andrew Gallagher, a consultant paediatrician at the Worcestershire royal hospital in Worcester, which adopted delayed cord-clamping in 2009, says that every healthy mother should have delayed clamping in their birth plan.

'Mothers should have as natural a birth plan as possible.

'Iron deficiency can cause serious problems. It affects the brain and learning capacity of toddlers ... [who] are going to be slower to learn, for example to speak and to understand.

It's time for sweep away an outdated and potentially harmful and thoughtless practice that we have been doing for decades.

Dr Gallagher estimates that around 30 to 50 percent of hospitals now delay the cutting of the placenta.

Belinda Phipps, chief executive of the NCT, said: 'When a baby is born, about a third of the baby's blood is still in his/her cord and placenta.

'With no good evidence to support it, it is accepted practice to accelerate the arrival of the placenta with an injection and clamp and cut the cord immediately, depriving the baby of this blood.'

Influential bodies such as the World Health Organisation now urge delay, while research published by medical journals such as the British Medical Journal (BMJ) have helped prompt a move away from immediate clamping.

"Evolutionarily, there is clearly value for this," Sanberg said, explaining that all mammals, including most humans through history, allow the maternal blood to finish being transferred before severing the cord. The squatting birthing position, only recently out of vogue in the West, may have even facilitated this transfer by harnessing gravity.

"Only in the last half century or so has mankind started cutting the cord early," Sanberg said.

A Swedish study published in the BMJ in 2011 found that infants who had had delayed cord-clamping at birth had larger than usual iron stores at four months and were less likely to be anaemic.

Melanie Johnson is a practicing Doula and expert in breast feeding practices for new mothers.

Reference Sources 101, 138, 231

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