Delay Umbilical Cord Clamping After Birth, Physicians Group Recommends
Doctors shouldn't be too hasty to cut the umbilical cords of babies who've just been delivered, a physicians group says. The American Congress of Obstetricians and Gynecologists, in an opinion from its Committee on Obstetric Practice that was published on the ACOG website, said that instead of quickly clamping off the cord that connects the newborn to its placental sac, doctors should wait an additional 30 to 60 seconds. Those extra seconds for babies born at term are associated with an increase in hemoglobin levels in newborns, the statement said. Hemoglobin is a red cell protein that carries oxygen throughout the body and improves iron stores for several months. The statement said good hemoglobin levels prevent iron deficiency anemia during the first year of life. Iron deficiency has been linked to cognitive delays and impaired motor and behavioral development in the child. Waiting several seconds more to clamp off the umbilical cord also has benefits for premature babies, ACOG said. The practice improves circulation in the newborn just after birth and decreases the need for blood transfusion due to a decrease in red blood cell volume. In addition, delaying clamping lowers the risk of brain hemorrhage and intestinal disease. While there are various recommendations for times to cut the cord, Maria Mascola, the lead author of the new guidance, said there is increasing evidence that waiting an additional 30 to 60 seconds to clamp the umbilical cord has clear health benefits. Mascola said that the practice does not interfere with early care of the newborn, and that it does stimulate breathing and skin-to-skin bonding between mother and child immediately after birth. The opinion issued by ACOG on delayed clamping noted that there is a slight risk of jaundice in the newborn. But the problem is manageable, and doctors and other health care professionals should have proper procedures in place to handle it. Jaundice is a temporary yellowing of the newborn baby's skin and eyes because of excess bilirubin, a yellow pigment of red blood cells. The group noted that delaying clamping does reduce the amount of blood from the newborn that is available for banking for future use, and families considering banking the blood should be counseled accordingly. Banked cord blood contains potentially lifesaving stem cells for use in the event that the infant becomes sick with leukemia, lymphoma or sickle cell anemia, to name a few conditions.