Delayed Cord Clamping?

[libbyam2003]

I'm interested in getting more information about delayed cord clamping. Does anyone have links to reputable info?

 

[TrixieLox]

I'm interested in this too after seeing the news today. Presume you're posting this in response to that? More info in this Guardian article. I guess it doesn't harm delaying the clamping so might as well ask for it?

 

[MindUtopia]

It's not from the U.S. as I don't think there has been as much policy change there since there's no national health care system, but here's an article from the Royal College of Midwives here.

https://www.rcm.org.uk/midwives/news/clamping-update-to-be-delivered/

There's also a practice guideline in PDF from the RCM about delayed clamping if you search for it on their website as well if you want really in depth clinical details. It's generally considered the best practice here in the UK now and all babies should ideally have delayed clamping unless there is a reason not to.

I did delayed clamping with my daughter. Actually, the cord stayed intact for over an hour while I delivered the placenta. Assuming everything has gone well and baby doesn't need to be moved off your chest for additional care, I can't see why anyone wouldn't want to do it. It not only makes sure baby gets all the benefits of the cord/placenta blood, but (and I think almost even more importantly) buys you extra time to have skin-to-skin contact and bond with your baby while you are still connected. You never get those moments back and I loved that I had that extra hour with her right after birth when no one could have physically separated us.

 

[libbyam2003]

Trixie, yes that article is what got me thinking about it! It popped up on my facebook from Babble.

mindutopia - Thank you for the input and insight!

I've read the delay might increase odds of jaundice, so I'm looking to find what they say for both sides of the debate. Looks like they also say it can lead to hemorraging for the mother, but a lot is written to shoot that down so not really as concerned about that as about the jaundice.

Positives, helps iron levels... along with all the bonding stuff of course.

 

[_Lexi_]

I really wanted this, but after our history with Joshua, been told its not an option x

 

[Zfbaby]

We've asked to delay clamping but have to discuss it in detail on the day. I'm having a c-section so not 100% sure how this will work for us.

 

[Mel_jj]

I did delayed cord clamping with DS2 and wish I could have done it DS1, it means that all babies blood that is left in the placenta/cord/you can get back in baby before its cut, this obviously has many benefits and means baby will have its full blood volume. It was really nice to have the longer skin to skin as well before baby was taken to be weighed etc etc.

I am planning on doing it again this time!

 

[MindUtopia]

Trixie, yes that article is what got me thinking about it! It popped up on my facebook from Babble.

mindutopia - Thank you for the input and insight!

I've read the delay might increase odds of jaundice, so I'm looking to find what they say for both sides of the debate. Looks like they also say it can lead to hemorraging for the mother, but a lot is written to shoot that down so not really as concerned about that as about the jaundice.

Positives, helps iron levels... along with all the bonding stuff of course.

Here's another article that I just saw today from BBC which gives lots of good info: https://www.bbc.co.uk/news/health-22307946

And yes, you're right, it will increase the chances of your baby being jaundiced, but that's not a bad thing (though some doctors and midwives still panic about it). There are two types of jaundice: the severe kind which means your baby's body isn't flushing bilirubin out because the liver is underdeveloped and isn't working properly (this is a bad thing and needs to be treated) and physiologic jaundice, which just means your baby has more bilirubin because he/she has more red blood cells (which is a good thing!). This second kind is what will likely happen with delayed clamping and there's actually some evidence that the heightened bilirubin in newborns blood can be protective and have some antioxidant benefits. If you think of it, the cord doesn't naturally detach at birth, so our bodies are obviously meant to remain attached for a period of time to the placenta (or evolution would have made us differently), so there's likely a reason why this is. Besides the heightened iron levels, these antioxidant benefits might be another reason for this. I also read somewhere (which I can't find now) that babies with delayed clamping don't have the vitamin K deficiency that can in rare cases cause hemorrhaging in babies. I don't think this has been extensively studied yet, but it also makes a lot of sense.

As for hemorrhaging in mothers, delayed clamping should have no relation to PPH unless it was done at the expense of a managed 3rd stage in women who needed it. Most women will naturally deliver the placenta in about an hour or so, but for those who don't there is an increased risk in some cases of PPH and things like a retained placenta. In those cases, they can give you an injection of synthetic hormones (Pitocin, basically) to expel the placenta. However, you can still wait 3-5 minutes before clamping and cutting the cord because almost no one's placenta would be delivered that quickly anyway, so you'd still be waiting on the placenta and have plenty of time to receive the injection before any issues came up with PPH. My placenta didn't come naturally and we waited an hour (so obviously way more than the minimum 3-5 minutes) and then clamped and cut the cord and then I got the injection. It was totally fine and I didn't bleed any more than normal. And I had a home birth, so it was all done at home in my bedroom while I just laid in bed and relaxed with my baby. So no big deal at all.

 

[libbyam2003]

Thank you everyone for the responses! And mindutopia, wow, what a wealth of knowledge!! Now I just hope my dr sounds half as smart with his answer when I ask him in 2 weeks! Because right now I'm definitely hoping he agrees with the merits of delaying the clamping. Thanks for the article!

 

[misslissa]

Defo planning on doing this if all goes well. Can't see any down side so no reason not to.

 

[Jess137]

I told my Dr that I wanted to delay cord clamping, and was expecting an argument - but she said that she does this already even for c sections! She said that recent research shows that there are a lot of benefits. So dr's in the US are starting to see the light

 

[oedipamass]

^^ That's great! I just brought it up to my doctor this morning and he was very resistant and acted like I was crazy. : (

 

[AlesiaNicole]

I'm curious how it works with a c-section? I'm going to talk to my doctor about it but what do they do with the baby? Is the cord long enough to allow the baby behind the screen thing they have up?

 

[summer rain]

My main worry with DCC is that OH and I already have a seemingly genetic problem where our babies get very heavily jaundiced and tests have never shown an obvious cause-as in a handful of cases it is due to ABO incompatibilty but most cases it has been proven that it isn't. In the case of OH and I we know for sure that is not an issue as we both are O+. The theory several specialists have come out with when dealing with our babies is that they get too much blood from the placenta and from me.

This is even without significantly delayed cord clamping though the two cases where the cord clamping was slightly delayed that bit longer, not deliberately it just happened that way, the jaundice was significantly worse and required phototherapy and those babies were very very red which soon turned to yellow. My eldest was the worse as his blood had so many cells in it that it was like thick ketchup or treacle and it affected his breathing and feeding so he ended up very very poorly indeed. The fact he was getting dehydrated due to not feeding well and this problem it was like a vicious cycle. My two boys where the cord was clamped almost immediately were still very yellow but didn't need readmission or phototherapy. So I'm in a bit of a dilemma here as no-one I have asked, midwives, doctors and also looking at research it's just not clear one way or another. None of mine have ever been anaemic and all have had excessive levels of red blood cells regardless. So just not sure what to do . I absolutely want to avoid any risk of this baby needing to be readmitted but in this area if their bilirubin is above a certain level at a week to ten days old they absolutely insist on it xx

 

[Anthrogirl]

All very interesting and I have no articles to add. I find it fascinating, having foaled mares, that the reproductive and neonatology veterinarians stress the vital importance of letting the cord pulse out before clamping. In fact, they'll tell you that if you manage nothing else in the birth, ensure quiet so that the cord can pulse out before mom or baby gets up. When I brought up this point as well as others (ie increased hemoglobin, more rapid oxygen stabilization in baby, easier third stage for mom) my OB with #2 said that it's more important for all of the other non-human mammals and in humans it really doesn't make a difference. Really?

 

[MamaFlick]

I talked to my midwife about this on Friday and she said that it's a good idea because it helps reduce the baby's chance of being anemic for the first three months of life. I haven't done a lot of research on my own but I trust her opinion. Also read a little bit about it and everything I read made it seem like a good idea.

https://www.scienceandsensibility.org/?p=5730

 

[mnonie]

I'm gonna do a bit of research as to me it seems more natural, then put it to OH. Not sure what he'll say as I know his position if there's any risk to me . We asked at our antenatal class and were told that they've never not clamped the only thing that puts me off is can OH still clamp the cord after its stopped pulsating? X

 

[Jess137]

Yes and it's easier to cut the cord after it stops pulsing too

 

[mnonie]

sorry up here there is no midwife info on this, do you still have the injection? would it take a awful lot longer for the womb to reduce in size?

 

[summer rain]

Yes you can still have the injection at any point and I don't see how it would make any difference to the womb contracting in size? Xx