Delayed cord clamping: 3 minutes to save your baby's life

By  | 

It's likely something you haven't heard about unless you've recently given birth: delayed cord clamping.

More hospitals are now waiting to cut the cord, particularly in premature babies who need the extra support. But Silicon Valley is now stepping up by mandating a three-minute delay for all newborns.

Here is an outline of the benefits and the rest of the story for us.

Everyone looks forward to the cuddles and reading, especially big sis Jazlyn. It's a moment that mom Patty Mier wasn't sure she would ever be able to experience.

"Jazlyn was born at 27 weeks, at 2 pounds. She did have a Grade 4 bilateral brain bleed," Mier said.

Jazzy is doing well now, due in part to the efforts made by doctors in the very first few minutes of her life. They performed what is called delayed cord clamping.

"Usually a clamp is applied that truncates the blood flow between mother and baby, and delayed cord clamping just implies that we wait a little. It has a lot of benefits for the baby," Santa Clara Valley Medical Center head of the neonatal unit Dr. Balaji Govindaswami said.

"They had told us with the delayed cord clamping she would receive that extra oxygen in her blood to help with her brain," Mier said.

The extra time allowed Jazlyn's blood pressure to stabilize as well as increase levels of iron and brain myelin.

"We believe that some of the benefits of her brain being able to recover were probably helped waiting that minute," Govindaswami said.

"You really don't think about all this stuff until you're actually given the situation," Mier said.

Fortunately, Govindaswami was prepared for the situation. He's one of the leading advocates of delayed cord clamping in the country.

"I would say that we're the first hospital that has embraced this standard of care and taking it to the next level. We like to wait for two to three minutes for all babies, if possible," he said.

And for Mier, that's the right call.

"When you're in a tough situation, all you think about is your child, and you just want the best for them," she said.

The World Health Organization recommends waiting at least one minute before clamping. Govindaswami urges expectant parents to also advocate for themselves.

Research has found that the procedure could save the lives of one-third of premature babies worldwide, or as many as 100,000 babies.

RESEARCH SUMMARY
DELAYED CORD CLAMPING: 3 MINUTES TO SAVE YOUR BABY'S LIFE REPORT #2680

BACKGROUND: Delayed cord clamping (DCC) is the prolongation of time between the delivery of a newborn and the clamping of the umbilical cord. It is usually performed 25 seconds to 5 minutes after giving birth. DCC allows more blood to transfer from the placenta to the baby, sometimes increasing the child's blood volume by up to a third. The iron in the blood increases the newborn's iron storage, which is vital for the development of a healthy brain. DCC is typically only used with preterm infants, as babies born before full-term are said to benefit greatly from the extra blood received. The American Congress of Obstetricians and Gynecologists (ACOG) endorses DCC in preterm infants but believes there isn't enough evidence currently to confirm the potential benefits of delayed umbilical cord clamping in full-term babies. The lack of research in the past has meant for many years standard care during the delivery of the placenta has been to clamp the umbilical cord immediately after birth (10 – 30 seconds). Immediate cord clamping has also been the preferred option because it allows for the immediate transfer of the baby to the neonatologist. (Source: https://americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/)

BENEFITS AND RISKS: New studies have found that DCC can have a positive effect on both preterm and full-term babies with benefits including an increase in placental transfusion, a 60 percent increase of RBCs and a 30 percent increase in neonatal blood volume. However, some infants can be at a greater risk of hyperbilirubinemia, polycythemia, and respiratory distress. Hyperbilirubinemia occurs when bilirubin levels build up too much in the blood. In the womb, the placenta takes care of the excess bilirubin, but after birth, the baby's liver must process the bilirubin on its own. Polycythemia occurs when there is an excess of red blood cells in circulation. This can cause issues with breathing, circulation, and may lead to hyperbilirubinemia. Respiratory distress occurs when there is not enough of a liquid coating in the lungs after birth to keep the airways and tiny alveoli of the lungs open. This can cause a buildup of damaged cells near the lungs and a buildup of carbon dioxide in the blood. When this happens, babies often need to be placed on a ventilator. (Source: https://americanpregnancy.org/labor-and-birth/delayed-cord-clamping-risks-benefits/)

NEW STUDY HELPING NEWBORNS: Hudson Institute, Monash University and The Royal Women's Hospital in Australia conducted a trial to understand if babies who stay connected to their mother via the umbilical cord at birth had a smoother entry into the world, including the one in 10 babies who fail to spontaneously breathe. Study lead, Hudson Institute and Monash University PhD student and clinician, Doug Blank, MD, explains, "While babies are in the womb, the placenta acts like a lung, providing the baby with oxygen and nutrients. Until a newborn is safely able to breathe by itself, it seems logical that babies should stay attached to the placenta via the umbilical cord for a few minutes after birth until they are breathing well enough on their own to provide their body with the oxygen." The original discovery revealed that newborns who need help breathing after birth can be safely assisted by doctors while remaining connected to their mother which could be up to five minutes after birth. Babies who have this continued support from their mother had more stable oxygen levels and heart rates than those whose umbilical cord is clamped immediately at birth. (Source: https://hudson.org.au/latest-news/early-cord-clamping-could-save-lives/)