Cutting the umbilical cord? Not so fast, says new research

Throughout history, our ancestors understood the nutrient-rich nature of the umbilical cord and of leaving babies attached to it minutes beyond birth. Some mammals, such as chimpanzees, leave the cord attached for days after delivery, while others slowly chew it off.

Now, a new study from Baylor Research Institute shows the science behind those animal instincts—and could give delayed cord clamping the support it needs to someday become more mainstream.

Research coming from Baylor University Medical Center at Dallas’ neonatal intensive care unit (NICU) suggests that letting mom and premature baby stay physically attached for just a few seconds longer could save that newborn’s life.

According to the American College of Obstetricians and Gynecologists, they state that obstetricians should wait at least 30 to 60 seconds after birth before cutting the umbilical cord for all healthy newborns. This is quite the opposite of what doctors used to think, once believing that immediate cutting of the cord would reduce the risk of maternal hemorrhage. However, there’s been no research to support that moms are put at any risk, and in fact, there are clear benefits.

The Positive Benefits of Waiting

In the study, researchers reviewed 148 very preterm infants (less than 32 weeks’ gestation), which were a mix of historic and current patients at Baylor Dallas. When comparing babies who were immediately removed from the placenta and had the cord cut with those who had the 45-second delay, the effects of waiting were evident.

“We were impressed by the overall results, especially the significant reduction in intraventricular hemorrhage [bleeding in the brain] by almost 50 percent,” said Arpitha Chiruvolu, MD, FAAP, the principal investigator for the study. “There were no adverse effects, and significantly fewer babies who got delayed cord clamping were intubated in the delivery room.”

The study also showed that in the first minute after childbirth, oxygen-rich blood from the placenta flows to the baby through the umbilical cord — supplying extra oxygen supplements for the first breaths. The blood also carries important nutrients, iron, antibodies, and clot-making factors.

The Future for Delayed Cord Clamping

Delayed cord clamping has become more popular in full-term infants, but its use for premature babies was previously unclear, mostly because doctors weren’t sure if leaving preemies in the placenta could make things worse. This was despite the fact that the American College of Obstetricians and Gynecologists endorsed 30- to 60-second delays for all babies in 2012.

“When we were reviewing literature on delayed cord clamping, we found that it might be associated with good outcomes in preterm [infants], but a large number of hospitals do not have a consistent policy,” said Dr. Chiruvolu, a neonatologist on staff at Baylor University Medical Center and quality director for Baylor’s NICU.

Delaying clamping isn’t recommended in all cases, and the jury is still out for its widespread use. For instance, delays longer than a minute have been linked with neonatal jaundice — which requires onsite phototherapy — and some infants born with heart or breathing problems need immediate cord cutting and resuscitation.

Barring those special circumstances, and if research continues to support the technique, delayed cord clamping could be more mainstream in the future — helping more moms and babies reconnect with their animal instincts.

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Cutting the umbilical cord? Not so fast, says new research