Wednesday 21 March 2018

Delay in clamping umbilical cord of newborn babies boosts their iron, doctors find

Jane Kirby

WAITING at least three minutes before clamping the umbilical cord in healthy newborn babies improves their iron levels, new research suggests.

Delaying clamping should be standard practice and is not linked to jaundice or other problems for the baby, according to the study published online in the British Medical Journal (BMJ).

Previous research has shown conflicting results on the ideal time for clamping the umbilical cord, although other researchers have found a delay improves iron levels.

The Royal College of Obstetricians and Gynaecologists (RCOG) has no specific recommendation on when the umbilical cord should be clamped but its scientific opinion paper says: "Infants who have immediate cord clamping have lower iron stores for up to six months after birth."

It calls for more research into the area but adds: "If there is no need to rush a newborn baby to the resuscitaire, simple measures such as drying and keeping warm may be instituted before separating the infant from the placenta."

In the latest study, experts in Sweden analysed 400 babies about to be born after a low-risk pregnancy.

They were split into two groups, one which had the umbilical cord clamped at 10 seconds or less after delivery and the other which had the cord clamped three minutes or more after delivery.

At four months, the babies had their ferritin levels tested - used to determine how much iron the body has stored.

Babies who had a three-minute delay before their cord was clamped typically had a 45pc higher ferritin concentration and a lower prevalence of iron deficiency than the other group.

They were also less likely to have neonatal anaemia after two days.

The authors said: "Delayed cord clamping, compared with early clamping, resulted in improved iron status and reduced prevalence of iron deficiency at four months of age, and reduced prevalence of neonatal anaemia, without demonstrable adverse effects.

"As iron deficiency in infants even without anaemia has been associated with impaired development, delayed cord clamping seems to benefit full-term infants even in regions with a relatively low prevalence of iron deficiency anaemia."

The authors said that in Europe, the prevalence of iron deficiency anaemia is 3pc to 7pc among young children, while iron deficiency alone could be as high as 26pc.

The researchers estimated that, for every 20 babies having delayed clamping, one case of iron deficiency would be prevented, regardless of whether the baby also had anaemia.

A study published in 2007 found that early clamping of the umbilical cord does not benefit mother or baby and could be harmful.

Dr Andrew Weeks, a senior lecturer in obstetrics at the University of Liverpool's School of Reproductive and Developmental Medicine, said there were benefits in waiting before clamping or cutting the cord.

Another 2007 study published in the Journal of the American Medical Association, said waiting two minutes before severing the cord cut the risk of serious blood disorders and benefited the baby in the first few months of life.

The research, involving around 1,900 newborns, also found that a delay of at least two minutes reduced the risk of anaemia and low iron levels in the blood.

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