In the first minutes after birth, as it starts to breathe on its own, a newborn can receive a substantial blood transfusion from the placenta
Most expectant mothers are too concerned about a safe delivery to worry about precisely when the umbilical cord should be cut afterwards. But at a conference this week at Birmingham University, doctors and midwives will argue that timing of the procedure is vital – and that a delay in cutting the cord is safer for the baby.
At present, guidelines advise that in the third stage of labour (after the birth) the cord should be clamped and cut as quickly as possible, unless a mother specifically requests otherwise.
Drugs such as oxytocin, considered harmful to the baby, can then be given to the mother to speed up delivery of the placenta and reduce the risk of haemorrhage. Early cord-clamping also means the midwife can take the baby away to clear the airway and ensure the baby is breathing easily; and it is also thought to reduce the risk of jaundice.
But clinicians at the conference will argue that delayed cord-clamping – waiting at least 30 seconds, and preferably longer, before the cord is cut – can protect babies from iron deficiency and, potentially, irreversible developmental delay.
In the first minutes after birth, as it starts to breathe on its own, a newborn can receive a substantial blood transfusion from the placenta – as much as a 32 per cent increase in blood volume – with iron levels benefiting as a result.
A Swedish study of 400 children found that delaying cord-clamping reduced the risk of a baby having iron-deficiency anaemia, which can impair learning development and motor skills.
“The consequences of iron deficiency from early cord-clamping for some vulnerable babies could be serious,” says David Hutchon, a fellow of the Royal College of Obstetricians and Gynaecologists in London. “These range from death, to cerebral palsy, to autism, to Sids [cot death], to slightly lower intellectual ability.”
The Swedish study, and a review of 11 others published in 2008 by the Cochrane Library, also found no evidence that immediate clamping protects against jaundice in babies or reduces the risk of post-partum haemorrhage.