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Esther Hornstein, L.Ac., Dipl. | Article

Delayed Cord Clamping: the Future of Labor and Delivery?

11/13/2012
By Esther Hornstein, L.Ac., Dipl.

Throughout almost all of human history, in all parts of the world, the umbilical cord remains connected both to the baby and the placenta at least until the cord stops pulsating and sometimes longer. The practice of quickly clamping and cutting the cord within 20 seconds of birth is a common practice in most American labor and delivery rooms. Doctors do this so that other professionals can take charge of and examine the baby right away. However, recent research has had doctors wondering if this practice is beneficial for healthy and stable babies.
While a baby is in utero, blood is circulated between the baby and the placenta via the umbilical cord. Once the baby is born, as much as one-third of the child’s blood volume remains in the cord and placenta. The cord continues to pump this blood to the baby for 2-5 minutes after birth. To ensure that the baby’s blood does not pump back into the placenta, a substance called Wharton’s jelly which is in the cord, responds to the change in temperature when outside of the womb and becomes gelatinous. The Wharton’s jelly thereby fills the cord and naturally occludes the blood vessels a few minutes after birth.

When the cord is impulsively cut, the baby sustains an enormous loss of blood. This fact leads some pediatricians to advocate for “delayed cord clamping”, this allows the cord to finish pulsating before it is clamped and cut.

Benefits of Delayed Cord Clamping
A growing number of studies suggest that delayed cord clamping is responsible for improving a full term baby’s blood count, improving oxygen levels in the brain, reducing risk of serious bacterial infections, stabilizing blood sugar levels, affording the baby with a supply of iron for six months to a year, improving organ growth and more.
According to Traditional Chinese Medicine, the blood circulating between the baby and the placenta after birth cleanses the baby from maternal toxins accumulated during pregnancy. By leaving the cord alone until pulsating stops, according to tradition, the baby is afforded even more immunity.
Modern Research Proving Traditional Practices
At one time, the medical community thought, erroneously, that allowing all the blood to evacuate into the baby from the cord could cause jaundice. Doctors who continue to object to delayed clamping do so because either because they do not want to try something “new” or because they have not read the research (British Medical Journal 2007, August 17 18;335 (7615):312-3. Weeks, A. “Umbilical Cord Clamping After Birth”) on the topic.

In fact, evidence to support delayed cord clamping is so strong that the Royal College of Obstetricians and Gynecologists now require delayed cord clamping in all hospitals in the UK.
The American Academy of pediatrics published an article in April 2006 recommending that clamping be delayed to reduce anemia and improve iron storage. If cord clamping is done too soon after birth, the infant may be deprived of a placental blood transfusion, resulting in lower blood volume and increased risk for anemia. Additionally The Journal of Pediatrics, a publication of The American Academy of Pediatrics, states that “Early umbilical cord clamping contributes to elevated blood lead levels among infants with higher lead exposure.” (November 2007)

The gap from the pediatrician who wants delayed cord clamping to the obstetrician who ultimately decides when to cut the cord is often bridged by the mother. Most OBs will not delay the cord clamping unless the request is clearly expressed by the mother. Unlike in the UK, American OBs do not have a standard procedure when it comes to cord clamping. However, some OBs do make a habit of delaying the cord clamping as long as the baby does not need to be transported to specialists or the intensive care unit. A mother who feels strongly about the issue should discuss it with her OB before going into labor to make sure her doctor knows her preferences.

Delayed cord clamping is beneficial even in cases of complicated births. For example; if the baby is not breathing right away after birth, delaying clamping will allow blood and oxygen to flow to the baby from the placenta until the baby’s lungs begin to breathe.

Delayed Clamping Vs. Cold Storage and Donation
Some parents choose to harvest the cord blood and bank it in private cold storage for future stem cell use for family members. This necessitates rushing to clamp and cut the cord early, to prevent valuable stem cells from going into the baby. The lifetime probability of undergoing a transplant of stem cells from a donor (such as a sibling) is 1 in 400. The overall odds of undergoing any stem cell transplant are 1 in 217.
Dr. Alan Greene, a prominent natural-style pediatrician, calls the extra blood the baby receives from delayed cord clamping “once-in-a-lifetime,” rich, umbilical cord blood. This blood is packed with an assortment of powerful stem cells. It would be better to let these potent stem cells plant themselves in the baby as a last gift at birth, to grow within and carry out the purposes for which they were designed than to store them, perhaps needlessly for many years. Cutting edge science is just beginning to appreciate and understand the true value of this gift. By letting the baby receive the cord blood, the parents may be preventing the very diseases that would be cured by banking it.
Another alternative is donation. The act of donating cord blood is a very generous and altruistic deed. Donated cord blood samples can aid in the treatment of leukemia and other life threatening illness. However, one must realize that if a blood sample size is too small for such treatment, it will be sold for research. About 50%- 75% of donations are not adequate enough to use as stem cell transplants and, therefore, the hospital takes the liberty of selling them. The hospitals are paid, for donated cord blood that can’t be used for human transplants, in the sums of thousands of dollars to the highest bidder. Even though the mother’s motives for donating her child’s blood are virtuous, the hospital’s motives for facilitating cord blood donations are not truly noble.
To reiterate, if the cord blood donation is not large enough to be used for a stem cell treatment, it may be used to promote government research of cloning, weaponry and so on. It may be greater to allow the child to receive its rightful blood than to donate it to an anonymous party. To maintain the available supply of stem cells, it is possible for stem cells to be harvested from the Wharton’s jelly of the cord after the blood has finished pumping.
Mothers have a choice about what happens to their baby’s cord blood. Let them know that delayed cord clamping might just be the link to her baby’s health.

Esther Hornstein is a wife and a mother of 2. She holds a New York State license to practice acupuncture and is nationally board certified by the NCCAOM. She has participated in acupuncture hospital projects in Lutheran Medical Center and the NYU Hospital for Joint Diseases.