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The Importance of Delayed Cord Clamping

PROTECT YOUR BABY’S PLACENTA AND UMBILICAL CORD BLOOD

Jeanice Barcelo – September 4, 2011

This is a note for all parents. Please be aware that, without proper awareness and precautions, your baby’s life force can become a marketable commodity. Hospitals are selling infant cord blood to the highest bidder, and parents who allow hospitals to keep their baby’s placenta are endangering their child’s physical and spiritual well-being.

It is important to understand that the clamping and cutting of a baby’s umbilical cord immediately after birth (or before the cord has stopped pulsing) will enable the hospital to gather up the baby’s cord blood and sell it for profit.

“Anti-ageing stem-cell injections composed of umbilical cord blood – £8,500. Consultations cost £150 per hour and take place in London’s Wimpole Street with Dr Robert Trossell. His patients fly out to Holland, where treatment is carried out. Antiageing treatments involve being injected with stem cells extracted from the umbilical cords of babies who have had a natural birth to full term… They claim that stem cells have the ability to rejuvenate the body and renew the cells, not just to produce younger, smoother skin, but increased sex drive and energy.”

A barbaric kind of beauty
http://www.dailymail.co.uk/femail/article-399376/A-barbaric-kind-beauty.html

“When parents sign consent allowing the hospital to “dispose” of the placenta and other remnants of birthing, they can be sold for medical research as opposed to being burned, for as much as $30,000 each. This figure was reported by the Children’s Hospital in Randwick, Australia. This was confirmed in the 10th edition of the Principles of Anatomy and Physiology, 2003 page 1076.”

Restricted Umbilical Cord Problems
http://www.givingbirthnaturally.com/restricted-umbilical-cord-problems.html

It is also important to understand that premature clamping and cutting of the umbilical cord is extremely detrimental to the well-being of an infant:

“In as little as 5 minutes after birth, the umbilical cord naturally begins to clamp, halting this blood flow. The common practice of hospitals, however, is to immediately place a clamp on the cord, usually within 1 minute, and often within 30 seconds, following the baby’s birth. This deprives the baby of a continuous source of oxygen until the lungs begin functioning properly. In addition to injuring the baby’s lungs, this lack of oxygen can cause serious brain damage, leading to birth injuries such as cerebral palsy, autism, learning disorders and mental deficiency.”

Doctors’ Practice of Clamping Umbilical Cord Too Soon May Cause Brain Damage, Cerebral Palsy, and Autism
http://www.chicagobirthinjurylawyerblog.com/2009/05/doctors_practice_of_clamping_u.html

AVOID LETTING MEDICAL PERSONNEL CUT YOUR BABY’S CORD TOO SOON, AND MAKE SURE YOU DO NOT ALLOW THEM TO KEEP YOUR BABY’S PLACENTA OR UMBILICAL CORD BLOOD!

Special note for fathers — please do not allow yourself to be manipulated into hurting your baby when the hospital staff offer to let YOU cut the cord. Unless that cord has stopped pulsing, please don’t cut it!!! And do whatever you can to prevent anyone else from touching it too.

“In a natural vaginal birth with no medications, the cord pulsates on average for 7 minutes. In a medicated birth, including c-sections or babies with a compressed cord, the cord will pulsate for as long as 20 minutes. Good practice is to leave the cord alone for 12 minutes or until it turns white/silver in color.” – see featured image

Restricted Umbilical Cord Problems
http://www.givingbirthnaturally.com/restricted-umbilical-cord-problems.html

Link to original article HERE

RELATED:

Photo: The pale looking baby had the cord clamped immediately. The other baby’s cord clamping was delayed. Can you see the dramatic difference? Source: Natural Birth and Baby Care

– ACOG Recommends Delayed Umbilical Cord Clamping for All Healthy Infants
December 21, 2016
http://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-for-All-Healthy-Infants

– 5 Benefits Of Delayed Cord Clamping
http://www.mommypotamus.com/benefits-of-delayed-cord-clamping/

– Just Say No: Cord Clamping
https://www.naturalbirthandbabycare.com/just-say-cord-clamping/

– Birth Injuries Related to Umbilical Cord Clamping
http://www.cordclamping.org/

– How Early Umbilical Cord Clamping Damages Babies’ Brains

– Commonly Asked Questions About Childbirth Answered

– THEY ARE STEALING YOUR BABIES CORD BLOOD
http://birthofanewearth.blogspot.com/2011/11/they-are-stealing-your-babies-cord.html

– ON THE THEFT OF INFANT CORD BLOOD FROM PREMATURE BABIES
http://birthofanewearth.blogspot.com/search/label/Umbilical%20Cord%20Cutting

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From Quora:

How soon after a baby is born should the umbilical cord be clamped/cut?
https://www.quora.com/What-determines-whether-a-child-gets-an-innie-or-outie-belly-button

Laszlo B. Tamas, Neurosurgeon with ties to the Bay area and Silicon Valley.
Updated Apr 21, 2014 · Upvoted by Kate Simmons, myofascial pain specialist and Liang-Hai Sie, Retired general internist, former intensive care physician.
When I first approached this question, I almost passed on it. Though I’m a physician, Obstetrics is very far from what I do, and the question seemed to be merely technical in nature. I imagined there would be various opinions, and little science. But I did a little digging … and boy, was I completely wrong!

The first few minutes of your life could be your most important!

Delayed (1-3 minutes) clamping of the umbilical cord is clearly better in most situations.

And it’s not just me saying that, but the World Health Organization, International Federation of Gynaecology and Obstetrics, editorials in the British Medical Journal, and by numerous leaders in academic Medicine, of which group I can recommend:

David Hutchon (writing in the British Medical Journal):
http://www.bmj.com/content/341/b…

Nicholas Fogelson (University of South Carolina):
http://academicobgyn.com/2009/12…
http://academicobgyn.com/author/…

Most of continental Europe has adopted delayed clamping long ago.

Many reputable organizations accept delayed clamping as a perfectly reasonable option, including the American Academy of Pediatrics and the Canadian Society of Pediatricians. Meanwhile, the Royal College of Obstetricians and Gynaecologists is calling for another randomized trial, while the American College of Obstetricians and Gynecologists seems to be burying its head in the sand.

But that’s just opinion. Where’s the proof?

1. what does Nature say?

All mammals switch from placenta to lung breathing at birth by themselves, and have done so for millions of years.

Before birth, a large part of the fetal blood volume is circulating in the placenta, where it picks up its supply of Oxygen and nutrients. Kind of like scuba gear, until the fetus becomes a neonate and takes its first deep breath. That moment sets in motion the huge transition from sending blood to the placenta for essentials to sending blood to the lungs.

The umbilical cord continues to carry blood back and forth from the placenta until nature sends signals that:

the lungs are working fine (high PO₂)
vital organs have enough blood flow (central venous pressure rises to that of normal neonate)

After these signals are received, fetal blood left in the placenta (as much as 40% of the newborn’s total blood volume) is squeezed back to the fetus to fill the lungs (“placental transfusion”), the arteries and vein in the umbilical cord constrict really strongly, and their walls get swollen, cutting off all blood flow.

In humans, without a bunch of drugs interfering, this “natural clamp” (loss of umbilical cord pulsations = no blood flowing through) occurs 1 to 6 minutes after birth (with analgesics, the range is 1 – 20 minutes).

Once the cord blood flow is stopped, the placenta can then be expelled, and then the whole set fall off anywhere from an hour to a day or so later.

This is the way it has been for mammals, and the way it was for the original native cultures around the world. And what a robust mechanism it is! Keep in mind – things that change this mechanism may lead to fetal disaster, so genes associated with this get tossed out of the gene pool pretty quickly!

2. what did doctors do until the late 1950’s and 60’s in the U.S. and U.K.? And why did things change?

Until the 1960’s, doc’s pretty much waited until the umbilical cord pulsations stopped before clamping and cutting the cord (several minutes). But then things changed, and they started clamping the cord “immediately,” which means 10 – 30 seconds after birth. No “placental transfusion,” no waiting for blood to return to the neonate before clamping.

No – the change was not the result of randomized prospective trials showing a benefit to early clamping. Nor was it done because doc’s had a better idea than Nature.

Let me quote from the Royal College of Obstetricians and Gynaecologists: “Active management of the third stage of labour [of which early clamping is a pillar] became part of clinical practice in the 1960’s, accompanying the widespread introduction of oxytocin.” In other words, when doctors took up the habit of artificially inducing labor (which is what oxytocin is used for).

Once doc’s began inducing labor, delivery became more precipitous, and because labor-inducing (and other) drugs cross the placenta and can adversely affect the infant, early clamping of the cord was necessary. With hurried delivery, one also had to be prompt in moving the infant to a warm environment, be prepared to intervene for crises (e.g. intubation), and transfer to the Neunatal ICU if necessary. None of these could be accomplished quickly while waiting for the cord to stop delivering blood to the baby.

And then other factors have come into play, including the epidemic of lawsuits with any adverse outcomes (protective medicine might include drawing an early blood gas from a freshly clamped cord; low threshold for “resuscitation”). There is also now some concern that a private market has developed for umbilical cord blood (available only if the cord is clamped early), an extremely rich source of stem cells. Finally, a little-known fact is that cosmetic companies are keen to obtain human cord and placental tissue for use in their products.

3. are there medical risks to delayed clamping?

Besides the risk of “delayed resuscitation,” proponents have mentioned:

baby having too much blood (“placental transfusion” as over-transfusion)
liver not being able to handle extra blood, causing jaundice
risk of more hemorrhage in the mother

Problem is, there is precious little evidence in clinical trials for any of these (see below). Plus – why would Nature design a robust million-year mechanism in a way that “over-transfuses” a newborn child or causes more hemorrhage in a mother?

And early clamping does have risks:

hypovolemia, hypotension and shock (after all, the cord blood represents as much as 40% of infant’s blood volume!)
hypoxia, especially if neonate doesn’t breathe well right away (clamping cord too early is like occluding the hose to your scuba tank before you reach the surface to breathe)
anemia
the combination of the above factors raises concern about brain damage
the premature loss of the richest source of stem cells (and of important hormones and factors) in the neonate’s body

4. so much for opinion and theory, but are there any randomized, prospective trials?

I thought there would only be one or two such trials published. Instead, there is a river of randomized trials, and the pattern of results is very consistently in favor of delayed clamping. A few highlights from these studies, showing advantages of delayed clamping versus early clamping (note that many of these trials were of premature neonates):

30% more blood volume and 60% more red blood cells

(“placental transfusion”)

50% less need for blood transfusion to infant (from 8% down to 4%)
fewer units of blood transfused per patient
significantly lower risk of hypovolemia and shock
improved Oxygenation
much less anemia, more iron, and >50% higher levels of the protein that transports iron (ferritin)
much lower rate of late onset sepsis (a serious infection)

(8% compared with almost 0%)

>50% lower risk of intra-ventricular hemorrhage

(a common and important type of brain bleed)

>50% reduction in encephalopathy (brain damage)

(due to shock, low Oxygen, or both)

lower risk of necrotizing enterocolitis
less need for mechanical ventilation

The predicted increase in jaundice, having too much blood (hypervolemia), and maternal hemorrhage with delayed clamping was not borne out in these large-scale studies (in fact, in some studies, it was the opposite to expected result).

You might check out these big trials and reviews, in some of the most respected medical journals:

Effect of timing of umbilical cord clamping at birth of term infants on maternal and neonatal outcomes.
Cochrane Database Syst Rev 16(2):CD004074 (2008 Apr)

A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints.
Transfusion 48(4):658-665 (2008 Apr)

Late vs early clamping of the umbilical cord in full-term neonates: systematic review and meta-analysis of controlled trials.
JAMA = Journal of the American Medical Association 297(11):1241-52 (2007 Mar)

Timing of umbilical cord clamping: new thoughts on an old discussion.
J Matern Fetal Neonatal Med 23(11):1274-85 (2010 Nov)

Timing of Umbilical Cord Clamping in Term and Preterm Deliveries and Infant and Maternal Outcomes: A Systematic Review of Randomized Controlled Trials.
Ind Pediatr 48:123-129 (2011 Feb)

5. How late does “delayed clamping” mean?

Different studies define it in slightly different ways. It can mean:

clamp at 1 – 3 minutes (most studies)
clamp when cord pulsations disappear (a few studies)

(up to 10 – 15 minutes if anesthesia present)

leave cord alone until placenta presents itself (rare)

There is also the expectation that the infant not be drained of blood by things like lifting him or her above placenta.

6. can the “placenta transfusion” serve as a lifeline?

First of all, not all newborns start life with a big breath and cry! And in those who start a bit late, the “placental lifeline” averts disaster by keeping their Oxygenation going.

Second, in uncommon and dangerous situations where the infant cannot establish normal breathing after birth, the cord can literally become a lifeline. Examples include when the cord is wrapped around the neck and other sorts of airway obstruction, placental engorgement, fetal hypovolemia, and venous congestion.

In Ex Utero Intrapartum Treatment (EXIT), a fetus in distress is brought out of the womb just far enough to correct a lesion – while relying on the “placental lifeline” to maintain the fetus.

There has even been a case report in which a newborn girl had her upper airway obstructed by a growth. Though in distress, she maintained Oxygenation via the “placental lifeline” for some 18 minutes as an airway could be secured, diagnosis made, and corrective action initiated.

7. can early clamping be causing more long-term harm than we realize?

This is an extremely intriguing question, the answer to which is not yet clear. The problem is that you can’t test much in the way of cognitive skills in a newborn baby, and it really takes many years to know how their higher brain functions will fare. But keep in mind – the human newborn uses >80% of its resting metabolism for brain growth and function.

In an old study using a primate model, monkeys with early clamping (and other interventions) did have long-standing (years later) problems with memory and judgement, and a lower cell density in many brain regions related to cognitive performance.

Some have pointed out the apparent coincidence between the start of “Active Management of Labor” (a euphemism for creating a crisis and system of “rescue” when there sometimes isn’t one) and the more recent ADD epidemic.

8. does Nature get the last word?

Not quite, but medical opinion seems to be shifting steadily back towards where Nature started. It is unusual to hear comments like these in Medicine:

“It is painful for me to report that nowhere in the world has the normal physiology of childbirth been more distorted than it has in the United States.”
(Doris Haire – President of the American Foundation for Maternal and Child Health – New York)

“The perinatal/neonatal professions are indoctrinated with the fallacy that cord physiology produces pathology, that placental transfusion is overtransfusion, that cord clamping is absolutely necessary for a neonate to have a normal blood volume and to avoid jaundice, plethora, polycythmia and hyperviscosity, and that brain hemorrhage results from too much blood … very, very few neonates begin life in the atmosphere with a physiological blood volume following physiological cord closure.”
(George Morley – ObGyn and Fellow of the American College of Obstetricians and Gynecologists)

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Natural mechanisms are not all perfect (would any of us want to have a major chest or abdominal surgery these days without anesthetic?). But if we stray far from them in Medicine, should we not take a huge supply of humility and self-examination with us?

ADDENDUM:

Looks like Nature wins again. A large randomized trial was just published in Lancet (Effect of gravity on volume of placental transfusion: a multicentre, randomised, non-inferiority trial) showing that after birth (placenta intact for 2 minutes), it is just as safe for the mother to hold the child on her tummy (bonding) as holding it at the level of the vagina (uncomfortable, but doctrine up to now).

When are we going to accept that we as physicians should not second-guess Nature so easily – and certainly not without proving that our theories are better than hers?
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– Premature babies: Simple procedure by Australian doctors could save thousands of lives each year
http://www.abc.net.au/news/2017-10-30/delaying-clamping-umbilical-cord-could-save-premmie-babies/9098902?smid=Page:%20ABC%20News-Facebook_Organic&WT.tsrc=Facebook_Organic&sf128498766=1

– Routine Birth Practices Exposed As Medical Abuse – Dr Todd Gastaldo
https://www.vaccinationinformationnetwork.com/routine-birth-practices-are-medical-abuse-dr-todd-gastaldo/

– Birth Trauma and the Dark Side of Modern Medicine – Jeanice Barcelo
https://www.vaccinationinformationnetwork.com/birth-trauma-and-the-dark-side-of-modern-medicine-jeanice-barcelo/

– Pregnancy, Birth & Infancy
https://brightfuture83.wordpress.com/2018/05/03/pregnancy-birth-infancy/