Thursday, November 29, 2012

Delayed Cord Clamping

The question is often raised about when exactly the umbilical cord should be clamped and cut. According to the American College of Obstetricians and Gynecologists, published in the latest December issue journal and in collaboration with the NIH liaison to the American Academy of Pediatrics, Dr. Raju, delaying cord clamping for preterm babies is beneficial. There is no clear evidence for term births.

There is no exact number in seconds or minutes that should dictate the delay. Ordinarily the cord is clamped fifteen to twenty seconds after the birth. The delay may be thirty to sixty seconds. Evidence suggests that the most important benefit of this delay, at least for preterm babies, is the possibility of a fifty percent  reduction in intraventricular hemorrhage. This reduces the need for blood transfusion for low blood pressure or anemia.

Even "milking " the cord in preterm infants has been suggested but thus far there is not enough evidence or testing to be conclusive. We are fairly used to clamping the cord after it has stopped pulsing. And this seems to be intuitively beneficial for all babies. Now we have evidence that for some babies it may be essential.