Delayed Cord clamping is something which is not been practiced actively in day to day births which are been seen. Leaving even for 2 minutes shows to have large benefits to baby.
For the first time in Chennai Bloom Natural Birthing Centre and HappyMom Pregnancy to Motherhood are working together to bring this awareness.
We in HappyMom pregnancy classes reinforce the importance of delayed cord clamping make sure leave the cord intact for atleast for 2 minutes.
After a baby is born, it’s common practice to immediately clamp and cut the umbilical cord, before passing the baby to her mother.
After all, the placenta and umbilical cord are unnecessary once the baby has arrived, right?
Due to a plethora of studies telling us that waiting before clamping the cord does offer benefits to newborns (after 10 years of lobbying, the UK are finally set to make delayed clamping to be standard practice), some of us have started to open our minds to the possibility of leaving the cord alone after the birth.
It seems that we’ve been thinking incorrectly in the past.
New research just out suggests that waiting before cutting the cord has more far-reaching benefits than we realised, with impacts well past infancy.
Researchers suggest that waiting at least three minutes before cutting the umbilical cord after the birth may help to improve children’s fine motor and social skills at four years of age. This is in addition to the huge benefits already discovered.
Globally, clamping and cutting the umbilical cord immediately after birth is standard practice. In 2011, researchers demonstrated that leaving the cord intact for at least three minutes decreases the risk of iron deficiency in babies for up to 4-6 months after birth. Now we are learning that delayed clamping provides long-term benefits too. Delaying clamping of the umbilical cord allows the volume of blood from the placenta and cord to transfer to the baby. This increases the baby’s blood volume by up to a third, providing valuable red blood cells and boosting iron stores. It also contains precious stem cells that belong to your baby. Why cut off this valuable source of goodness? What The Researchers Found In their investigation, the researchers followed up on babies from their earlier study. The children were now four years of age. Of the original 600 infants, 263 children took part in the study. Of these children, 141 had cord clamping delayed by three or more minutes after birth. The other 122 had cord clamping within 10 seconds of birth. The researchers completed developmental assessments, including IQ and cognitive tests. Parents completed a questionnaire regarding social and personal care skills. The results of the tests and questionnaires showed there was no difference in IQ or development between the children who had immediate cord cutting and those whose cords were left intact for three minutes after birth. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/
But what the test results did show is that the boys who had delayed cord clamping (DCC) had better fine motor skills, such as gripping a pen, and more pro-social behaviour, compared to those boys who had immediate cord clamping after birth. Girls generally have better iron stores from birth, and are better protected against iron deficiency. Why Does Iron Matter? Iron deficiency has long been associated with poor behavioral, motor and intellectual development in children. The World Health Organisation (WHO) recommends leaving the cord intact for one minute as a general practice, with a target of at least three minutes if possible. Other peak groups as the UK National Institute for Health and Care Excellence (NICE) also recommend delayed or deferred cord clamping for at least one minute. The practice is not widespread, but is growing as the evidence showing the clear benefits grows. Doctors vary in their understanding of the current evidence showing that delayed cord clamping is beneficial to babies for the first 6 months following birth. This new research has long term implications for how maternity care providers proceed with the management of the third stage of birth. Iron deficiency in toddlers has become prevalent in developed countries. Statistics showing countries such as Australia, the US and UK have an average 10% of children aged between 1-3 with iron deficiency. During early infancy, the brain is rapidly growing and developing and iron is essential to that process. Limiting the amount of iron that is available to a baby during this time of rapid brain growth clearly impacts future brain development. While iron supplements are an option, natural sources of iron are more gentle to tummies (much less likely to cause constipation) and are more readily absorbed. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/
Delayed umbilical cord clamping (not earlier than 1 min after birth) is recommended for improved maternal and infant health and nutrition outcomes.
When newly born term or preterm babies require positive-pressure ventilation, the cord should be clamped and cut to allow effective ventilation to be performed.
Newly born babies who do not breathe spontaneously after thorough drying should be stimulated by rubbing the back 2–3 times before clamping the cord and initiating positive-pressure ventilation.
Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation.
2. WHO. Guidelines on basic newborn resuscitation. Geneva, World Health Organization; 2012 (http://www.who.int/maternal_child_adolescent/documents/basic_newborn_resuscitation/en/).
3. WHO. WHO recommendations for the prevention and treatment of postpartum haemorrhage; 2012 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/).
For the first time in Chennai Bloom Natural Birthing Centre and HappyMom Pregnancy to Motherhood are working together to bring this awareness.
We in HappyMom pregnancy classes reinforce the importance of delayed cord clamping make sure leave the cord intact for atleast for 2 minutes.
Delaying Cord Clamping May Offer Years Of Benefits, Study Finds
After all, the placenta and umbilical cord are unnecessary once the baby has arrived, right?
Due to a plethora of studies telling us that waiting before clamping the cord does offer benefits to newborns (after 10 years of lobbying, the UK are finally set to make delayed clamping to be standard practice), some of us have started to open our minds to the possibility of leaving the cord alone after the birth.
It seems that we’ve been thinking incorrectly in the past.
New research just out suggests that waiting before cutting the cord has more far-reaching benefits than we realised, with impacts well past infancy.
Researchers suggest that waiting at least three minutes before cutting the umbilical cord after the birth may help to improve children’s fine motor and social skills at four years of age. This is in addition to the huge benefits already discovered.
Globally, clamping and cutting the umbilical cord immediately after birth is standard practice. In 2011, researchers demonstrated that leaving the cord intact for at least three minutes decreases the risk of iron deficiency in babies for up to 4-6 months after birth. Now we are learning that delayed clamping provides long-term benefits too. Delaying clamping of the umbilical cord allows the volume of blood from the placenta and cord to transfer to the baby. This increases the baby’s blood volume by up to a third, providing valuable red blood cells and boosting iron stores. It also contains precious stem cells that belong to your baby. Why cut off this valuable source of goodness? What The Researchers Found In their investigation, the researchers followed up on babies from their earlier study. The children were now four years of age. Of the original 600 infants, 263 children took part in the study. Of these children, 141 had cord clamping delayed by three or more minutes after birth. The other 122 had cord clamping within 10 seconds of birth. The researchers completed developmental assessments, including IQ and cognitive tests. Parents completed a questionnaire regarding social and personal care skills. The results of the tests and questionnaires showed there was no difference in IQ or development between the children who had immediate cord cutting and those whose cords were left intact for three minutes after birth. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/
But what the test results did show is that the boys who had delayed cord clamping (DCC) had better fine motor skills, such as gripping a pen, and more pro-social behaviour, compared to those boys who had immediate cord clamping after birth. Girls generally have better iron stores from birth, and are better protected against iron deficiency. Why Does Iron Matter? Iron deficiency has long been associated with poor behavioral, motor and intellectual development in children. The World Health Organisation (WHO) recommends leaving the cord intact for one minute as a general practice, with a target of at least three minutes if possible. Other peak groups as the UK National Institute for Health and Care Excellence (NICE) also recommend delayed or deferred cord clamping for at least one minute. The practice is not widespread, but is growing as the evidence showing the clear benefits grows. Doctors vary in their understanding of the current evidence showing that delayed cord clamping is beneficial to babies for the first 6 months following birth. This new research has long term implications for how maternity care providers proceed with the management of the third stage of birth. Iron deficiency in toddlers has become prevalent in developed countries. Statistics showing countries such as Australia, the US and UK have an average 10% of children aged between 1-3 with iron deficiency. During early infancy, the brain is rapidly growing and developing and iron is essential to that process. Limiting the amount of iron that is available to a baby during this time of rapid brain growth clearly impacts future brain development. While iron supplements are an option, natural sources of iron are more gentle to tummies (much less likely to cause constipation) and are more readily absorbed. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/
Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants
Full set of recommendations*
WHO recommendations (1)
In summary:Delayed umbilical cord clamping (not earlier than 1 min after birth) is recommended for improved maternal and infant health and nutrition outcomes.
From 2012 WHO guidelines on basic newborn resuscitation (2):
In newly born term or preterm babies who do not require positive-pressure ventilation, the cord should not be clamped earlier than 1 min after birth.When newly born term or preterm babies require positive-pressure ventilation, the cord should be clamped and cut to allow effective ventilation to be performed.
Newly born babies who do not breathe spontaneously after thorough drying should be stimulated by rubbing the back 2–3 times before clamping the cord and initiating positive-pressure ventilation.
From 2012 WHO recommendations for the prevention and treatment of postpartum haemorrhage (3):
Late cord clamping (performed approximately 1–3 min after birth) is recommended for all births, while initiating simultaneous essential neonatal care.Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation.
Remarks
- The evidence base for recommendations on the optimal timing of umbilical cord clamping for the prevention of postpartum haemorrhage includes both vaginal and caesarean births. The WHO guideline development group considered this recommendation to be equally important for caesarean sections.
- Delayed umbilical cord clamping should be performed during the provision of essential neonatal care.
- Recommendations for the optimal timing of umbilical cord clamping apply equally to preterm and term births. The guideline development group considered the benefits of delayed cord clamping for preterm infants to be particularly important.
- Some health professionals providing care for an HIV positive pregnant woman and/or working in high HIV prevalent settings have expressed concern regarding delayed cord clamping as part of the management of the third stage of labour. These professionals are concerned that, during placental separation, a partially detached placenta could be exposed to maternal blood and this could lead to a micro-transfusion of maternal blood to the baby. The evidence shows that the benefits of delaying cord clamping for 1-3 minute outweighs the risks of transmission of HIV. HIV testing should be offered intrapartum, if not already done. WHO recommends that all HIV positive pregnant and breastfeeding women and their infants should receive appropriate antiretroviral (ARV) drugs to prevent mother to child transmission of HIV. Thus, the proven benefits of at least a 1–3 minute delay in clamping the cord outweigh the theoretical, and unproven, harms. Delayed cord clamping is recommended even among women living with HIV or women with unknown HIV status. HIV status should be ascertained at birth, if not already known, and HIV positive women and infants should receive the appropriate ARV drugs.
- Delayed umbilical cord clamping should not be confused with milking of the cord. The terms are not necessarily synonymous (milking refers to physically expressing blood from the umbilical cord). There are various recent studies assessing the effect of cord milking, practised at different times after birth, with a variety of “milking” times, associated with early or delayed cord clamping. These studies need further analysis, as cord milking has been proposed as an alternative to delayed cord clamping, especially for preterm infants.
- The WHO guideline development group considered that the package of active management of the third stage of labour includes a primary intervention: the use of a uterotonic drug. In the context of oxytocin use, controlled cord traction may add a small benefit, while uterine massage may add no benefit for the prevention of postpartum haemorrhage. Early cord clamping is generally contraindicated.
- Clamping “not earlier than one minute” should be understood as the lower limit period supported by published evidence. WHO recommends that the umbilical cord should not be clamped earlier than is necessary for applying cord traction to reduce post-partum haemorrhage and speed expulsion of the placenta (3), which the guideline development group clarified would normally take around 3 min.
- For basic newborn resuscitation, if there is experience in providing effective positive-pressure ventilation without cutting the umbilical cord, ventilation can be initiated before cutting the cord (2).
References
1. WHO. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva, World Health Organization; 2014 (http://www.who.int/nutrition/publications/guidelines/cord_clamping/en/).2. WHO. Guidelines on basic newborn resuscitation. Geneva, World Health Organization; 2012 (http://www.who.int/maternal_child_adolescent/documents/basic_newborn_resuscitation/en/).
3. WHO. WHO recommendations for the prevention and treatment of postpartum haemorrhage; 2012 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/).
No comments:
Post a Comment