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    The Argument for Delayed Cord Clamping and Against Umbilical Cord Blood Donation

    The Argument for Delayed Cord Clamping and Against Umbilical Cord Blood Donation

    Did you consent to cord blood donation after the birth of your child, or did you opt for delayed cord clamping and cutting? While pregnant with my firstborn, I performed quite a bit of research on umbilical cord blood, delayed cord clamping, and cord blood donation. Among my research was the article “Delay Cutting the Cord, Research Suggests” that discussed a study entitled “Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials” published in the Journal of the American Medical Association that suggests that waiting to clamp and cut the umbilical cord provides newborns with several health benefits. According to the study, delaying cord cutting results in results in better blood counts and iron levels for the newborn baby. Furthermore, the study also hints that delayed cord clamping and cutting offers some protection against anemia.

    Clamped Umbilical CordPrior to the births of both my babies, I decided that I wished to delay cord clamping barring a legitimate medical reason that would require immediate cutting. With both pregnancies, I included in my birth plan that I wanted to wait until the umbilical cord stopped pulsing before clamping and cutting. Delaying the clamping and cutting of the umbilical cord provides a newborn with several health benefits including better blood counts, increased red blood cells, a decreased risk of anemia, and an increased duration of early breastfeeding. The benefits of delayed cord clamping were too great for me to rush into separating my babies from my placentas.

    Until recently, doctors immediately clamped and cut the umbilical cord once the baby was born. One crazy reason for cutting too soon is because some doctors believed that if a newborn received his or her full blood volume from the placenta, then the baby would have too many red blood cells and become jaundiced. Such a belief is unfounded. As the JAMA meta-analysis shows, delayed cord cutting does increase the blood volume in the baby; however, better blood counts are beneficial for newborns, not detrimental.

    Another reason for immediately cutting the cord is so that the doctor can sweep the baby away from the mother for examination. In most cases, waiting to check the baby is not only possible but also desirable. A baby needs to be able to bond with his or her mother immediately after birth. Sweeping the baby away to be examined can cause a host of problems including troubles with breastfeeding. Both my babies went into my arms immediately after birth. Unless a medical emergency arises, a baby should know his or her mother as his or her first introduction into the world. Cord clamping can wait until the placenta stops delivering blood to a newborn baby.

    More than just one study have indicated the benefits of delayed cord clamping and cutting. In my search for scientific evidence, I discovered the article “Current Best Evidence: A Review of the Literature on Umbilical Cord Clamping” in the Journal of Midwifery & Women’s Health. In the article, Judith S. Mercer CNM, DNSc, FACNM, reviews the current literature on umbilical cord clamping and cutting. She determines a number of benefits to delayed cord cutting. First, immediately cutting the umbilical cord can reduce the number of red blood cells in a newborn by up to 50 percent. Fewer red blood cells can result in both immediate and long-term problems for the baby. Second, babies whose cord clamping and cutting was delayed experienced lower levels of anemia during the first two months of life as well as longer durations of early breastfeeding. Premature infants received even greater benefits from delayed cord cutting and clamping. Finally, few if any significant risks exist for delayed cutting and clamping. In other words, delayed cord clamping and cutting is not only extremely beneficial but also lacks significant risks. Waiting is pretty much only positive.

    Other more recent studies have also found benefits to delayed cord clamping and cutting. The World Health Organization (WHO) currently recommends late cord clamping (one to three minutes after birth) unless the newborn requires resuscitation. A 2014 study published in the journal Pediatrics concludes that delayed cord clamping by two minutes results in better development for the newborn during the first days of life. Adding to the growing body of evidence of the benefits of delayed cord clamping, a follow-up study published in the journal JAMA Pediatrics reveals an associated between delayed cord clamping (DCC) and fine motor skills at age 4, especially among boys.

    Newborn with Umbilical CordWhile researching delayed cord clamping, I additionally came across a related topic: umbilical cord blood donation. In particular, I read a post imploring all parents to donate their babies’ umbilical cord blood. Cord blood, like other blood, contains red blood cells, white blood cells, platelets, and plasma. Unlike other blood, however, cord blood also contains hematopoietic stem cells, or cells that form blood similar to the blood-forming cells found in bone marrow. Cord blood can be used as a source of stem cells and as an alternative to bone marrow, often for patients with genetic or metabolic diseases. Scientists are also currently investigating the possibility that the stem cells in cord blood may be able to be used to replace the cells of other tissues such as nerve or heart cells.

    At first glance, cord blood donation seems perfectly innocuous and safe. According to the National Cord Blood Program website, cord blood collection is easy and poses no medical risk to the mother or newborn baby. However, in order to donate cord blood, there must still be blood left in the umbilical cord. Instead of delaying the clamping or the cutting of the cord so that the baby receives all of his or her blood from the placenta, cord blood donation requires immediate clamping or cutting. Unfortunately, as I have already pointed out, the research indicates that immediately clamping or cutting the umbilical cord can reduce the number of red blood cells in a newborn by up to 50 percent. Such a loss of red blood cells immediately after birth results in an increased risk of anemia during the first few months of life. Anemia in a newborn can be very dangerous and can lead to a host of other health problems.

    In addition to a loss of red blood cells, by cutting off blood flow from the umbilical cord prematurely, newborn babies also receive less oxygenated blood. Immediately cord clamping and cutting starves the newborn of oxygen and nutrient rich blood, which can causes injury to the brain. More research needs to be done on the harms of early cord clamping. However, the message is clear: Cord blood donation, and, more specifically, the early cord clamping necessary for cord blood donation can pose a medical risk to the baby.

    Not clamping or cutting the umbilical cord until the cord stops pulsing and thus stops delivering all the blood to the baby is the biological norm. Although proponents of cord blood donation argue that cord blood collection is “easy and poses no medical risk to the mother or newborn baby,” the scientific evidence suggests otherwise. Despite the few potential benefits of cord blood donation, umbilical cord and placental blood belongs to the newborn baby. Clamping and cutting the cord early starves a newborn of iron- and oxygen-rich blood.

    In my opinion, delayed cord clamping and cutting is the best choice for newborns. After the births of my daughter and son, I opted to delay clamping until the cord stopped pulsing. I wanted to provide my babies with as many health benefits as I could right from the start of life. Only in the rare case that my baby and I required a medical intervention that required immediate cord clamping and cutting would I ever consider donating our umbilical cord blood. Cord blood is too valuable to a newborn to donate for some hypothetical future situation. Therefore, I chose delayed cord clamping and cutting for both my babies.

    References

    Better Fine Motor Skills with Delayed Cord Clamping: http://www.eurekalert.org/pub_releases/2015-05/uu-bfm052615.php
    Cord Blood Q&A: http://www.nationalcordbloodprogram.org/qa/what_are_advantages.html
    Delayed Cord Clamping After Birth Better for Baby’s Health: http://www.medicalnewstoday.com/articles/263181.php
    Delayed Cord Clamping Results in Better Immediate Newborn Outcomes: http://www.medicalnewstoday.com/articles/287041.php
    Delay Cutting the Cord, Research Suggests: http://abcnews.go.com/Health/Healthday/story?id=4506259&page=1#.TrxgHWrmtDY
    Delayed Umbilical Cord Clamping May Benefit Children Years Later: http://www.npr.org/sections/health-shots/2015/05/26/409697568/delayed-umbilical-cord-clamping-may-benefit-children-years-later
    Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age: A Randomized Clinical Trial: http://archpedi.jamanetwork.com/article.aspx?articleid=2296145
    Effect of Timing of Umbilical Cord Clamping and Other Strategies to Influence Placental Transfusion at Preterm Birth on Maternal and Infant Outcomes: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003248.pub3/abstract
    Effect of Timing of Umbilical Cord Clamping of Term Infants on Maternal and Neonatal Outcomes: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004074.pub3/abstract
    Late vs Early Clamping of the Umbilical Cord in Full-term Neonates: Systematic Review and Meta-analysis of Controlled Trials: http://www.ncbi.nlm.nih.gov/pubmed/17374818
    Long-term Follow-up of Placental Transfusion in Full-term Infants: http://archpedi.jamanetwork.com/article.aspx?articleid=2296144
    Mercer, Judith S. 2010. Current Best Evidence: A Review of the Literature on Umbilical Cord Clamping. Journal of Midwifery & Women’s Health 46(6). 402-412. http://www.ncbi.nlm.nih.gov/pubmed/11783688
    OMG, You Did Not Just Cut Off a Third of My Baby’s Blood Supply?!: http://erinmidwife.com/2011/05/30/omg-you-did-not-just-clamp-out-a-third-of-my-babys-blood-supply/
    Optimal Timing of Cord Clamping for the Prevention of Iron Deficiency Anaemia in Infants: http://www.who.int/elena/titles/cord_clamping/en/
    The Timing of Cord Clamping and Oxidative Stress in Term Newborns: http://pediatrics.aappublications.org/content/early/2014/07/09/peds.2013-3798.abstract
    Timing of Umbilical Cord Clamping After Birth: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth
    Tolosa, Jose N., Dong-Hyuk Park, David J. Eve, Stephen K. Klasko, Cesario V. Borlongan, & Paul R. Sanberg. 2010. Mankind’s First Natural Stem Cell Transplant. I 14(3). 488-495. http://www.ncbi.nlm.nih.gov/pubmed/20141549
    A Two-minute Delay in Cutting the Umbilical Cord Leads to a Better Development of Newborns During Their First Days of Life: http://www.alphagalileo.org/ViewItem.aspx?ItemId=148233&CultureCode=en
    Umbilical Cord Clamping Dangers: http://www.kencap.info/umbilical-cord-clamping-dangers/
    What Are the Advantages of Cord Blood?: http://www.nationalcordbloodprogram.org/qa/what_are_advantages.html
    What Is Cord Blood?: http://www.nationalcordbloodprogram.org/qa/what_is_cordblood.html

    Image Credits

    Clamped Umbilical Cord: http://commons.wikimedia.org/wiki/File:Umbilicalcord.jpg
    Newborn with Umbilical Cord: http://www.freeimages.com/photo/63155

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