The clamping of the umbilical cord is suggested to be delayed in term and preterm infants, because of the several benefits that this procedure would provide. The research supporting this statement belongs to an American Academy of Pediatrics (AAP)-endorsed guidance, coming from the American College of Obstetricians and Gynecologists (ACOG).
The guidance was published, Dec. 21, on the official AAP website, and it will also appear in the January issue of the journal Obstetrics and Gynecology, under the name of Delayed Umbilical Cord Clamping After Birth.
Delayed Umbilical Cord Clamping
In 2015, a similar recommendation was issued, suggesting that the umbilical cord should not be cut earlier than 30 to 60 seconds after birth, when it comes to term and preterm infants. However, the World Health Organization recommends delaying the procedure by an entire minute in the same conditions.
"While there are various recommendations regarding optimal timing for delayed umbilical cord clamping, there has been increased evidence that shows that the practice in and of itself has clear health benefits for both preterm and term infants," noted Maria A. Mascola, M.D., lead author of the committee opinion.
Physiologic studies in term infants have suggested that the blood transfer from the placenta takes place approximately one minute after birth, and is extended for a total of three minutes; the first breaths that the newborn takes have been correlated with this process.
Additionally, the blood supplies have important quantities of iron, which can further prevent iron deficiencies in the first year of life of the newborn. Iron deficiency can account for cognitive, motor and behavioral impairment, due to the irreversible developmental processes that it obstructs.
The longer the placental transfusion, the greater the benefits. The connection also facilitates immunoglobulins, as well as stem cells, which are indispensable for tissue and organ repairs.
Major Health Benefits
Among the benefits that the delay in this procedure facilitates, the hemoglobin increase and the iron improvement are some of the most crucial when it comes to the upcoming stages of development of the newborn. Delaying this procedure could show positive effects even several months after the child is born, and positively affect the developmental processes.
For preterm infants, the delay could also result in a reduced need for blood transfusion, due to the better transitional circulation and higher levels of red cells. Additionally, it also translates into a smaller incidence of necrotizing enterocolitis and intraventricular hemorrhage.
When it comes to preterm children, the transitional circulation is the first which can be improved through the means of this delay, which can result in a higher number of red blood cells.
Another study, published in the journal Pediatrics, suggests that the umbilical cord milking can be employed in improving the circulatory functions for babies who are born through cesarean section, too.
However, although there are major health benefits of delaying this procedure, it has one potential disadvantage as well, as it could lead to a slight increase in the cases of jaundice, which would require phototherapy. Along with the recommendation, ACOG also notes that neonatal jaundice should be monitored and treated, when necessary.
