New study on stem cells in cord suggest delayed cord clamping after birth

Here's the typical scene: Mom delivers baby. Baby has some suction to help clear the mucous from it's nose and mouth. A pink, screaming baby! Cord is clamped and doctor asks Daddy, "Do you want to cut the cord now?"

That all happens in a matter of seconds, but there's a good bit of new evidence that suggests that at least the last part, cord clamping and cutting, should be delayed not just by a matter of seconds, but by several minutes.

The University of South Florida study in the Journal of Cellular and Molecular Medicine is the most recent in a series of trials testing the benefits and risks of delayed cord clamping. Studies where conducted to test the effectiveness of delayed clamping for increasing hemacrit levels, improving respiratory functions, reducing incidence of sepsis, encouraging organ growth in preterm infants, lowering the rate of transfusions for anemia, reducing incidence of hemorrhage, and having stable glucose levels. In each trial, delayed cord clamping (DCC) was shown to have statistically significant benefits to babies--both preterm and term, born vaginally or via cesarean.

The JCMM article looked specifically at the effect of stem cell transfer from placenta to baby as the cord continues to pulse minutes after birth. As the abstract states:

[S]ince it was known that umbilical cord blood contains various valuable stem cells...the merit of delayed cord clamping has been magnified.

Commenting on this study on LiveScience, Paul Sanberg, the lead researcher, noted that this is an evolutionarily significant process, to let the cord continue pulsing--one that is practiced in all mammals, save for humans in Westernized societies. By giving the placenta time to transfer it's full nutritional, oxygenated, and stem cell enriched blood to the baby immediately postpartum, we are giving our children the best shot at full development. Sanberg goes so far as to comment on the squatting position for delivery--one that is commonly adopted by women spontaneously in the second stage of labor (pushing)--as being the most beneficial for stem cell transfer, thanks to the aid of gravity.

Further comment on the advantages of delayed cord clamping can be easily found through a number of scientific journals.

Recently, the Journal of Perinatology published the results of a trial at the Women and Infants' Hospital in Providence, Rhode Island, assessing the benefits and risks of delayed cord clamping, particularly for infants with very low birth weights (VLBW). The trial sought to clarify a decade worth of studies on this subject to hopefully ween out some of the methodological errors in the previous trials. The researchers noted:

At term, approximately two-thirds of the fetal – placental blood volume (FPBV) is in the fetus. In a preterm pregnancy, approximately one half of the FPBV is in the placenta leaving the preterm fetus more vulnerable when the cord is clamped immediately because the infant receives very little placental transfusion. During transition from fetal to neonatal life, there is an increase in the circulatory bed as various organs—lung, liver, kidney, etc.—begin to assume the functions sustained by the placenta during fetal life. This increase in circulatory bed or capacity may need additional blood volume that is deprived by immediate cord clamping. The resulting relative hypovolemia leads to decreased blood pressure, poorer perfusion, fewer available nutrients, and may create a subtle hypoxia or hypoxemia that may adversely affect the organs at the cellular level.

The study also found that infants who had delayed cord clamping showed lower incidence of necrotizing enterocolitis (NEC)--a breakdown of intestinal tissue--and better feeding capabilities than those who had immediate cord clamping (ICC).

Improved lung capability and a reduced incidence in supplemental oxygen has been noted in several studies, including the above mentioned two, as being relative to delayed cord clamping. It is thought by some researchers to be a result of the increased blood volume shown in infants who had DCC versus ICC. Often, early clamping is done to bring the baby to a warming bed to be oxygenated, but many studies have shown that keeping the cord pulsing does a great deal to encourage successful oxygenation and improve resuscitation outcomes. The added benefit of keeping the infant in the mother's arms can go a long way

For decades, babies were whisked away to warming beds immediately after birth, deeming the immediate cutting of the cord necessary. More recent studies show that having the infant placed on the mother's abdomen immediately after birth and staying with the mother for an extended period of time has tremendous benefits for both mother and baby. This allows for delayed cord clamping, and even the practice of lotus birth--keeping the umbilical cord and placenta attached till it naturally separates from the child--possible for families who choose to practice this tradition. In any regard, waiting for the cord to stop pulsing does not barre the care providers from performing any standard newborn procedures--many of which can be delayed for the few minutes it takes to wait for the pulsing to stop, and/or can be done while the infant remains in the mother's arms.

Regardless of your chosen place of birth--homebirth, birthing center, or hospital--talk with your care provider about the possibility of having delayed cord clamping. Most care providers won't have a problem with allowing the few precious minutes it takes for this to happen. If you are writing a birth plan, it is a good idea to put your intentions for delayed clamping in this, as well, and to inform your nursing staff if you are birthing in the hospital.