This post is a continuation of Unang Yakap, Part 1 posted a few days ago. Today I will discuss step 3 in the newborn protocol: Properly-timed cord clamping.
But before we do that, let’s review our steps. 1) Immediately after a baby is born, he/she should be dried thoroughly for at least 30 seconds. 2) Once the baby is dry (and at this point should be breathing well), he/she is placed naked on the mother’s bare tummy or chest. A bonnet should be placed on the baby’s head and a blanket on its back to help keep him/her warm.
At this point, the person attending the delivery (Obstetrician or midwife) should be holding the umbilical cord, feeling for its pulse and waiting for those pulsations to stop. When the pulsations stop, the cord is clamped and cut. This is step 3.
Until recently, cutting the umbilical cord immediately after birth was the standard of care in the Philippines and many other parts of the world. Studies have shown that this practice is not beneficial, and can actually deprive a baby of part of its blood volume.
While inside the womb, a newborn’s blood circulates through its own body, the umbilical cord and the placenta. When the baby is born, blood that is contained in the placenta moves through the cord and back to the baby. The cord pulsates during this time and pulsations stop when the job is done. This typically takes about 1-3 minutes. If the cord is cut immediately after birth, there isn’t enough time for blood that is in the placenta and cord to be returned to the baby, and the baby is deprived of a portion of his/her own blood.
Why does the extra blood matter? Blood carries oxygen, and this extra oxygen is very helpful to babies when they make the transition from life in the womb to life in the outside world. Blood also holds most of the iron in our body, so babies whose cords are cut immediately are 80% more likely to develop anemia in their first year of life.
In preterm babies, the standard practice is to cut the cord immediately. This is because doctors assume that the baby is going to need some assistance with breathing and may need even further resuscitation. However, more recent published data has shown that waiting 30 seconds to 1 minute to clamp the cord of a preterm infant decreases the risk of brain hemorrhage (a serious complication that premature babies are at risk for) and cuts the risk of anemia in half. There are many other potential benefits to preterm babies as well, including protection against infection.
Here is a wonderful video by Penny Simkin that clearly illustrates where a baby’s blood goes when it is born, and why it is a good idea to wait before clamping the cord.
Waiting to clamp the cord until the appropriate time is clearly helpful to babies and poses no danger to the infant or its mother. This is Step 3 in the Unang Yakap protocol.
I hope this was helpful. I will discuss step 4 ( Non-separation of the newborn from the mother for early breastfeeding) in my next post. In the meantime, feel free to comment and ask questions!
To read on to Part 3, click here https://drzeka.wordpress.com/2013/08/27/unang-yakap-part-3-on-nonseparation-of-the-newborn-and-mother/