When to cut the umbilical cord? Sooner or later?

A new study published today in the British Medical Journal rekindles the debate on whether there is a benefit to waiting a little while to cut the umbilical cord after a baby is born.

The standard of care in the U.S., as well as other developed nations, is to cut a newborn’s umbilical cord within seconds of delivery. But as this new study shows, babies whose cords are cut sooner may have a greater risk of being anemic at four months compared to babies whose cords are cut after 3 minutes of life.

This has certainly been a subject of much debate recently. At first, it was thought that preterm babies or babies that looked like they were having difficulty during labor would benefit most from giving them a boost of extra blood from the placenta before cutting the connection. But then again, these are the same babies that the OB wants to cut the cord quickly to get them over to the pediatric team. And do healthy, full term babies really need extra blood from the placenta?
Cord blood banking is also an issue.  Delayed cord clamping would lead to very little, if any, cord blood remaining to be banked. If you wait until the umbilical cord stops pulsating (transporting blood) before cutting it, there is not enough there to save.

Dr Hakakha’s opinion: I think you have to weigh your options.  If you have a family history of certain disorders that may benefit from cord blood banking, that may be a better option.  If however, you don’t, and are delivering a 35 week infant, delayed cord clamping may be a more reasonable choice.

Dr Brown’s opinion: This study only looks at outcomes at 4 months of age. Most babies do not develop iron-deficiency anemia until 6-9 months of age. And, the study does not look at long-term outcomes of babies whose cords were cut sooner rather than later. I’d like to see what (if any) effects occur later in life to see if there is benefit or harm from the timing of cord clamping.

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