delaying cord clamping?

[emamum]

could someone give me a quick run down on why or link me to somewhere that explains it please? its not something thats done over here and i would like to know more (google gave me a bajillion different sites)

[womenswisdom]

Did not have time to read the whole thing, but skimming it, it looks like a thorough explanation: http://www.medscape.com/viewarticle/...16&uac=33158MZ.

[fruitfulmomma]

womenswisdom - your link requires a password. Do you have another?

The reason for delayed clamping is so that the baby gets his full blood supply. A very large amount of blood is present in the placenta at birth so when it is clamped right away baby loses all that blood.

Here is another thread...
http://www.mothering.com/discussions....php?t=1217833


Scroll down to #4 on here...
http://www.midwiferytoday.com/enews/enews0130.asp

Scroll down a little ways for several quotes...
http://www.midwiferytoday.com/enews/enews0343.asp

[KGB]

We delayed clamping/cutting for the following reasons:

1) It eases the transition with the baby getting oxygen through the cord to breathing with his lungs. If you cut the cord too quickly, you're basically forcing him to get ALL his oxygen through his lungs immediately which I imagine would be a shock to the system.
2) It allows blood to continue flowing to the baby as needed to deliver oxygen and oxytocin. I've heard that when a baby is placed on his mother's chest, they'll actually exchange a bonding hormone that helps to calm him and start the bonding process.
3) I put faith in how humans have delivered babies for millions of years. Before clamps and scissors were invented, babies were delivered with the cord still attached until the placenta was passed. Then the connection was severed. Generally, I tend to lean more towards the natural than the clinical.
4) I've heard cases where the cord was cut too early which caused complications and admission to the NICU -- the doctors actually admitted that cutting too early was the cause.
5) There have been studies that have shown a huge benefit of delayed clamping especially in cases of premature babies.

We did, however, receive a bit of reluctance from our doctor about waiting. She said there was no reason for it and studies have shown that there's a slight risk of causing jaundice because babies are born with "too much blood" anyway. I don't believe the "too much blood" excuse, and I believe the extra risk for jaundice is negligable. Our baby was actually less jaundiced than most. Waiting a few minutes for our baby's benefit was worth more than our doctor losing a few minutes of her time and costing her $$$ that she could have made seeing another patient.

[elanorh]

I don't have my links since I did the research nearly 4 years ago, on a different computer.

But, basically - there was no medical reason to institute immediate clamping (not based on any research at all). It's one of those non-evidence-based approaches used to childbirth. Basically, clamping the cord quickly made the doctor's job quicker and easier, and so that's what they did. They justified it by saying that DCC caused the blood to 'thicken' (don't recall the medical term) and that it caused jaundice.

Actual research has shown that while there may be an increased level of jaundice, that jaundice hasn't translated to the dangerous levels in the research studies conducted. Moreover, in the research done on preemies and delayed cord clamping, even as little as 30 seconds of wait time translated to better outcomes for those infants in the NICU and beyond. There was a good article about this in Pediatrics, I think (done by a NICU nurse PhD).

On the anecdotal level - dd1 (clamped immediately) was jaundiced (but didn't require a bili light or anything) - dd2 was not jaundiced. Dd2 was also pinker, more alert when awake, had a better latch, and really seemed to thrive more in the first few weeks (she didn't lose any weight after birth, and immediately began to pile on the weight as well).

Our OB told us that he didn't have a problem with it, although it wasn't a common request and not hospital policy. He told me that IF there was a problem (too much blood loss by me) then he'd have to cut the cord and administer pitocin, but otherwise he didn't have any concerns, and likewise for our Ped.

You would want to make sure your HCP knows not to give you pitocin to manage your placental delivery (many hospitals/HCPs do this as policy unless otherwise directed).

Dd2's cord stopped pulsing after 4 minutes or so and the OB clamped her cord at that point.

Absolutely - continue your research - and consider it. I would do it with any other children we had.

(One caution - make sure that you clarify with your HCP that you want to delay CLAMPING and cutting, until the cord has ceased pulsing. I've heard stories about OBs clamping the cord and then waiting five minutes to cut it. ).

ETA: I brought all the scientific studies I could find, to my appointment with the OB when we talked about this. I actually met with the nurse practitioner at that appointment, she passed the papers to him and he had reviewed them prior to our appointment. I didn't bring the 'touchy-feely' articles that didn't include peer-reviewed journal publications because I wanted him to take the discussion seriously.