Delayed cord clamping and jaundice?

[APToddlerMama]

I'm pregnant with #2 and trying to decide if we want to delay clamping the cord or not.  I have read all the benefits, but I am a little worried about jaundice.  #1's cord was cut immediately, and he ended up with really bad jaundice, super high levels, and a NICU stay which was no fun. 

Does anyone have any links for any research on how much the risk of jaundice is increased with delayed clamping?  I know that jaundice isn't necessarily bad in many cases, but having gone through it once where it was, I am a little nervous that the risks might outweigh the benefits. 

[starrlamia]

these may help

http://scholar.google.ca/scholar?q=delayed+cord+clamping+and+jaundice+study&hl=en&as_sdt=0&as_vis=1&oi=scholart

[1love4ever]

My MW said that the reason the baby is more likely to get jaundice with a delayed clamp is because the baby gets more blood in its body than does a baby whos cord is cut immediatly.  She says there are 2 types of jaundice and this type is not bad or harmful!  In the hospital the baby is put under a UV light, but a baby can also be held in the sunshine(even through a window) with just a diaper on and this will help also.  Maybe ask your MW about jaundice?

[APToddlerMama]

Originally Posted by starrlamia 

these may help

http://scholar.google.ca/scholar?q=delayed+cord+clamping+and+jaundice+study&hl=en&as_sdt=0&as_vis=1&oi=scholart

Thank you.  I checked this out and am still sifting through the research. 

Originally Posted by 1love4ever 

My MW said that the reason the baby is more likely to get jaundice with a delayed clamp is because the baby gets more blood in its body than does a baby whos cord is cut immediatly.  She says there are 2 types of jaundice and this type is not bad or harmful!  In the hospital the baby is put under a UV light, but a baby can also be held in the sunshine(even through a window) with just a diaper on and this will help also.  Maybe ask your MW about jaundice?

What worries me is we did the laying in the sunshine with DS every day, and by day four or five, his jaundice was so terrible he required a NICU stay...which was the harmful type of jaundice.  I know that some jaundice is normal and even protective.  It is just that we ended up with a pretty bad scenario.  DS has some special needs and who knows why, but sometimes I wonder if it had to do with how jaundiced he became. 

[Toposlonoshlep]

Are you sure about the through-the-window part? I read somewhere that windows filter out a lot of the beneficial UV. 

My son's cord clamping was delayed in the hospital because of my wishes and he did end up slightly jaundiced, but I just kept nursing him and within three days it cleared up.
 

Originally Posted by 1love4ever 

My MW said that the reason the baby is more likely to get jaundice with a delayed clamp is because the baby gets more blood in its body than does a baby whos cord is cut immediatly.  She says there are 2 types of jaundice and this type is not bad or harmful!  In the hospital the baby is put under a UV light, but a baby can also be held in the sunshine(even through a window) with just a diaper on and this will help also.  Maybe ask your MW about jaundice?

[Toposlonoshlep]

Also, I was wondering, since I can't quite figure it out, what are the benefits of delaying cord clamping? Like I mentioned, we did it with DS, but without much research as to why. I guess I just figured it pulsed for a reason and it probably needed to transfer the stuff over. But in more scientific terms, what are the benefits?

[1love4ever]

Originally Posted by APToddlerMama 

What worries me is we did the laying in the sunshine with DS every day, and by day four or five, his jaundice was so terrible he required a NICU stay...which was the harmful type of jaundice.  I know that some jaundice is normal and even protective.  It is just that we ended up with a pretty bad scenario.  DS has some special needs and who knows why, but sometimes I wonder if it had to do with how jaundiced he became. 

I am not sure as to if or how they can tell whether or not it is the harmful type of jaundice, but it would be my guess that if it is the harmful type it would occur even if the cord was cut right away.  I think you should definatly ask your MW!

Originally Posted by Toposlonoshlep 

Are you sure about the through-the-window part? I read somewhere that windows filter out a lot of the beneficial UV. 

My son's cord clamping was delayed in the hospital because of my wishes and he did end up slightly jaundiced, but I just kept nursing him and within three days it cleared up.
 

Yes I am sure that UV rays come through the window.  The only way they would not is if the window  was UV treated.  I have a friend who's DD is sensitive to sunlight and she has to put sunscreen on her in the middle of winter even when they are inside all day because of the rays that might come through the window.  My DH is a truck driver and he has gotten many sunburns through a rolled up window as well lol!

Quote:

Originally Posted by Toposlonoshlep 

Also, I was wondering, since I can't quite figure it out, what are the benefits of delaying cord clamping? Like I mentioned, we did it with DS, but without much research as to why. I guess I just figured it pulsed for a reason and it probably needed to transfer the stuff over. But in more scientific terms, what are the benefits?

I will have to look in my Ina Mays Guide to Childbirth book again, I know it mentions it.  I know one benefit is that if the baby does not start breathing right away or is having a hard time, he is still getting oxygen through the umbilical cord, so in a case where the baby can not breathe for awhile, it may actually save him because his body and brain is not being deprived of oxygen.  Also, a baby whos cord cutting is delayed has more blood in his body because blood keeps coming to him through the cord, meaning his body does not have to work as hard after birth trying to produce enough blood, because he already has enough.  I will look and see what my book says about it and post probably tomorrow with what I find. 

Here is an article that I found on it too  http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/ 

[Lula's Mom]

Lots more information: http://midwifethinking.com/2010/08/26/the-placenta-essential-resuscitation-equipment/  I like her posts.

She mentions that there are possible links between pitocin injections and jaundice, but that more research needs to be done. I don't think I had heard of that before. Anecdotally, I did not have pitocin during my 3 labors (well, once, but after the cord was cut) and my babies had normal physiological jaundice that went away within a week.

[1love4ever]

Here is an excellent link!  http://www.childbirthwithlove.com/controversy.html    Please read everyone!

[knitgirl]

I think it really depends on the reason for the jaundice. Was it because of rh-incompatibility, or an ABO incompatibility? We had a severe ABO incompatibility, and happened to delay cord clamping. I don't think clamping or not would have changed that we needed a NICU stay. We ended up getting a blood transfusion, it was so bad. My kid is totally fine now, thank goodness, but whoa - could have been bad!

After researching what *could have happened* I would never ever mess with sticking a jaundiced child in a window or the sun! There are so many things that happen because people aren't paying attention or don't think it's bad enough to warrant bili-blankets or other care. Please see your doctors if you have concerns!!

[jocelyndale]

We delayed clamping.  I've had lifelong struggles with iron deficiency anemia and I wanted my son to get the best start possible with his early blood stores. Since delayed clamping is evidence-based practice, my provider (OB) had no issues with it whatsoever. 

He was pretty yellow, but his bili levels were never a cause for concern.  He was a bit sleepy, which was very frustrating when we were trying to get breastfeeding established, but new babies are hard a completely new experience any which way you slice it.  We spent time nursing outside.

And this kid has never had any issues with his iron.  Very happy about that.

For those wondering, quite a bit of UV-A passes through ordinary window glass.  I don't know which type is emitted by bili lights.  I suppose I could look up wavelengths, but someone who's had more sleep today should do that.  ;)

[dot1]

There are tons of abstracts on Pub Med which summarize the benefits.  My understanding is that bilirubin levels can be higher with delayed clamping; however the research has not demonstrated it to be of clinical significance.  I would suspect in your case that there may have been a problem with the liver to begin with, which is why the jaundice didn't clear up.  Here's an example of a study and if you go to the site you can find many other similar ones. http://www.ncbi.nlm.nih.gov/pubmed/17374818

We delayed cord clamping with dd1, she developed a touch of jaundice but was totally fine and didn't need any treatment, alert, nursed right away and has been extremely healthy.  Labour was also induced with lots of pitocen, so that might have made her more likely to be jaundiced also (one more chemical for her little liver to deal with).

[1love4ever]

Just wanted to come back with an update that DS, born at beginning of Nov, had his cord attached and not clamped for 30 min and never got jaundiced at all.  Midwife said that my bfing him every 2hrs or more frequently likely helped