Clamp the cord quick to avoid jaundice???

[ann_of_loxley]

What?
Ive never heard of this...???

From what I understand - its a good idea to delay cord clamping. Right?

Well my friend is due her baby any day now and her MW said she is clamping the cord after 5 mintues and is not waiting around forever for her placenta to be delivered. She thought she would ask me for advice and how soon the placenta would naturally come out. It varies - can be anywhere from 10 minutes to a few hours really! lol...
Well she had a meeting with her MW today and she said she wants to clamp is so soon after the birth to avoid her baby getting jaundice.... how? what? Is this an outright lie?

Someone let me know!

[Mommal]

Active management of the third stage of labor is BIG right now, so I'm not surprised that your friend's MW is at least somewhat on board with the trend. (See http://www.cochrane.org/reviews/en/ab000007.html for more.)

FWIW, 5 minutes does constitute delayed cord clamping. In general, active management requires that the cord be clamped within 30-60 seconds of birth.

Delayed cord clamping is good. It results in significantly elevated transfer of blood to the baby, and studies have shown that delayed clamping elevates a baby's iron levels for up to 6 months postpartum, reducing the baby's chances of becoming anemic. (See this article from the WHO: http://www.who.int/reproductive-heal..._chapter1.html , look under "Review of Evidence on Cord Care Practices.)

However, delayed cord clamping probably does elevate a newborn's risk of having jaundice that requires phototherapy. (See http://www.greenjournal.org/cgi/cont...ract/112/1/177)

Since your friend's midwife doesn't sound inclined to wait around for the placenta to come out on its own, there are some natural things your friend can do to avoid the dreaded "controlled cord traction" that usually constitutes active management of the third stage. The best one is to nurse her baby as soon as possible, as oxytocin produced by the suckling of a newborn acts to contract the uterus, expel the placenta, and shut down blood flow. If your friend's baby won't nurse immediately after birth, your friend can also use nipple stimulation and gravity to get the placenta to come out on its own.

HTH!

[nashvillemidwife]

Active management also usually means giving the mom pitocin before the placenta is delivered, in which case the baby gets an unnatural amount of blood pushed into his body due to the powerful uterine contractions which does contribute to jaundice.

[ann_of_loxley]

thanks! - I found some pretty good info on whale as well!

[stacyann21]

I had never heard this before : We delayed cord clamping for several minutes (because I thought it was beneficial) and my son had terrible jaundice for the first several weeks of life. I also refused Pitocin. Reading this really upset me. I will definitely have it clamped sooner next time!

*eta: Did the study make a note of who BF and who didn't? Were the women randomly chosen to clamp later or did they choose to. I would figure mamas who chose to would be more likely to BF. We all know about "BFing jaundice".

[nashvillemidwife]

No one is saying it's not beneficial. You've got to weigh pros and cons, and remember that jaundice is very common and may not have any relation to your baby's delayed cord clamping at all. There are just too many factors.

I always practice delayed cord clamping (no pitocin) and I have never seen severe jaundice.

[Kidzaplenty]

The only jaundice I had in my children is the one child that had her cord clamped immediately. All the others were delayed.

I don't think there are enough studies or information to really say that delayed clamping causes it, though it may be a slight factor in some cases, but even then, it is usually very mild.

But this is just my opinion from the studies that I have read.

[Belle]

My first child had her cord clamped right away. I got pitocin before the placenta was born and it was yanked out ten minutes after dd1's birth.

My second was born at home in water. The cord wasn't clamped until the placenta was born. 11 minutes after she was born. Nobody messed with the cord or pulled on it.

Both of my children developed mild jaudice. Take what you will from that.

[daughteroftruth]

As far as jaundice goes, I noticed no differance between my boys who were cut soon after birth, and my daughter who we waited several hours after the placenta was delivered.

But I will say that my daughter was much more alert and responsive then her brothers were.

[mwherbs]

years ago I had a book by Dr Klaus (of Klaus and Kennel fame) and in it he stated ALL babies have jaundice it is just a matter of degree. yes I think that there is a study connecting some increase in jaundice with late cord clamping- but as Nashvillemw has said if a shot is given a huge push on the blood still in the placenta occurs and sends it into baby and can do some damage to cells in the process- jaundice is from cell breakdown - healthy cells usually don't break down( except in immune process)--- I have also run across some crazy practices like physically stripping the cord in order to speed up the process-- if this was done in their study even by a couple providers it could change the stats...

another thing to think about is all the standards have been set using the old methods of quick cutting. Studying what normal is for late cutting is probably needed on a big scale, it might change what determines baseline jaundice--- I know that standards changed from when my first baby was born and the second--
so in the long run babies have healthy non-anemic hct at 3 and 6 months and that means things like better oxygenation to the brain and whole body-- so I guess you have to decide

[elanorh]

On my old computer I had some studies linked, which helped me decide to delay cord clamping. One of them specifically addressed the "jaundice" issue. There was a study with a control group (delayed vs. regular clamping) and they found that not one of the delayed clamped babies' jaundiced progressed to a danger point.

Jaundice is, indeed, normal. Some scientists believe that it is protective, in fact, for infants - as long as it doesn't progress to the point where it becomes dangerous for them.

We didn't delay with Ina; she had jaundice which took awhile to clear but didn't become dangerous.

We did delay for SJ. She didn't develop jaundice. She also didn't lose a speck of her birth weight - gained from the minute she was born (!!) - she was far more alert than her sister was following birth; she slept well, but she was just a very happy, focused baby those first few days. She had a better latch too ....

I'm a firm believer in delayed cord clamping. There is no research out there which proves that it's dangerous, and there IS research out there which shows its benefits.

We just "do" active management of labor in the USA, and therefore we cut the cord immediately (it's much more efficient for the doctor, too, because they don't have to wait so long for the placenta and the cord to stop pulsing). But it means that sometimes babies will have as much as 50% less of their blood, because it will remain in the placenta. This can contribute to lower iron levels for them as infants too.

I did a quick google and found this article, which was cited in a LOT of other articles (links below it) - in well-known medical journals. So I'd suggest reading this particular article and then checking out the other articles which mention it, several of which refer to full-term neonates.

http://pediatrics.aappublications.or...7/4/1235?rss=1

I had never heard this before We delayed cord clamping for several minutes (because I thought it was beneficial) and my son had terrible jaundice for the first several weeks of life. I also refused Pitocin. Reading this really upset me. I will definitely have it clamped sooner next time!

Please read the link above, and other articles! My sister's baby was born via c/s and she had jaundice for about three weeks (formula-fed, she was adopted) - near hospitalization for it actually, although the at-home bili treatment finally got it cleared up. She obviously didn't have delayed cord clamping, nor was she bf'd.

Jaundice is made out to be this awful monster. And unchecked, at high levels, it can have devastating impacts. I just don't think that your son's jaundice was necessarily caused by delayed cord clamping. It may have increased the jaundice, but there would probably have been jaundice anyway. Most babies do have it.

[Kidzaplenty]

Very interesting article. Thanks for the link.