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Old 09-27-2012, 08:59 PM   #1
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Links that an OB would trust on delayed cord clamping

I've read multiple times and multiple places that waiting until the cord stops pulsating is best for the blood supply to the baby. I'm due to have my 3rd hospital birth at the beginning of April and would like to discuss this with my OB. I chickened out last time though because I couldn't really find any medical studies backing the advantage of it and I like to be super prepared. Are there? Or, any links to the contrary, I'm open to that as well.
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Old 09-27-2012, 10:10 PM   #2
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I'd like to know, too!
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Old 09-28-2012, 07:38 AM   #3
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Google "grand rounds delayed cord clamping". That should get you to a couple of very informative (if clinical) youtube videos, and some links to compiled research. I would link it, but I'm on my phone.

ETA: The article I'm thinking of is on academicobgyn.com
ETAA: Is your OB against delayed cord clamping? You might also just ask him what he prefers to do and why...most docs I've encountered are familiar with it by now and unless there's an emergency with the babe, they are usually ambivalent about waiting even if they don't think it's crucial.
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Old 09-28-2012, 08:06 AM   #4
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Re: Links that an OB would trust on delayed cord clamping

Your OB should have already read up on it. I know dh knows about it, and although he's not an OB, their jobs overlap a lot (he's a baby Dr).

The thing is, the evidence of any benefit is pretty weak. It's one of those things that probably won't harm your baby, unless you have kids who tend to get jaundice, and may have some small benefits. We don't delay cord clamp our kids because jaundice is a major issue for my babies. Having more RBC's increases jaundice because the baby needs fewer RBC's after birth than it does before birth. Before birth, it needs more because the placenta isn't as efficient at oxygenating blood as the lungs are. But after birth, babies tend to be slightly anemic, and the thought, although there is little real evidence, is that this is protective for the baby to reduce possible stroke risk and jaundice. But anyway, as the baby's body kills off the extra RBC's, the byproduct is billirubin. In a mature liver this is cleared very easily, but it takes a few days after birth for the newborn's liver to be very good at it, and babies get jaundiced as it builds up in the blood stream. At least, this is the very basic explanation. There's some other potential things that may be beneficial to slightly anemic babies, but I don't know them all. Blood is crazy complex, to tell the truth. That's why there's a whole specialty just on blood.

If your baby is not a jaundice risk, then it's probably not going to hurt or help, and most hospitals will just go with the flow about it these days. So, I guess what I'm saying is, you probably don't need to make a case for it. Also, I think these things are usually best saved for when you are actually in labor. An OB is likely to forget things you want to happen at your birth if you just mention it in the office, but when you're in labor they will be more likely to remember. I usually don't talk about the birth at all until I'm admitted, and that's gone over really well. GL.
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Old 09-28-2012, 12:28 PM   #5
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Re: Links that an OB would trust on delayed cord clamping

Thanks for the replies! I don't want to make a case for it unless there is actually a reason to so I'm trying to get myself educated as well. You can pretty much find somewhere on the internet to back up anything you believe which is why I want to find a medical study because at least sometimes those are reputable

Thanks for the info on jaundice and cord clamping, I wasn't aware of that before but it makes sense.
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Old 09-29-2012, 01:03 PM   #6
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Re: Links that an OB would trust on delayed cord clamping

My understanding is that the benefits come in if you are going to breastfeed (which isn't iron fortified, like formula is) because there are lower rates of anemia (once the baby is several months old) if cord clamping is delayed. Anemia was an issue for my sibs and I (all EBF) when we were babies. Not sure how reliable this info is, but I'm planning on delaying clamping for this reason. But I'm also delivering with a CNM is very supportive of my choices.
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Old 09-29-2012, 06:53 PM   #7
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Re: Links that an OB would trust on delayed cord clamping

You probably aren't going to have access to info online that your OB doesn't have more comprehensive info about. Do you have complete journal access, or access to Up To Date? Dh liked Up To Date when he was looking for info for parents.

You could also ask your Pediatrician to print some stuff off for you, if you think it is going to be a problem, and you don't have journal access. Pediatricians are, in general, more educated about newborns than OB's, so although their jobs overlap a lot, talking to your Ped about it might give you more comprehensive parent education about it, and even if s/he is unable to print stuff off for you, s/he might be able to give you some leads about specific journals you can look in.

Also, talk to your Ped about the iron supplementation and anemia in BF infants. The opinions about how much of a problem anemia is seems to vary between Peds. The AAP does have set guidelines, though, and that is what they are supposed to follow. But if you have a good rapport with your Ped, they may chat with you about it even if it goes against the AAP's recommendations. When dh was doing general Peds he would prescribe the supplements for BF babies, but he had (has) differing opinions about it than the AAP policies.
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Old 09-29-2012, 07:52 PM   #8
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Re: Links that an OB would trust on delayed cord clamping

why is it bad for kids that have a high risk of Jaundice....my kids have a huge risk due to something wrong with me. both girls were NICU and re admitted cause it was so bad
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Old 09-29-2012, 09:22 PM   #9
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My son has increased risk of jaundice and didn't end up with it severely with delayed cord cutting my oldest was in the nicu and they cut the cord immediately. . There are lots of studies most dr are up to date and doing it anyways now.

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Old 09-30-2012, 07:57 AM   #10
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Re: Links that an OB would trust on delayed cord clamping

It's better to think of it as "physiological clamping/cutting" vs. delayed, imo. What is the biological NORM? Immediate cord clamping is an intervention that should be limited unless there is a real reason that cord simply has to be cut, or it comes off on it's own. The ONLY mammal that initiates it's own immediate clamping is a dolphin, I beleive? It's in that "grand rounds" on academic OBGYN. Why is that? The extra blood volume is important because the baby needs it to inflate the lungs for breathing and still have enough extra to circulate without putting stress on the body. It's not JUST because it increases RBC and iron levels, which is true, but not the only reason.
Immediate clamping is the intervention, not the biological norm. It's ridiculous to me that there is even a debate about the benefits of allowing the child the biological norm. FWIW, with both of mine the cord was allowed to pulse, and the first wasn't jaundiced at all and the second did have mild jaundice. Studies have generally shown that mild jaundice may be a bit higher with physiological clamping, but then again mild jaundice is NOT HARMFUL, and may well be the biological norm.

Here's the link to academic ob/gyn.
http://academicobgyn.com/2009/12/03/...in-obstetrics/
http://academicobgyn.com/2011/01/30/...-grand-rounds/
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