Don’t cut a newborn’s umbilical cord right away, study suggests

Doctors often clamp the umbilical cord right after a baby is born. But a new study suggests that there might be many benefits, and few risks, if doctors hold off for at least a minute to allow more blood to flow from the placenta to the baby.

After a review of available literature on the subject, researchers found that babies whose cord was clamped later had higher iron levels and were less likely to become anemic than those who were clamped right away. The one downside was an apparent slight increased risk of jaundice in babies whose cords were clamped later. That condition is treated with light therapy.

One reason doctors have chosen to clamp the cord early is a fear of hemorrhage in the mothers. But after reviewing the data, the authors of the new study say this is not an issue. “This review of 15 randomized trials involving a total of 3,911 women and infant pairs showed no difference in postpartum hemorrhage rates when early and late cord clamping (generally between one and three minutes) were compared,” reported the researchers, who were led by Susan McDonald, a professor of midwifery at Melbourne’s La Trobe University/Mercy Hospital for Women. The review was published in The Cochrane Library.

Babies whose umbilical cords were clamped early were twice as likely to be iron deficient three to six months after being born compared to those whose cords were clamped later, the study found. There was, however, a 2 percent increase in jaundice in babies whose cords were clamped later.

Dr. Joanne Stone, a professor of obstetrics, gynecology and reproductive science and director of maternal fetal medicine at the Mount Sinai Medical Center, said that the study “does show a benefit in the immediate period after a baby is born in terms of a higher iron stores and birth weight. What that translates to in five years we don’t know yet. Long-term studies will hopefully answer that question.”

Delayed clamping isn’t right for every mother and baby, however, Stone said.

“There are situations in which it would be appropriate and ones where it is not,” she explained. “In a low -risk patient who is delivering vaginally in the hospital where the baby’s bilirubin levels can be monitored, it makes a lot of sense.”

There’s no information on C-section deliveries in the new research. In C-sections, you want to be able to close the abdominal incision as quickly as possible to protect the mother’s health, Stone said.