To Clamp or Not to Clamp

A study published on November 16, 2011 in the British Medical Journal backs up what midwives have been doing for years: delayed cord clamping in healthy, uncomplicated babies.

A randomized controlled trial of 400 full-term infants born between April 2008- September 2009 took place in Sweden. These pregnancies were all low-risk. The midwives were randomized to cutting the cord at 10 seconds or 3 minutes or more after the birth. Blood was drawn from the cord at birth, and then from the infant on day 2 and at 4 months of age. Infants in both groups had similar hemoglobin (the iron-containing protein in red blood cells that carries oxygen), however, the infants randomized to delayed cord clamping had higher ferritin levels and lower iron-deficiency anemia. There was no difference in complications thought to be a result of delays: respiratory problems, elevated platelets or jaundice.

Delayed cord clamping allows the placenta to continue to transfuse blood from mother to baby through the cord. This not only increases the blood volume in the baby, but also increases iron stores as shown by this study. We know that adequate iron is necessary for brain development.

Andersson, O. Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial. BMJ 2011;343:bmj.d7157

Written by Jennifer Williams, CNM