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  • If allowed, one way to include dad in childbirth is to make him the one to cut your child’s umbilical cord. (Click here for the full story.)
    PHOTO BY Courtesy of Joy Celeste

    Moms who are pregnant might be feeling anxious about giving birth in the middle of the COVID-19 pandemic, but it’s important to keep calm and have an open communication with your OB-GYN so you are better prepared for the arrival of your baby. One of the things you can ask is whether your birth plan can still be prioritized — especially life-saving practices like delayed cord clamping.

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    What is delayed cord clamping?

    Delayed cord clamping is the extension of the time between the delivery of a newborn and the cutting of the umbilical cord. According to the American Pregnancy Association (APA), “this allows more blood to transfer from the placenta to the baby, sometimes increasing the child’s blood volume by up to a third.” The blood contains essential nutrients like iron and antibodies, which is essential for healthy brain development.

    Delayed cord clamping may be done whether a mother gives birth via normal or cesarean delivery. The World Health Organization (WHO) says that delayed clamping is just as important for cesarean births.

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    How long can you wait before cutting the umbilical cord?

     There is no set waiting time before cutting the umbilical cord. But according to the APA, findings by the WHO suggest that waiting one to three minutes after delivery or longer can be recommended for all births. These are the guidelines followed by the Philippine Pediatric Society (PPS).

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    What are the benefits of delayed cord clamping?

     Several studies have proven that delayed cord clamping can have a positive effect on both preterm and full-term babies. Here are some of the reasons:

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    1. It can help save preemies’ lives.

     A 2017 study, which looked into nearly 3,000 Australian babies born before 37 weeks, found that delaying cord clamping by up to 60 seconds dramatically reduced by a third the number of premature infant deaths in hospitals.

    According to the American College of Obstetricians and Gynecologists (ACOG), the extra blood that babies get from the placenta has been associated to help improve transitional circulation, better establishment of red blood cell volume, and decreased need for blood transfusion in premature babies. It also lessens the chances of the premature infant from suffering from brain hemorrhage and necrotizing enterocolitis, an intestinal disease common in preemies wherein the intestinal tissue becomes damaged and begins to deteriorate.

    David Osborn, an associate professor at the University of Sydney and lead author of the study mentioned above, estimated that for every one thousand preterm babies born more than 10 weeks early, delayed cord clamping could save up to 100 more lives. “This means that, worldwide, using delayed clamping instead of immediate clamping can be expected to save between 11,000 and 100,000 additional lives every year,” he said.

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    2. It provides long-term neuro-developmental benefits.

     Preemies are not the only ones who reap benefits from delayed cord clamping — full-term infants also get neuro-developmental benefits from it. A 2015 study found that children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose umbilical cords were cut within 10 seconds.

    The additional blood flow from the placenta has been linked to increased hemoglobin levels at birth and improved iron levels in full-term infants. The iron in the blood increases the newborn’s iron storage, which is crucial for healthy brain development, according to the APA.

    In 2019, a study published in The Journal of Pediatrics suggested that waiting for five minutes before cutting the cord can also improve early brain development. According to researchers, waiting “while infants are held skin-to-skin with the mother, leads to more myelin development.” The regions of the brain affected by this increased myelination are those associated with motor, sensory-processing and function, and visual development.

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    “These are all important for early phase development,” said Debra A. Erickson-Owens, co-author of the study, a certified nurse-midwife and a University of Rhode Island professor of nursing.

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    3. Decreased risk of iron deficiency anemia.

     According to the APA, delayed cord clamping transfers an additional 40 to 50 mg/kg of iron to newborns. This prevents iron deficiency during baby’s first year, including severe side effects associated with it. Common side effects are cognitive impairment and central nervous system problems.

    Are there risks associated with delayed cord clamping?

     According to the ACOG, there is a small increase in the incidence of jaundice in infants undergoing delayed cord clamping. But the benefits may outweigh the risk, so long as phototherapy is immediately available.

    If, however, there is increased risk of postpartum hemorrhage (e.g. placenta previa or placental abruption), the ACOG says that “the benefits of delayed umbilical cord clamping need to be balanced with the need for timely hemodynamic stabilization of the woman.”

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