At her nine-month check up, my firstborn's hemoglobin level was low. What followed was a sleepless, expensive roller coaster ride filled with iron supplements, invasive tests and many tears — both hers and mine. When I was pregnant with my second child, I stumbled upon research that said delayed clamping of the umbilical cord increases iron stores up to six months after birth in full-term infants.
What's in Cord Blood?
Expectant parents are well aware of the value of cord blood. After all, we get hit with advertising from services offering to bank it in case of an emergency for a hefty price tag at every turn — from flyers stuffed in shopping bags at maternity stores and baby fairs to brochures in the welcome goodie bags from hospitals. What many don't realize is that our babies can also be guaranteed to benefit from it for free by asking our doctors or midwives to simply wait 1 to 3 minutes to cut the cord. If not, a third of baby's blood, including iron stores, and a third of its stem cells remain in the placenta.
"We know that if the baby has iron deficiency, they are more likely to develop anemia," says Kristina Reber MD, FAAP, associate division chief of the Neonatology Section at Nationwide Children's Hospital and assistant professor of Pediatrics at The Ohio State University College of Medicine. "Iron deficiency is also associated with neurodevelopmental problems and developmental outcomes."
Dr. Reber doesn't want parents to panic that their child will develop these issues if delayed cord clamping (DCC) isn't possible, as she says babies in the United States have other iron resources, such as iron-fortified food.
What the Research Says
Research, such as meta-analyses from the Journal of American Medical Association and last year's Cochrane review, have clearly shown the benefits of DCC in full-term infants, who only have a small risk of jaundice that requires phototherapy.
"For a long time, the evidence has shown delayed cord clamping is best for babies, and it also just makes sense," says Stephanie N. Tillman, CNM, MSN, midwife with Access Community Health Network in Chicago, Ill. "It's one of the things to ask for that's easy to do."
Despite these considerations, Tillman says DCC is an option that isn't always offered and is provider specific. Some providers who do DCC hold babies below mom to let the blood flow downward. But Tillman says parents don't need to choose between DCC and immediate skin-to-skin contact, which is beneficial for warmth, bonding and breastfeeding.
"All the research has shown that the pressure from the pulsation continues to push the blood toward baby. There isn't any value to the concern," Tillman says.
Sean Daneshmand, MD, perinatologist with the San Diego Perinatal Center and founder of Miracle Babies, a nonprofit organization that supports families with newborns needing neonatal care, says most of his patients are requesting DCC and that it's possible for babies born by C-section as well. Dr. Daneshmand says studies are also being done on milking the umbilical cord for situations when DCC is not possible and immediate resuscitation isn't required.
"I think that patients should be pushing for delayed cord clamping so long as there aren't other complications at birth," Dr. Daneshmand says.
While it's too soon to tell if using DCC benefitted my second baby, I will cherish those first minutes snuggling skin-to-skin together forever. So, it turns out it was a wonderful gift to me, too.