Delayed cord clamping

AK118

I searched and didn't see much on here regarding delayed clamping. I've just started doing some Internet research and plan on talking with my OB at my next appointment. Just wondering if any of you ladies (STM+ or FTM who have spoken with dr. or work in the field) had any helpful info to share. Thanks!

wildtot

I will be speaking to my doc about tomorrow. I've read some it has some good benefits.

jonesl12

I was just reading about this. I'm all for it if it's possible.

thaisac1

I don't know anything about this, but here's a credible source:

https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth

"However, currently, evidence is insufficient to confirm or refute the potential for benefits from delayed umbilical cord clamping in term infants, especially in settings with rich resources."

brie_and_almonds

This was literally the only thing we had in our birth plan for DD. It was moot because she ended up a c section, but from the research I did, there's no reason not to.

thaisac1

brenlo42 said:

This was literally the only thing we had in our birth plan for DD. It was moot because she ended up a c section, but from the research I did, there's no reason not to.

From my very limited understanding of this from reading the ACOG summary above, there is one potential downside to it, which is a 69% increase in the need for phototherapy (which is used to treat jaundice in the neonate).

AmadorRose

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes?

Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

Bubbles3592

I plan to do delayed cord clamping, if possible. If there are complications during labor, your birth plan basically gets thrown out the window. But if everything goes smooth, I would really like to do it.

thaisac1

AmadorRose said:

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes? Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

I agree with your interpretation; if a baby is born at term he/she probably won't need the extra blood. If premature, that's a different ballgame.

My answer to your specific question is only partial since this is not my specialty; but I do not think there is a genetic component to neonatal jaundice short of actual genetic conditions that would be obvious in your family if present. I could be wrong though as I have never looked into this in depth.

AmadorRose

thaisac1 said:

AmadorRose said:

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes?

Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

I agree with your interpretation; if a baby is born at term he/she probably won't need the extra blood. If premature, that's a different ballgame.

My answer to your specific question is only partial since this is not my specialty; but I do not think there is a genetic component to neonatal jaundice short of actual genetic conditions that would be obvious in your family if present. I could be wrong though as I have never looked into this in depth.

Now I have something to do on my Christmas vacation, because I have to know whether Caucasian babies are more or less likely to be jaundiced than mixed or Hispanic babies. Hopefully I can find something I can interpret!

AEG84

I'm torn. I know my doula is a big proponent. But I've also read that when you do delayed cord clamping, there is typically not enough cord blood left to donate it, which I would like to be able to do. So, undecided at this point. I haven't talked to my doctor yet so I'll add it to my list for the next appointment.

thaisac1

AEG84 said:

I'm torn. I know my doula is a big proponent. But I've also read that when you do delayed cord clamping, there is typically not enough cord blood left to donate it, which I would like to be able to do. So, undecided at this point. I haven't talked to my doctor yet so I'll add it to my list for the next appointment.

This is a good point, actually! For anyone considering cord blood donation, this is a make or break point.

AmadorRose

Ooh can we talk about donating the placenta for use in skin grafting here or is it too far off? Someone mentioned on the second tri board that she had done it with her first and I'm curious to see if anyone I "know" has any knowledge.

thaisac1

AmadorRose said:

Ooh can we talk about donating the placenta for use in skin grafting here or is it too far off? Someone mentioned on the second tri board that she had done it with her first and I'm curious to see if anyone I "know" has any knowledge.

That's the first I hear of it!

AmadorRose

@thaisac1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542901/

I'm only about 15 pages in but it sounds promising. Full-thickness burns and vomit are the only things that really give me the heebie-jeebies, and I'd rather my unused parts went to something more worthwhile than in a biohazard bag for disposal somewhere.

Edit: apparently I can't grammar tonight.

tripledaggerWed95976

AmadorRose said:

Ooh can we talk about donating the placenta for use in skin grafting here or is it too far off? Someone mentioned on the second tri board that she had done it with her first and I'm curious to see if anyone I "know" has any knowledge.

So I just did some quick research on it-- it appears you are only eligible to donate if you deliver through c-section. Other than that, it sounds like a great cause

thaisac1

AmadorRose said:

@thaisac1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542901/ I'm only about 15 pages in but it sounds promising. Full-thickness burns and vomit are the only things that really give me the heebie-jeebies, and I'd rather my unused parts went to something more worthwhile than in a biohazard bag for disposal somewhere. Edit: apparently I can't grammar tonight.

@AmadorRose WHAT, are you trying to tell me you won't eat your placenta???? How could you???

AK118

@AmadorRose maybe start a separate placenta thread since they are two separate things? Thanks!

AmadorRose

@thaisac1 I thought I mentioned that I don't like vomit

@AK118 it's done, didn't mean to hijack your thread!

thaisac1

AmadorRose said:

@thaisac1 I thought I mentioned that I don't like vomit @AK118 it's done, didn't mean to hijack your thread!

@AmadorRose you could make placenta cupcakes or placenta chips!

momofmanyinthemitten

I waited with DD2 and she was a tad jaundiced, but certainly didn't need phototherapy.

thaisac1

To be perfectly honest, I think that if the delayed clamping was something unequivocally beneficial, all doctors/ hospitals would have adopted it as gold-standard of practice. Medical guidelines for all specialties are updated often, no medical professional would willingly withhold a beneficial strategy from newborns… If this is not common practice, there may not be enough evidence to support it after all. My 2 cents.

spicedice

We delayed clamping with DS1 and plan to do it again with DS2, unless something happens and we have to deviate from the birth plan.

We also pretty much delayed everything until after DS1 had had time to snuggle me and breastfeed. They got his weight probably after he tried feeding three times and peed all over a nurse.

ivyvines6

AmadorRose said:

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes?

Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

I'm glad you brought up jaundice being linked to genetics. I didn't even think about that, but the last four of my mom's kids had it bad.

spicedice

Knottie9983816 said:

AmadorRose said:

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes?

Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

I'm glad you brought up jaundice being linked to genetics. I didn't even think about that, but the last four of my mom's kids had it bad.

I know all of my siblings and I had jaundice because my mom is O+ and all of her kids are B+. O+ moms, check your SO's blood type for more than just RH! If they are anything other than O, you may be at an elevated risk for your baby being born jaundiced.

cosmobella

Agree on the blood type thing. My first was fine (O+ like me) but DS2 was A+ and needed several days of phototherapy for his jaundice. The nice thing is that he was able to have the phototherapy in the room with me so we weren't separated.

momofmanyinthemitten

thaisac1 said:

To be perfectly honest, I think that if the delayed clamping was something unequivocally beneficial, all doctors/ hospitals would have adopted it as gold-standard of practice. Medical guidelines for all specialties are updated often, no medical professional would willingly withhold a beneficial strategy from newborns… If this is not common practice, there may not be enough evidence to support it after all. My 2 cents.

Guidelines are changing all the time. There are plenty of things that docs do that aren't beneficial to the patient, but are convenient for the doc. When DD1 was born, they said to wait until a year to introduce common allergy foods. Now it's recommended at 4-6 mos (DH is an allergist), but many FP and pedis aren't even aware of this. Just because it's not adopted by all doesn't mean it's not good. That said, delayed cord clamping isn't a must have for me, but my OB is really laid back and generally gives mom and baby a minute or two to snuggle before clamping anyway.

mojomama6

I have to agree with @kielpinskim 's point about recommendations taking a while to trickle down to common practice. Allergen foods are a good example; obstetric care, though, is quite possibly the worst specialty for this, even according to my own ob.
I'm not passionate about delayed clamping, but since the blood does actually belong to the baby, I see no reason to hasten cutting the cord. *shrug*

thaisac1

mojomama6 said:

I have to agree with @kielpinskim 's point about recommendations taking a while to trickle down to common practice. Allergen foods are a good example; obstetric care, though, is quite possibly the worst specialty for this, even according to my own ob. I'm not passionate about delayed clamping, but since the blood does actually belong to the baby, I see no reason to hasten cutting the cord. *shrug*

One thing is when some studies show benefit and doctors don't change practice for being unaware... The other thing is when the societies evaluate all available evidence and come up wit Guidelines or Position Statements to be followed. Then, there is no excuse for not following.

If delayed cord clamping was being done by most doctors/ hospitals; and only a few doctors/ hospitals here and there were not doing it, one could assume that the information about the benefits was not being disseminated widely. But, although this is not my specialty, my overall impression is that delayed clamping is not the common practice. Which likely means that societies have not endorsed it as such. Take this with a grain of salt, as I am not an obstetrician.

It takes more than a few studies to get the societies to introduce a recommendation. So even though you may find the studies on your search, it may not have been enough to dictate a new gold standard of practice. The link I posted above corroborates this hypothesis: The American Society of Obstetrics and Gynecology presently concludes that there is not sufficient evidence to recommend for or against delayed cord clamping at this time.

jest+jun

Ok first I will say that I've done no research regarding this but I can offer the experience of my friends. They had a home birth and actually did not clamp the cord at all, instead they let it come off naturally with no ill effects. Their son will be 1yr soon, a healthy and happy little boy.

Also I saw the question on here about how genetics might affect jaundice and I wanted to say that it actually has a lot to do with race. My mother is Caucasian and my father a mix of Japanese, hawaiian, philipino etc. It is very common in hawaii for full term babies to be born jaundiced simply because of the amount of mixed races in hawaii. Its so common actually that its actually odd to see babies completely free of it. None of my 3 children required photothereapy like I did at birth but I still had to take them all back to the doc a few days after birth to get blood to test their bilirubin levels.

Also I was an o+ child of an AB- mother who already had the antibodies from delivering my brother vaginally. Which is a whole other thing, I guess. But still, according to the OBs in hawaii this has less to do with jaundice as being of mixed asian/Caucasian descent.

Hope this helped. I'm no expert on the subject its just that I've been around it all my life it seems.

kalanieileen

fbanke42 said:

Knottie9983816 said:

AmadorRose said:

What I'm getting from this is that, unless you have a preterm infant, there isn't enough evidence to support delayed clamping. Yes?

Also, @thaisac1 since you're here...how much can jaundice at birth be blamed on genetics? Several of my nieces and nephews have been moderately jaundiced and now I'm curious what, if anything, influences it.

I'm glad you brought up jaundice being linked to genetics. I didn't even think about that, but the last four of my mom's kids had it bad.

I know all of my siblings and I had jaundice because my mom is O+ and all of her kids are B+. O+ moms, check your SO's blood type for more than just RH! If they are anything other than O, you may be at an elevated risk for your baby being born jaundiced.

Wow, I have never heard of blood type causing jaundice. I am O+ and actually don't know what DH is. I'm adding this to my list of questions I want to ask my OB-- perhaps she has some anecdotal evidence she can share.

kalanieileen

@jest+jun did you live in Hawaii? I'm from Lahaina! I will have to ask my mom if I was jaundice or not: I am Filipino, Hawaiian, Chinese, and German. Very very true about mixed babies in Hawaii-- it is speculated in the next few years to come that there will be no more pure native Hawaiian blood due to the mass influx of different races reproducing in Hawaii.

Going to school there, having to prove my bloodline (show if I have Native Hawaiian blood) to be accepted into certain schools made me feel like Hogwarts with the purebloods and halfbreed thought process.

AK118

Hate to be a pain, but if we could try to keep this thread on topic, I'd appreciate it. It's hard sorting through this board sometimes as it is. Thanks, ladies!

jest+jun

@kalanieileen Omg yea :-) im on big island and when I applied to kam schools in keaau I had to get like 3 generations birth certificates to prove my ancestry lol totally like proving urself to the ministry of magic.

Ok sorry bout that lol maybe a whole new topic for jaundice is needed?

Somersky

Right now, our plan is to delay it. It's standard practice with our midwives (and maybe the whole hospital where our midwives' office is?).

BrittnyS10

I've been considering delayed clamping. I had no idea about the increased risk for jaundice. I plan to ask my midwife her opinion on delayed clamping before I completely make up my mind. I have an appointment tomorrow and will ask her then, if I remember.