Delayed Cord Clamping

jennlynn777 · June 2016

Hey ladies. I'm not sure if this has been discussed or not but I found it pretty interesting. So I thought I would share. Has anybody ever done this?? I have not but my husband and I are considering it.

Here is a link that explains it and a video as well! :-)

https://thestir.cafemom.com/pregnancy/125775/delaying_cord_clamping_explained_video

Shiva14 · June 2016

I asked for it last time and the doctor said they only do it for premies and refused to do it for us..... since I have the same doctor I'm not holding my breath this time. There are definitely benefits but I have also heard that it can heighten the risk of jaundice. My son had severe jaundice so that's another reason why we wouldn't do it this time around.

mrsvoorhees-2 · June 2016

We had planned to do it last time but DDs heart rate had gotten too high so we weren't able to. My hospital doesn't do it as a standard practice because studies show it really only helps in preemies and not full term, but I don't see a reason to not do it. I plan to ask for it again and trust my dr to make the decision in the end like last time.

Bibliobebe · June 2016

We're planning on delayed clamping. Our clinic does it regularly at parents' request so that gives us some confidence.

Themaritimemama · June 2016

No delayed clamping here, as PP mentioned, due to jaundice levels. My second and third had jaundice and required light therapy, so we don't want to take the risk.

BabyBoyH92016 · June 2016

I was interested in this and my doctor said that studies have shown that only preemies benefit from delayed cord clamping. If I go full term, I will not delay clamping since its not without risk.

Sbrown721 · June 2016

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

KristinUM12 · June 2016

Delayed cord clamping is the default at the midwife center I'm using. I think they would clamp sooner if requested, but I didn't ask.

OBMommy · June 2016

Ditto to the above comments. DCC helps prevent anemia but greatly increases the risk for jaundice. Since anemia in infants is much more rare than jaundice, I will not be practicing delayed cord clamping.

Bibliobebe · June 2016

An interesting article from NPR on delayed clamping:

https://www.npr.org/sections/health-shots/2015/05/26/409697568/delayed-umbilical-cord-clamping-may-benefit-children-years-later

As far as I've seen there have been plenty of studies that show that delayed cord clamping can be potentially beneficial, though maybe not exactly necessary. Perhaps not enough studies to lead to a full scale turn around of the entire medical practice regarding it, but enough that women who would like to participate have enough reason to AND women who don't wish to participate also have plenty of reason.

camichael84 · June 2016

I'd asked for it with my first, but the oncall OB that delivered DD didn't get told, I presume, and it wasn't on my mind as it was happening. After learning the jaundice risks, we won't be asking this time. DD1 was jaundice and stayed under bili lights for a day and a half. I don't want to do anything that would heighten the risks of that.

tinypikachu · June 2016

I found out recently that this is the default practice at the hospital. We didn't really care either way so we won't care if they do it or not.

Thscary · June 2016

We won't be doing DCC because we are having cord blood collected, so DCC isn't even an option

mrsvoorhees-2 · June 2016

After this thread, I don't think I'm going to request it now! Thanks for all the input ladies, as usual!

ruemcclanahan · June 2016

@MrsVoorhees Same! After reading the thread I looked more into it and we think it isn't for us. I'm going to talk to my OB and see what she recommends,

Bibliobebe · June 2016

@MrsVoorhees @Megan324 I fully support each mom 100% in their baby decisions, I'm just curious as to what made you two change your minds about delayed cord clamping. NOT because I'm questioning you but because I'm just curious about what precise risks are making you reconsider (maybe I haven't considered them myself).

I'm also curious about jaundice concerns. I'm a FTM so I've never had to deal with a jaundiced baby, though one of my siblings (or myself) had it, I remember my mom mentioning it, and there hadn't been much concern regarding it at the time. Since I've never had the experience, I don't know what those concerns are, so my opinions are coming from a place of statistics. According to The March of Dimes 3 out of 5 babies have some form of jaundice at birth and the risks related to it are very minimal except in rare cases, especially when you have availability to blue light therapy, which I'm pretty sure every hospital has.

The only academic/medical studies I've been able to find say that the increased risk of jaundice is just inside 2%.

Also the most recent 2015-2016 medical journal articles I've come across via searching jaundice and DCC together are either entirely neutral about cord clamping (they can't find reason for or against) or they've discovered benefits. Here are a few:

Articles:
https://pediatrics.aappublications.org/content/137/3/e20153236.abstract

https://journals.lww.com/advancesinneonatalcare/Abstract/2016/02000/Delayed_Umbilical_Cord_Clamping_in_the_21st.13.aspx (Looks like the main concerns here is possible hindrance to immediate resuscitation and the convenience of the practice)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855192/ (This one is talking about utilizing delayed clamping in a specific medical case, which isn't exactly what we're talking about but I thought I'd include it)

https://www.jcnonweb.com/article.asp?issn=2249-4847;year=2015;volume=4;issue=3;spage=183;epage=187;aulast=Krishnan (Recommendation that DCC should become a standard of care in LOW RISK pregnancies).

https://www.tandfonline.com/doi/abs/10.3109/14767058.2015.1105951 (A more neutral study showing that infants without DCC didn't suffer any disadvantages but several of the infants had a better chance of avoiding anemia.)

I am not posting these articles to try to convince anyone specifically, I'm posting them because this is what I'm finding. I would love it if some of you would share your articles about the concerns regarding DCC so that I can be more informed on that perspective as well!

camichael84 · June 2016

@Bibliobebe I mentioned it in my earlier post and my first had jaundice. Here were the issues we encountered with it:

Unless she was nursing, she was under bili lights. The nurses are also the ones that decided when she could nurse (pretty much every 3 hrs). I could only see and hold my daughter for 20-30 minutes every three hours from the time she was a day and a half old until she was three days old. I know that is nothing compared to what some mom's endure, but after having her inside of me for 9 months, it was terrible.

To help her get the bilirubin out of her system, we had to supplement. My hospital had the option to use donor breastmilk or formula. We opted for donor milk that the nurses or DH bottle fed her. I also pumped what little I could get for them to syringe feed her that.

We ended up staying an extra day in the hospital because she had to be on the bili lights, and I think we were on the lucky side. I have a friend whose son stayed on the bili lights for over a week before they sent him home with a bili blanket.

I also believe every mom should make the decision that is best for them, but I want to share my experience with a jaundiced baby for that POV. My concern with DCC (in my particular situation) is making any potential jaundice worse than it already was.

Shiva14 · June 2016

@Bibliobebe my experience with jaundice wasn't nearly as bad as @camichael84 but it still sucked.

DS had no signs until his 2 day checkup. From there, his levels kept rising. I had to drive my 2 day old newborn to the pediatrician daily and watch him scream in pain as they drew blood from his little feet (after 5 days they were all bruised up). His levels kept rising and rising until he was 1 point from hospitalization. At that point we got a light blanket.

They have to be on that blanket 23 hrs a day. So you nurse, change, sleep with them on the blanket (which is a hard piece of plastic, not a blanket). You also have to be 3 feet from an outlet at all times. DS had to be on it for 7 days.

It was not the way I had envisioned my forst few weeks with my newborn for sure. Also, if jaundice gets bad enough it can cause brain damage. It may not happen often, but when you see your child's levels rise for two weeks straight despite lots of liquid/sun and eventually blankets, you worry anyway. A lot. To me, the delayed clamping is not worth potentially increasing the severity of my LO's jaundice. I am expecting this LO will also have it since my family is prone to it.

Shiva14 · June 2016

Here's a study I came across linking jaundice/DCC

not sure of the percentage, these are always confusing to me.

https://m.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Timing-of-Umbilical-Cord-Clamping-After-Birth?IsMobileSet=true

"In five trials, which involved a total of 1,762 infants, a significant increase was noted in the need for phototherapy for jaundice after birth among infants in the late umbilical cord clamping group"

Themaritimemama · June 2016

I had a similar experience to @camichael84 with jaundice. I had to try desperately to soothe my new infant from under lights, my son kept ripping off the eye covers, and they literally glued Velcro to the side of his head.. Supplemented to try to get their levels down, and the foot poking constantly was sad. Both kids with jaundice were under the lights for a few days a piece... It just wasn't fun. If it happens again, then it happens again... But I just wouldn't want to risk having a more severe case of it.

mrsvoorhees-2 · June 2016

@Bibliobebe same reason as @camichael84 We didn't have to do the lights, but had to closely monitor her jaundice and it's just stressful for a new mom. My nephew had dangerously high levels and I feel like with the studies not showing a strong indication that DCC is the way to go, I don't feel the need to risk it for no guarantee of only a slight potential benefit.

LizC216 · June 2016

Jaundice was pretty bad for my first. Very similar to @camichael84. She was under the lights/on the blanket for nearly 5 days. For 2.5 days, we had to leave her in the hospital after I was discharged. We could go back during the day to "visit", I hated it. I know there are worse things, but being a first time mom leaving the hospital without my baby was tough. I also felt bad for all the foot pricks and the follow up blood tests she needed after discharge. Each of my kids will be at risk for jaundice due to ABO incompatibility. Thankfully my second was jaundice free, but for me, I wouldn't do anything that could increase the chances of that happening again.

LizC216 · June 2016

Deleted. My above reply somehow posted twice.

rn1stbae · June 2016

I didn't view your video because I'm at work but at our hospital it's standard practice to delay cord clamping until either pulsation stops or about two minutes (two minutes usually comes first)(baby friendly hospital). In many places the cord will be milked even if you clamp it right away. I haven't done an official review of literature to see how long these articles are stating "delayed clamping" is and whether or not it's really tied in to higher bili levels, but, as long as our delivery goes without incident we'll be delaying clamping. The amount of blood that the baby can get is significant enough for me to want it. More blood = more hemoglobin, platelets, glucose, antibodies, all that good stuff! Also, this isn't to scare anyone but I had a really scary situation at work a few months ago where a 27 week mom spontaneously delivered in the middle of the night here in the ICU. Long story short one of the reasons the baby survived is because it was still receiving oxygen from mom via the cord.

mrsvoorhees-2 · June 2016

RN1stBae said:

I didn't view your video because I'm at work but at our hospital it's standard practice to delay cord clamping until either pulsation stops or about two minutes (two minutes usually comes first)(baby friendly hospital). In many places the cord will be milked even if you clamp it right away. I haven't done an official review of literature to see how long these articles are stating "delayed clamping" is and whether or not it's really tied in to higher bili levels, but, as long as our delivery goes without incident we'll be delaying clamping. The amount of blood that the baby can get is significant enough for me to want it. More blood = more hemoglobin, platelets, glucose, antibodies, all that good stuff! Also, this isn't to scare anyone but I had a really scary situation at work a few months ago where a 27 week mom spontaneously delivered in the middle of the night here in the ICU. Long story short one of the reasons the baby survived is because it was still receiving oxygen from mom via the cord.

In the situation of a premature birth, I would definitely request it!

Bibliobebe · June 2016

@RN1stBae With premature birth I think it's already widely accepted that delayed clamping is beneficial. It's the full-term babies that they (medical peoples) are trying to make decisions about regarding the benefits or risks, which means mamas-to-be are having to wade through the info to make their best decisions without too much conclusive research one way or the other. Which is fun (not entirely).

vampirina · June 2016

I think we're going to default to not requesting it (unless it's a preemie). Since the medical research seems to go either way, I think I'd just rather not at this point.

KimmySchmidt · June 2016

RN1stBae said:

I didn't view your video because I'm at work but at our hospital it's standard practice to delay cord clamping until either pulsation stops or about two minutes (two minutes usually comes first)(baby friendly hospital). In many places the cord will be milked even if you clamp it right away. I haven't done an official review of literature to see how long these articles are stating "delayed clamping" is and whether or not it's really tied in to higher bili levels, but, as long as our delivery goes without incident we'll be delaying clamping. The amount of blood that the baby can get is significant enough for me to want it. More blood = more hemoglobin, platelets, glucose, antibodies, all that good stuff! Also, this isn't to scare anyone but I had a really scary situation at work a few months ago where a 27 week mom spontaneously delivered in the middle of the night here in the ICU. Long story short one of the reasons the baby survived is because it was still receiving oxygen from mom via the cord.

Ew. DNW to think about it being "milked".

I don't care what anyone says, childbirth is disgusting.

rn1stbae · June 2016

KimmySchmidt said:
I don't care what anyone says, childbirth is disgusting.

Lol. Pretty much. Hopefully everyone sees this as light-hearted, because the baby survived through a freaky situation, but I ran out of the room to the nurses station and was like "Call OB and NICU! She had the baby!" And everyone just looked at me like I was crazy. Then I said "I'm serious! I don't know what to do!!!!" And my preceptor was like "What do you mean? She had the baby?"

"I don't know if it's prolapsed bowel or vagina or what, all I saw was something that looked like a potato but someone needs to get in here NOW!" And I turned around and ran away into the room. Then they believed me. But I had a weird intuition in the middle of the night and went to check the patient and sure enough there was all sorts of water and stuff in the bed. Oh, and a potato. Which turned out to be an bitty bitty baby that survived

I think I shit my pants btw.

crispy11 · June 2016

I'm team absolutely DCC for preterm baby and no thank you for full term baby. I was lucky enough to avoid significant jaundice with my girls, but I don't need the added stress of trying to make them poop out extra bilirubin while I'm working on breastfeeding; however, I had a long breastfeeding relationship with DD2 so fingers crossed, the beginning will be easier this time around!

yellowrose314 · June 2016

RN1stBae said:

KimmySchmidt said:
I don't care what anyone says, childbirth is disgusting.

Lol. Pretty much. Hopefully everyone sees this as light-hearted, because the baby survived through a freaky situation, but I ran out of the room to the nurses station and was like "Call OB and NICU! She had the baby!" And everyone just looked at me like I was crazy. Then I said "I'm serious! I don't know what to do!!!!" And my preceptor was like "What do you mean? She had the baby?"

"I don't know if it's prolapsed bowel or vagina or what, all I saw was something that looked like a potato but someone needs to get in here NOW!" And I turned around and ran away into the room. Then they believed me. But I had a weird intuition in the middle of the night and went to check the patient and sure enough there was all sorts of water and stuff in the bed. Oh, and a potato. Which turned out to be an bitty bitty baby that survived

I think I shit my pants btw.

Holy potatoes, I would have totally freaked out. Mad respect for you @RN1stBae!!!! Glad everyone survived that situation!

OBMommy · June 2016

camichael84 said:

@Bibliobebe I mentioned it in my earlier post and my first had jaundice. Here were the issues we encountered with it:

Unless she was nursing, she was under bili lights. The nurses are also the ones that decided when she could nurse (pretty much every 3 hrs). I could only see and hold my daughter for 20-30 minutes every three hours from the time she was a day and a half old until she was three days old. I know that is nothing compared to what some mom's endure, but after having her inside of me for 9 months, it was terrible.

To help her get the bilirubin out of her system, we had to supplement. My hospital had the option to use donor breastmilk or formula. We opted for donor milk that the nurses or DH bottle fed her. I also pumped what little I could get for them to syringe feed her that.

We ended up staying an extra day in the hospital because she had to be on the bili lights, and I think we were on the lucky side. I have a friend whose son stayed on the bili lights for over a week before they sent him home with a bili blanket.

I also believe every mom should make the decision that is best for them, but I want to share my experience with a jaundiced baby for that POV. My concern with DCC (in my particular situation) is making any potential jaundice worse than it already was.

This. Jaundice can be dangerous but can most certainly be treated. That being said, all of the above comments are absolutely true and can also result in a longer hospital stay and more blood draws for baby.

jennlynn777 · June 2016

Yeah this isy dilemma. I love the idea of giving him his full blood supply and all the extra goodies that can go with it, but my niece was born in Jan. with jaundice and they almost made the baby stay a few extra days. My sister in law was really upset and sad. Going home without baby because of a silly idea to delay the cord cutting? Not sure if that's a risk I'm willing to take. On the plus side none of my other children had jaundice. I don't know....it would be nice to know of a few moms who did it and it was successful without Jaundice.

midge519 · June 2016

jennlynn777 said:

Yeah this isy dilemma. I love the idea of giving him his full blood supply and all the extra goodies that can go with it, but my niece was born in Jan. with jaundice and they almost made the baby stay a few extra days. My sister in law was really upset and sad. Going home without baby because of a silly idea to delay the cord cutting? Not sure if that's a risk I'm willing to take. On the plus side none of ymy other children had jaundice. I don't know....it would be nice to know of a few moms who did it and it was successful without Jaundice.

lurker from October 2015

We did the delayed clamping, our hospital did the two minutes and then clamped. Our son had such beautiful color and was so lovely from the get go. It was like night and day co pared to my other children. They seemed to be more pale in color and just over all crankier. My other two births were 7.5 and 3.5 hours respectively and neither had jaundice. It worked great for us and the nurses loved that we asked to do it.

beachmama14 · June 2016

Delayed clamping is standard at my hospital. We did it with my daughter and didn't have any issues. No jaundice or any need for an extended stay. I understand the other concerns completely, but for us it worked out fine and we will do it with this baby since we will be at the same hospital again.

jbscmama · July 2016

Not sure if I missed this but are y'all doing the cord blood banking and does that affect the delayed clamping??

beachmama14 · July 2016

jbscmama said:

Not sure if I missed this but are y'all doing the cord blood banking and does that affect the delayed clamping??

It's a one or the other thing, you can't do both. The blood in the cord can either be banked, or go into baby, or just be left in the cord.

mjpatzwa · July 2016

@jbscmama
We asked our hospital about this because we plan on donating whatever cord blood is left and they said that even if you wait until the cord stops pulsing that you may still have enough left to bank-- otherwise, they take what little is left and you have the option to clear it for them to use in research-- which still benefits kids with cancer. That was good enough reason for us

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