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NHS cutting cord too early?

(116 Posts)
wifflepuss Sat 27-Apr-13 15:15:29

Just wondering what peoples thoughts were on this.

www.guardian.co.uk/society/2013/apr/25/cutting-cord-babies-risk-nhs

lisad123everybodydancenow Sat 04-May-13 09:37:10

Message withdrawn at poster's request.

BoffinMum Sat 04-May-13 09:22:16

I think the reality is we know delayed clamping is good for most babies (although there is a slightly increased risk of PPH for their mothers) but we don't have enough evidence to know whether it is good for premature babies, or those born by cs, or in what circumstances.

MaybeAMayBaby Sat 04-May-13 00:45:15

Thanks 5.
It IS confusing and thankfully I have a debrief appt soon. All the doctors have been very cagey about the details like they are trying to protect themselves and their colleagues tbh. I got a few more details every time I asked in those first few days after (I then transferred hospitals). I've just been told she was delivered in her sac to the neonatal
Team (in next room). (I've assumed the placenta is in the sac-is it not? ) and that the neonatal doctors then discovered while resuscitating her that she hadn't had her cord clamped an she'd bled out back into the placenta. I remember the midwife rushing back in a calling another over to her and whispering urgently about it. I though she said placenta previa-but that makes no sense? I was later told that the obstetrician doing the csection was from a different hospital who have different policies. She needed an urgent transfusion but touch wood, has had no ill affects.
All the new medical team at the next hospital were amazed and shocked it happened-like it was a major routine thing to miss.

If it is not related to the delayed clamping as discussed on this thread (It certainly wasn't meant to happen) then I'll come back on and update. I don't want to necessarily scare people off something that could potentially be so positive to preemies. Incidentally, my DD has made fantastic progress throughout her short life. I'm constantly told she shouldn't be doing half the things she is. Maybe she did benefit?

5madthings Fri 03-May-13 09:27:23

maybd the evidence shows that yes it helps prem banies..if you leabe tje cord.to.stop pulsaring eventually he flow.equalises.amd the baby ends up with the blood it needd.

I have nevrr hesrd of too much bloof going back into the placenta and that is not what the studies say.

Maybe it wasnt explained very well to you or maybe your dd experienced an anomoly, i would ask for further explanation as it doesny make sense tbh!

Ultimately the health if mum amd baby are priority and delayed clamping isnt always posdible but for a long time the cord has been clamped immediately just because when actually the evidence is that it is better to have delayed clamping
as lonh as circumstances permit that.

And yed thr placenta not being attached to you may have made a difference, did the placenta abrupt?

MaybeAMayBaby Fri 03-May-13 08:47:57

I'm even more confused now.
5madthings, if delayed clamping is benefitial to preemies, why did it all go wrong for mine? Don't know if you read my post earlier in the thread, but DD2 was born at 29 weeks and I have been told a 'mistake' meant her cord wasn't clamped at delivery. She was delivered in her bag (does it make a difference is the placenta isn't attached to me?) and needed up losing blood back into the placenta. She needed a transfusion straight away.
After 7 pretty uneventful weeks on the NNU, she is now home. I like to think she'll have no lasting affects from this, but people are advising me to complain. Are you saying that she should have benefited from this and was just unlucky?

Flisspaps Fri 03-May-13 08:30:29

Sorry, my point was aimed at grants1000 (just to be clear)

Well said Flisspaps.

gillybeandramaqueen Thu 02-May-13 08:50:05

This is brilliant. Thanks so much for sharing this... I had no idea about this and am glad that I now know. The article certainly makes a great deal of sense.

themidwife Wed 01-May-13 19:33:24

Absolutely I agree - if you have complications you need to go down the managed route & it isn't the only thing that matters. The thing that matters too is that you are safe.

Flisspaps Wed 01-May-13 18:29:06

I didn't have the option - two instrumental births with PPH.

I'd have preferred delayed clamping. But it certainly isn't the be all and end all, as you're making it out to be. It's like ALL preferences for labour and birth.

5madthings Wed 01-May-13 14:19:04

No its not the be all BUT it gives benefits particularly to premature babies who are then less likely to need invasive treatments and blood transfusions etc. That's why its being recommended.

The iron levels are a small thing but the fact that it gives premature babies a higher chance of a positive outcome is important.

grants1000 Wed 01-May-13 14:10:29

As I said it seems so important at birth and stresses those out who won't have the option and at the end of the day it does not make much difference when they are older, even if they are iron defficient at 6-8 months. I don't like scare mongering as if it is the B-all and end-all! If you don't do this, it's all over, not at all.

Actually, thinking about it....baby was delivered, straight onto my chest, I lay there for a bit, cord stopped pulsing within about 3-5 minutes, cord clamped and cut by OH, injection given, placenta out.

I expected the cord to pulse for a lot longer. My LO never suffered from jaundice, and had an APGAR of 9, 9, 9 :D

Yes, I had a managed third stage with delayed clamping.

5madthings Tue 30-Apr-13 23:04:30

A bad who has the cord clamped early can loose out on 59% of their red blood cells, massively important for oxygenation. By delaying clamping you ensure they get this, makes a massive difference esp to premature babies who then are less likely to need blood transfusions.

For a baby who is not breathing the umbilical cord whilst pulsating is a lifeline, literally providing oxygen. Hence the equipment to enable resuscitation without clamping the cord.

Shiraztastic Tue 30-Apr-13 22:54:30

Er, well, let's see.... When the baby is inside their blood flows to and from the placenta via the umbilical cord. At any one time, a proportion (25% from memory) of the baby's own blood is in the cord/ placenta. At birth the system is designed to work so that the placental flow shuts down son after birth, and as it does so, more of the blood out of the cord transfers back into the baby. Clamp it off before that happens, and the baby is missing a proportion of their blood. There is good research that shows that early cord clamping leads to worse iron status at 6-9 months.

5madthings Tue 30-Apr-13 22:06:29
5madthings Tue 30-Apr-13 22:05:36

www.inditherm.com/default.asp?langid=1&contentid=1366

Here equipment like this and there is another thread I found on mnet where I got this link.

5madthings Tue 30-Apr-13 21:59:25

grants they now have a special table for resus warming etc which adjusts and is mobiles do they can leave the cord uncut whilst working on the baby.

The blood in the placenta will natural stop flowing, only when it does that does thebaby have all,the blood it should have.

the evidence ius that premature babies do much better if there is delayed cord clamping, they continue to get vital oxygen and are much less likely to need blood transfusions etc after the birth.

There is a post on this thread that explains the benefits to premature babies and on another thread there was a link to the special resusitaire table/warmer that they use.

grants1000 Tue 30-Apr-13 21:54:07

Babies can't 'be missing the blood they should have' medically impossible, they have the blood they need and make their own, which is based on yours and the cord blood already received. Nothing to be 'terrified' about Shiraztastic.

grants1000 Tue 30-Apr-13 21:51:55

I can't fathom the logistics of this, both my children born 2002 - 5 weeks early and 2007 - 3 weeks early, had to go on the peads heat table thing (sorry can't remember what it's called) with a bevvy of nurses and consultants, which was across the other side of the room, but even if it was next to me can't see how it would owrk, cord not long enough, different height of bed and unit etc. Also both children have never been iron poor, I would have rather they were looked at ASAP due to their early arrival than left until the cord had stopped pulsating, both needed help with their breathing/lack of oxygen, cord blood oxygen being insufficient, is more important I feel.

Both are now healthy, tall, happy boys aged 6 and 10. I'd never even heard of this until now, but I think it is just one of those things that seem very important to do at the time but really don't have any impact in later life. Like skin to skin and all that jazz, total fear mongering nonsense that if you don't do it ASAP you will have no bond with your child, utter rubbish.

In the end you have your baby the way you have your baby!

Shiraztastic Tue 30-Apr-13 18:30:01

I had one managed third stage (and even in that the cord was not cut instantaneously) and then three physiological third stages, where the cord had long since stopped pulsating before it was cut (10 mins plus each time -more like half an hour after dc2). One baby had very slight jaundice, no treatment needed. The others not at all.

The bit that I find terrifying is the difference in iron status at 6-9 months in premature (I.e. immediate) versus NORMAL (I.e. delayed) cord clamping. Babies who don't get that cord blood are missing a good volume of blood that they should have.

duchesse Tue 30-Apr-13 14:07:19

Yeay for hippy community midwives! I had the same lovely one for the births of DDs 1 & 2 -both times she was technically off-duty but insisted on doing my births as she was my community midwife. She said my sort of birth was why she'd decided to be a midwife and that they were the only sort that kept her in midwifery.

Bramshott Tue 30-Apr-13 12:13:51

Ah yes, maybe Duchesse.

themidwife Tue 30-Apr-13 11:54:20

Yes tricky with a very short cord!
If its long enough & the baby is kept up at chest level there shouldn't be over transfusion of blood to the baby causing polycythaemia & then subsequent jaundice. The thing with birth (& life in general) is that there are always variations & what works for some doesn't for others but I personally see that cord as a life line & hesitate to cut it until absolutely necessary ie after the placenta has delivered unless there are risk factors. But then, I'm a "hippy" community midwife grin

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