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Study finds benefits in delaying clamping of umbilical cord

When a baby is born, doctors will typically rush to clamp the umbilical cord within a minute after birth. But a new study adds to a growing body of evidence that suggests there are many health benefits – and few risks – in delayed clamping.

When cord clamping was delayed, babies were found to have higher hemoglobin levels one and two days after birth compared to babies whose cords were clamped within a minute of being born, according to a study published online Wednesday in the scientific journal, The Cochrane Library.

As well, delayed cord clamping also resulted in decreased likelihood of iron deficiency three to six months after birth, along with higher birth weight.

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While clamping the umbilical cord within one minute has often been thought to reduce the risk of maternal haemorrhaging, the new study, which reviewed data from 15 trials involving 3, 911 women and their babies, found that it made no difference to the risk of maternal blood loss, hemoglobin levels or hemorrhaging.

"In light of growing evidence that delayed cord clamping increases early hemoglobin concentrations and iron stores in infants, a more liberal approach to delaying clamping of the umbilical cord in healthy babies appears to be warranted," Philippa Middleton, of the authors of the review, said in a release.

Eileen Hutton, the director of the midwifery education program at McMaster University who has published a review of cord clamping, called the implications of this new study "huge."

"We are talking about depriving babies of 30 to 40 per cent of their blood at birth – and just because we've learned a practice that's bad," Dr. Hutton told the New York Times.

The World Health Organization recommends cutting the umbilical cord one to three minutes after birth.

Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, told The Globe and Mail earlier this year that there are pros and cons to consider when it comes to either cutting the cord early or waiting longer than usual.

As The Globe's Wency Leung reported, the SOGC's guidelines state that for babies born at full term, the potential risk of neonatal jaundice "must be weighed against the physiological benefit of greater hemoglobin and iron levels up to six months of age conferred by delayed clamping."

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The new study did find that delayed clamping resulted in a two per cent increase of babies born with jaundice, which is treated using light therapy.

Although there is a mounting body of evidence pointing to the benefits of delayed clamping, the practice is so deeply ingrained among many health professionals that it will likely continue, Dr. Jeffrey Ecker, the chair of committee on obstetrics practice for the American College of Obstetricians and Gynecologists, told The New York Times.

But this new review, he said, should change minds.

"It's a persuasive finding," Dr. Ecker said. "It's tough not to think that delayed cord clamping, including better iron stores and more hemoglobin, is a good thing."

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