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The American College of Obstetricians and Gynecologists (ACOG) today made
an important announcement regarding the timing of cord clamping in all healthy newborn infants.
In a news release “The American College of Obstetricians and
Gynecologists (ACOG) now recommends a delay in umbilical cord clamping for all
healthy infants for at least 30-60 seconds after birth given the numerous
benefits to most newborns.”[1]
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| Courtesy: https://combatbootmama.com/2014/11/15/cord-clamping/ |
The last recommendation was issued in 2012 by the committee which only
recommended delayed cord clamping in preterm infants and not for term infants
due to lack of sufficient evidence of benefits.
The latest endorsement is based on new research that shows that significant
benefits for both preterm and term infants due to the additional blood volume
gained from the placenta.
Maria A. Mascola, MD, the lead author of the Committee Opinion said
in the news release “While there are various recommendations regarding optimal
timing for delayed umbilical cord clamping, there has been increased evidence
that shows that the practice in and of itself has clear health benefits for
both preterm and term infants. And, in most cases, this does not interfere with
early care, including drying and stimulating for the first breath and immediate
skin-to-skin contact.”
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| Cord clamps |
The current recommendations by ACOG committee on obstetrics practice regarding
the timing of umbilical cord clamping after birth are:
- In term
infants, delayed umbilical cord clamping increases hemoglobin levels at
birth and improves iron stores in the first several months of life, which
may have a favorable effect on developmental outcomes.
- Delayed
umbilical cord clamping is associated with significant neonatal benefits
in preterm infants, including improved transitional circulation, better
establishment of red blood cell volume, decreased need for blood
transfusion, and lower incidence of necrotizing enterocolitis and
intraventricular hemorrhage.
- Given
the benefits to most newborns and concordant with other professional
organizations, the American College of Obstetricians and Gynecologists now
recommends a delay in umbilical cord clamping in vigorous term and preterm
infants for at least 30–60 seconds after birth.
- There
is a small increase in the incidence of jaundice that requires
phototherapy in term infants undergoing delayed umbilical cord clamping.
Consequently, obstetrician–gynecologists and other obstetric care
providers adopting delayed umbilical cord clamping in term infants should
ensure that mechanisms are in place to monitor and treat neonatal
jaundice.
- Delayed
umbilical cord clamping does not increase the risk of postpartum
hemorrhage.
The ACOG recommendations does not support nor refute umbilical cord
milking because of insufficient evidence of its benefits or harm. There are
many ongoing studies comparing benefits and risks of delayed cord clamping
versus milking of the umbilical cord in term and preterm infants.
ACOG also does not make any statements for delayed cord clamping in multiple
gestations due to lack of sufficient evidence and data.
Those parents consenting for banking of umbilical cord blood needs
special counselling as delayed cord clamping decreases the volume and total
nucleated cell counts of cord blood donations.
Delayed cord clamping does not have any adverse effect on maternal outcomes
nor does it increases the risk of postpartum hemorrhage.
[1] http://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-for-All-Healthy-Infants
