Calls for a change in NHS policy on when a baby’s umbilical cord is cut
29th April 2013
crying baby‘Clamping’ and cutting a baby’s umbilical cord within just seconds of them being born could leave the baby at a higher risk of health problems later in life, suggests new research. Therefore, numerous medical organisations, senior doctors and the National Childbirth Trust (NCT) are calling for midwives and other maternity staff to leave the umbilical cord alone from a time span of at least 30 seconds to when the cord is no longer pulsating. This is normally after around two to five minutes. Evidence is continually emerging that shows if the baby does not receive the important blood from the placenta this can cause iron deficiency and anaemia in later life. This can subsequently result in brain development to be affected. The placenta is an organ attached to the lining of the mother’s womb. It works at separating the baby’s blood supply separate from that of the mother’s, in addition to acting as a connection between the two. This link means the placenta can perform functions the unborn baby cannot do on his/her own. The placenta is connected to the baby by the umbilical cord. Currently, the midwife will use a plastic clip to clamp the umbilical cord at approximately 3 to 4cm (1½ to 2 inches) from the baby’s belly button, placing a separate clamp at the other end of the cord which is near to the placenta. Between the two clamps the midwife will then cut the cord, or one of the parents may be permitted to do this. Remaining will be what appears to be a stump, roughly 2 to 3cm (1 to 1½ inches) in length on the belly button.  This will usually turn black and fall off after between 5 and 15 days. The majority of babies delivered in Britain will have their cord clamped early, an NHS policy dating back to the 1960s and has backing from the National Institute for Health and Clinical Excellence (NICE). The procedure was introduced to try and minimise the risk of women bleeding after they have given birth. NICE guidance states that the cord should be cut early unless the woman has a low-risk pregnancy and actually wants it delayed until the cord is no longer pulsating, with the placenta to be delivered naturally. The long-standing advice is now being re-evaluated and new guidance will be published in 2014. Doctors hope this guidance will lead to delayed clamping. However, some hospitals are believed to be already operating with delayed clamping as standard after recent evidence would suggest this could be harmful for new-borns. Liverpool women's hospital began the procedure last May and is home to the UK's biggest maternity unit, with around 8,100 babies delivered there each year. Moreover, Bradford royal infirmary followed suit at the beginning of this year, now delaying clamping for a full minute for full-term babies and 30 seconds for pre-term new-borns, who may require medical help. Dr Andrew Gallagher, a consultant paediatrician at the Worcestershire Royal Hospital in Worcester, which began delaying cord-clamping back in 2009, says all healthy mothers should ideally have delayed clamping following them giving birth. He says: “Mothers should have as natural a birth plan as possible.  Iron deficiency can cause serious problems. It affects the brain and learning capacity of toddlers…who are going to be slower to learn, for example to speak and to understand. It's time for the NHS to sweep away an outdated and potentially harmful and thoughtless practice that we have been doing for decades.” In addition, NCT chief executive Belinda Phipps spoke on the issue, saying: “When a baby is born, about a third of the baby's blood is still in their cord and placenta. With no good evidence to support it, it is accepted practice to accelerate the arrival of the placenta with an injection and clamp and cut the cord immediately, depriving the baby of this blood. It's becoming increasingly obvious that things need to change. It is time all those who are becoming parents were informed about the disadvantages of early clamping on a baby’s breathing and iron levels. NCT would like to see the default position become leaving the cord for a few minutes until it stops pulsating unless the mother chooses either to have an injection to speed the arrival of her placenta or this is urgently required due to blood loss.”