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Delayed Cord Clamping
Neonatal Transitional Physiology: A New Paradigm. Mercer JS and Skovgaard RL. J Perinat Neonat Nurs (March 2002); 15:56-75.
Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change (in blood volume) occurs at no other time in one’s life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns. The authors present a model for neonatal transition based on and driven by adequate blood volume rather than by respiratory effort to demonstrate how neonatal transition most likely occurs at a normal physiologic birth.
Comment. This article is a review of recent literature concerning the optimal timing for umbilical cord clamping after newborn deliveries. The authors site studies showing many benefits from delayed cord clamping, including improving neonatal cardiopulmonary adaptation, blood pressures, oxygen transport, red blood cell flow, days on oxygen and ventilation, and anemia. Immediate cord clamping after delivery has been standard practice for as long as most of us can remember. However, the practice was not based on good scientific evidence, and in some cases, it is clearly harmful. Consider the infant who is born with a tight nuchal cord. In this circumstance, the compression of the umbilical vein frequently causes the baby to pool blood in the placenta rendering the infant hypovolemic. If the umbilical cord is clamped immediately, the hypovolemia perpetuates and the infant presents with pallor, poor perfusion and hypotension. On the other hand, if the nuchal cord can be reduced and the clamping of the cord is delayed, then a placento-fetal transfusion takes place through the umbilical vein which resolves the infant’s hypovolemia before shock develops. The authors contend that this same physiology (perhaps to a lesser extent) is present in most deliveries, and that placento-fetal transfusion post delivery is both physiological and beneficial. They also suggest that our current practice of immediate cord clamping after delivery is unnatural, and may, in some cases, be harmful. Except in cases where placental blood flow is already compromised (such as following a placental abruption), I am inclined to agree with them. Another study evaluating the benefits of delayed cord clamping in premature infant deliveries was reviewed in NeoNotes, Vol. 1, Issue 5, 2000 (1-024). That study concluded that premature infants whose cord clamping was delayed for 20-30 seconds required fewer blood transfusions, had higher mean blood pressures, and required fewer volume boluses. No adverse effects of delayed cord clamping were noted. We need to re-evaluate what constitutes optimal timing for umbilical cord clamping.
Date: 13 Apr 2002
Time: 18:54:38
I do not agree with the concept of delayed clamping as described here. The delayed
clamping is traditionally described as >3 minutes (Nathan & Oski's Hematology) and
early clamping as <30 seconds. Placenta holds 75-120ml of blood which is equal to 1/3
of term neonates blood volume. 1/4 of the placental transfusion is known to occur in 15
seconds. It is physiological to allow some time for placental transfusion, which may be
probably 15-30 seconds. Clamping immediately after body is delivered is unphysiological
and therefore I agree with clamping before 30 seconds. Beyond 30 seconds, we may be
compromising the resuscitation efforts and we may end up with all blood and no brain.
Hence, the term of delayed clamping does not refer to clamping before before 30 seconds of
life.
UserName: Pradeep Alur
Institution: Guam Memorial Hospital Authority
email: palur@hotmail.com
Date: 15 Oct 2002
Time: 23:14:20
When I read the debates that began over 200 years with Dr. Erasmus Darwin
(Grandfather of Charles)he wisely advocated to leave the umbilical cord alone,
or else more blood would be trapped in the placenta then ought to be in the
child.
We have Constitutional Rights and Declarations of Human Rights and for Family
and for Children. Hundreds of Countries support those rights, which
include "security of the person" and Equality Rights, which means
"every" persons, regardless of age, race, colour and sex, mental
and/or physical disability are to have "equal" protection.
Where is the infant's security of person and equal protection when we have those
who deprive the infant of natural process, of full allowance of delayed clamping
to transfuse the necessary blood from the placenta into the infants expanding
lungs.
Lungs take that 100 to 200 ccs of blood for proper pressure and volume to start
the infant's circulation from fetus to infant/adult. The lungs need the
red blood to do the exchange of gas, cleaning up the carbon dioxide for oxygen.
So why not let the Constitution end this debate and let the natural process
happen.
Now if you have reason to believe the drugs given to the mother during labor
poison this blood and the medical person is trying to force the child to create
new blood not poisoned, that is not being honesty reflected. If that be
true, we need the facts for the mother not to take any drug during labor.
To manage labor discomfort (some is certainly a pain in the back), I now
advocate for warm water showers or baths, to even birth the baby in the water.
The Society of Obstetricians and Gynecologists (SOGC) Policy #71, December 1998,
advocate for the water births and even gravity births, that causes the blood
flow and transfusion even faster. They identify flat on the back as
harmful, but they slipped on semi-sitting, equally harmful as the back.
So I advocate all these facts being told to the mother, long before she is in
labor, for her to have a Constitutionally right of informed choice. Even
to no clamping, the Pioneer method prior to 1914, that was no clamping or
cutting of the cord. Benefits: No cord infections, no hernias, no
flat and limp children that have to be given oxygen and blood transfusion; no
superbug in the cut cord, but a gentle conclusion to what may have been a
painful birth.
Lets think something of the security of person to have the blood nature and
design made specifically for the needs of the individual child. NOT too
much blood for the premature, just right, and not too much blood for the full
term and large baby, just right. A 9-pound infant makes 10 ounces of blood, so
why put 1/2 of that in research. That is not fair. The child is not
110 pounds, not known to be in good health; not age 17, the criteria for
donations to society of any one's blood.
The facts of how long the placenta cord will pulsate is actually
documented by Dr. Mavis Gunther to be 20 minutes. Are you shocked. Not too many
doctors have witnessed that fact, when they clamp at less then a minute.
That is stated as a fact of a mother who wrote me, too, on this matter, and both
her children's cords didn't stop pulsating until 15 minutes later, and one, as
Dr. Gunther found out, was also 20 minutes. I suspect a compressed
cord. Dr. Gunther related long pulsation to the use of drugs.
Dr. Gunther stated something I must agree with, that when infants are born
without intervention or a medical person present, they thrive. Why:
No clamps, no drugs, and that I can attest to the longevity of my parents, now
age 89 years old, born in a farm home, no drugs, no cutting of the cord ever.
The placenta was put in a warm towel, and baby in another warm towel. The
Birth was in the warmest room of the house, warmth essential to the mother and
the child, and for faster blood transfusion.
The Placenta and cord dried in 2-3 days time, and the child got all his blood
and not a test tube used in the cord stem cell blood research.
I suspect the use of blood taken from placenta, giving up 1/2 cup to 1 cup of
blood by hasty clamping, was cheap blood to use in experiments, and when did
that likely happend. When women were forced to birth in public hospitals,
starting about 1914, and coincidentally, that is when blood typing of ABO was
discovered. By 1923, the youngest child in my mothers family was born in a
hospital, actually about the last three. One thinks she is a mixed-up
baby, looking much different then all the rest.
Dr. Sarah Bukley has given me a declaration of hasty clamping for reasons of
Oxytocins used to be necessary for immediate cord clamping, supported by WHO and
the makers of the instant clamp and cut tool, Dupont. She has personally
experienced 3 natural births, no clamping or cutting of the cord, and birthed in
water. This too, was the Pioneer method now called the Lotus Method.
More can be read at this web site:
http://www.123-baby-birth.com
This is written by a grandmother, age 60. I support another Senior, Dr.
Morley. I think the young pups ought to listen more to Seniors.
I am taking this matter of hasty clamping, to Court for Laying of Information
for requesting an Coroner's Inquiry, for the death of an infant, year 2000, just
after immediate cord clamping was directed on "all" babies by SOGC,
Policy #89, May 2000.
The death may also be attributed to drugs given the mother, or something she
took, too, ate or drank. All infant's deaths that are unexpected ought to
have proper inquiries, even if a medical person is present, particularly, if a
medical person is present, to be objective. Infanticide for human parts is NOT
unthinkable in today's society, nor putting down the weaker infant believing
they will contribute little to society, being weak.
the child that died after being cut for its cord and then tried to be revived,
living only 14-minutes was 8 1/2 months gestation and it weighed almost
4-pounds.
If you go to the first name of sugar on my List of Contents, you will see
a living 4-month gestation child, weighing in only at 1-pound. He lived
because of supplements, Ambrotose, to be specific.
The other child would be alive had his mother NOT called the 9-1-1 medic and the
hospital that sent a doctor with the medic. Both trained in ICC and ECC.
One of them, not the mother, did the clamping. Which one is to be
determined by the court, if this can be allowed.
That is the way I see this issue, criminal assault and battery, attempted
murder, and when the child dies, manslaughter, if not infanticide.
ICC and ECC are NOT logical facts of science. TThose doing it are guessing
and playing GOD and FATE with another's infant. See the Fates on my web
site, and my Political Statement. I have found those that do ICC and ECC
take no accountability for health costs or education costs to a compromised
infant. Many look normal but internall they are compromised, The Magical
Child pages 48-50, state brain lesions for drugged babies followed by hasty
clamping. Author, an educator, Joseph Chilton Pearce, and he wrote this
book in the 70's.
Those doing hasty clamping have failed to document what they did and the
condition of the cord on the infant's medical chart, to remain there until the
infant is 27 years of age. They destroyed the evidence of hasty clamping
immediately, by burning the placenta or sending it to research.
They failed to put their belief into video of the treatment to the infant. That
is bad faith. Dr. Buckley has good faith and her care and attention to her
infant's placenta are on video for a Court's consideration to rule on this one
of long debate, needed public attention and awareness.
Most of the ICC and ECC has been done like a sneak attack on the infant, not
discussed with the mother or her choice to make an informed decision for no
drugs, and no clamping, ever.
I see the failing to video their decision and the draining out of the placenta
to see how much blood they actually deprived the infant and sent it off to
research as concealment.
I call this debate the Conspiracy of Secrecy. It is time to get the Secret
out into the public into the Courts as Criminal assault and battery for ICC and
ECC.
20-seconds when time period can be 20-minutes for a healthy infant needs some
explanation before a Judge and Jury, particularly when the infant dies.
Sincerely, Donna, a Granny in Protest of false science and practice on babies.
Let's pick on our own size. If you want stem cells, take them from your
own bones. It may be as simple as that.
UserName: Donna Young
Institution: www.123-baby-birth.com
telephone: 250-782-9223
email: donna@123babybirth.com
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