Cutting Umbilical Cord Early Eliminates Stem Cells 139
GeneralSoh writes "Delaying clamping the umbilical cord at birth may have far-reaching benefits for your baby, according to researchers at the University of South Florida's Center of Excellence for Aging and Brain Repair — and should be delayed for at least a few minutes longer after birth. This new recommendation published in the most recent Journal of Cellular and Molecular Medicine (14:3) notes that delaying clamping the umbilical cord allows more umbilical cord blood and crucial stem cells to transfer from mama to baby."
ORLY? (Score:1, Informative)
Also: Jaundice! (Score:5, Informative)
When my son was born a few years ago, the Doc didn't clamp the cord very quickly. Our baby also ended with a pretty decent case of jaundice and had to be under the "bili lights" for a few days, extending our hospital stay.
This can sometimes happen when the baby gets a big dose of red blood cells because he's a lot lower than the placenta (gravity) or because the cord isn't clamped very quickly. All those red blood cells die in a day or two, baby cannot break down/metabolize the dead RBCs correctly, and POOF, jaundice.
Just be careful. Jaundice can cause pleasant things like brain damage in neonates (due to immature blood/brain barrier).
http://en.wikipedia.org/wiki/Bilirubin#Toxicity [wikipedia.org]
http://en.wikipedia.org/wiki/Kernicterus [wikipedia.org]
Re:ORLY? (Score:4, Informative)
The kid's been attached to it for 9 months, and the last 2 minutes make _THAT_ much difference?
The cord is then under very different circumstances. At that point it is no longer bathed in a protective moistening medium and it is no longer getting nearly as much oxygen. Cutting the cord further reduces the oxygen level and gives it more surface area to dry out.
Re:How will they know when to cut it? (Score:5, Informative)
Yes, there is. It will stop pulsing. I've heard of cases where the baby was having trouble breathing, so they kept it going for half an hour until the breathing was right. As long as the cord is pulsing, the baby is still getting everything he needs through it. In most cases, the cord will shut down on its own in a minute or two.
Re:Also: Jaundice! (Score:3, Informative)
Apparently it is pretty common:
http://en.wikipedia.org/wiki/Neonatal_jaundice [wikipedia.org]
(first paragraph says 70% of the time. Other reading says 50% of the time for full term newborns.)
Here's the actual paper (Score:4, Informative)
Re:How will they know when to cut it? (Score:2, Informative)
Will it continue to pulse while only attached to the placenta? For example, is it possible or beneficial for both the baby and placenta to be outside the mother for a while?
Yes, it only pulses while attached. Basically everything is still hooked in to the mothers circulatory system at that point, and the pulsing you are seeing is actually the mothers heart pumping blood through the cord. There is something called Wharton's jelly that exists within the umbilical cord which, if left alone, will cause the cord to "clamp" itself off anywhere from 5-20 minutes after the birth. Check it out: http://en.wikipedia.org/wiki/Umbilical_cord#Physiological_postnatal_occlusion [wikipedia.org]
Re:Here's the actual paper (Score:2, Informative)
Also, while you're on the pubmed site, you might be interested in searching for other papers about the benefits of "delayed cord clamping" vs "early cord clamping." There are only a few cases where early cord clamping is beneficial, apparently. I was able to find many more articles on why delayed cord clamping is beneficial than I was on why early cord clamping is beneficial.
For those who like evolution: It's also interesting to think that for millions of years, man did not clamp immediately after birth. Unattended women wouldn't bother. And yet, here we are!
If you think that for every evolutionary tale there must be a creationary (whoah, what?) tale: do you think that $deity really made humans in such a way as to be entirely dependent on doctors to clamp as soon as a baby is born? Surely he would have taken care of that piece of awesomeness by introducing some new aspect of nature to handle it without our human intervention!
Re:ORLY? (Score:5, Informative)
There are quite a few things relating to circulation that don't happen until a few moments after birth (i.e. blood pressure, heart rate, heart valve changes). Perhaps a stem cell transference has something to do with that...
There are several valves in the embryo's heart (such as the foramen ovale) which allows a lot of the blood passing through the heart to avoid the lungs. A lot of the blood coming into the heart before birth is oxygenated from the umbilical cord, so it can get pumped right out without going to the lungs.
When the lungs become functional, pressure changes cause at least some of those valves to close immediately, so that the blood is now forced to go through the lungs before getting pumped back out to the body. These valves should close almost immediately to avoid deoxygenated blood being pumped out. That's really too quick to be directly affected by the stem cells. They -might- have something to do with later changes, where those valves permanently fuse shut, I don't know.
Re:currently in practice (Score:3, Informative)
You may want to check some actual facts [wikipedia.org]. As of 2009, the US was 46th out of 224. This definitely isn't something to brag about, but it's nowhere near the "highest". It's not even 3x the lowest...
Re:currently in practice (Score:4, Informative)
Re:Nice one, Timothy! (Score:4, Informative)
The bigger problem is that no blood is actually passed "from mama to baby". The maternal and fetal circulations are (almost) completely separated. Except for few red blood cells that accidentally pass (esp. around birth and trauma [wikipedia.org]), the placental barrier keeps the two circulations separate. Oxygen, nutritional material and waste are passed by diffusion, with no contact between the two blood pools. The reason for this is that the baby's blood type may be different than the mother's (because of paternal genes) and if the blood would have mixed, than there would have been an immune reaction against the baby's blood.
Delayed vs. early clamping affects the distribution of blood between the newborn baby and the placenta. The major determinant for this is the relative hight of each other, due to the rule of communicating vessels [wikipedia.org].
Re:How will they know when to cut it? (Score:5, Informative)
And I held and cut my own kids' cords - home births both of them, and the midwife said to leave clamping & cutting until the cord stopped pulsing, so I had to hold the cord until I felt it stop.
Surprisingly tough, too - it's like a rope of three blood vessels strengthened with gristle.
Re:ORLY? (Score:4, Informative)
"Probably" just doesn't cut it. While delayed clamping of the umbilical cord may have a number of benefits to premature newborns, there are several other reasons for neonatal anemia (and hence, your need for a transfusion of RBCs) that have nothing to do with the timing of clamping.
Also, several of the reasons for prematurity may cause birth with low Apgar scores. When a baby is born with low/zero heart rate or does not breathe soon after delivery, keeping it attached to the placenta is not going to give you better results than prompt clamping and institution of proper resuscitation.
Please try to exercise more common sense when you leave your opinions in a public forum. Oh, forget that last sentence, this is slashdot, after all.
Re:How will they know when to cut it? (Score:3, Informative)
Actually, it is connected to the baby's blood vessels. The branch vessels that they connect to collapse shortly after birth to seal off the cord.
Just after the birth of my daughter, the blood continued flowing in the cord for several minutes, leaving mother and child connected. Once the flow stopped, my wife's body started to try to expel the placenta even as I was trying to cut the cord.