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International debate rages over when to cut the cord to give baby the most benefit
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A new study seems to side with delaying cutting the umbilical cord for a few minutes after a baby is born. That's been the subject of substantial debate recently, with different experts coming down on different sides. - photo by Lois M. Collins
Doctors are beginning to debate and vote with their tools whether an umbilical cord should be clamped or cut as soon as a baby is delivered or whether a delay of several minutes might help the baby.

A Swedish study just published in JAMA Pediatrics looked at delayed cord clamping (after three minutes) versus standard practice (at 10 seconds), using 263 full-term births following low-risk pregnancies, and then seeing the children's outcomes on certain measures at age 4.

Researchers concluded that delayed cord clamping compared with early cord clamping "improved scores in the fine-motor and social domains at 4 years of age, especially in boys, indicating that optimizing the time to cord clamping may affect neurodevelopment in a low-risk population of children born in a high-income country."

CNN reported that when midwives delivered many babies in the early half of the 1900s, they usually waited a few minutes for the umbilical cord to stop "pulsating." Wrote Azadeh Ansari, "According to the American College of Obstetrician and Gynecologists, or ACOG, generally most umbilical cord clamping happens within 15 to 20 seconds after birth. The ACOG does not endorse the practice of delayed cord clamping but rather suggests cord clamping should take place between 30 to 60 seconds after birth, since the ideal timing for cord clamping has yet to be established."

It's an issue that British midwife Amanda Burleigh studied for a decade and her view that a delay is beneficial has begun to gain real traction. Last month, the Deseret News reported that Britain changed its guidelines for cutting the umbilical cord following birth. The move by The National Institute for Health and Care Excellence follows 10 years of lobbying by Burleigh.

The World Health Organization now recommends that clamping be delayed at least a minute "for improved maternal and infant health and nutrition outcomes."

Wrote Ansari of the new study: "Though the results are not dramatic, researchers involved with the study said this is an important step. 'It's incredible to see what a difference an extra three minutes and one-half cup of blood can have on the overall health of a child, especially four years later,' said Dr. Ola Andersson, lead author of the study and a pediatrician at the department of women and children's health at Uppsala University in Sweden. 'This is very promising, but larger studies are necessary.

Burleigh has said that some of the resistance to her idea comes from a simple reluctance by individuals to change how they do things.

Others say there's not clear evidence and that clamping immediately makes it easier to measure cord blood gases, which can indicate if the baby got enough oxygen during delivery. The cord is also sometimes harvested for stem cells.