How Long Does The Umbilical Cord Stay On?
The umbilical cord has a crucial role in the development of the baby. It offers both the transport of nutrients from the placenta to the baby as well as the elimination of toxic metabolic substances. It also helps the baby breathe during delivery until his lungs will fill with air for the first time.
The late cutting of the cord at 2 or 3 minutes after birth will prevent iron deficiency and decrease the risk of neonatal jaundice.
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Anatomy of the Umbilical Cord
Umbilical cord is formed in the 5th week after conception, replacing the yolk sac as the source of nutrients for the baby. It`s attached directly to the placenta, not to the mother`s circulatory system, therefore decreasing the risk of transmitting some viral diseases from the mother to the baby.
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The cord is composed of 2 arteries and a vein, protected by a gelatinous substance. The arteries transport the blood lacked of oxygen and nutritional substances from the baby to the placenta, while the umbilical vein supplies the baby`s body with oxygenated blood.
Until the end of pregnancy, the length of umbilical cord may reach up to 60 m.
History of Delayed Cutting of the Umbilical Cord
Before 1950s, early clamping was designed as a procedure performed in 1 minute from birth, while the delayed one over 5 minutes from birth. Currently, there isn`t a concrete definition of the conception of delayed clamping, therefore the interval varies a lot. For instance, Cochrane`s analysis has defined the delay of cutting the cord as 30 seconds or more after birth. The study performed by Van Rheenen has compared it at children born at term, recommending an interval of 3 minutes, except the case when the child requires an early intervention, a situation in which the recommendation is of 60 seconds (with the child between the mother`s legs). In a systematic research performed by Van Rheenen and Brabin, it was defined the concept of waiting until the cord ceased to pulse (the duration was of 305 seconds). Last but not least, a study has divided the births in 2 groups – 1 in which the intervention was performed at 1 minute and another one at 3 minutes. Taking into account these explanations, but also the opinion of midwives, it cannot be designated a standard measure, being a subjective and variable choice.
Current Recommendations on Umbilical Cord Cutting
However, studies and research in the past few years when it comes to umbilical cord cutting showed that the baby has a lot more to gain if the cord clamping is delayed.
So, keeping the umbilical cord for a couple of minutes after birth allows more blood rich in iron cord to be transported from the placenta to the baby. In other words, a quick cutting of the umbilical cord reduces the amount of blood that is transferred from the mother to the baby through the placenta, affecting the iron deposits from the baby`s organism. And the level of iron has a lot of importance for the brain development and, implicitly, the baby up to 2 years.
In fact, now WHO and AAP recommends doctors to wait at least 1 minute before cutting the umbilical cord to decrease the incidence of anemia due to iron deficiency among babies.
A long time ago, it was believed that the cutting of the umbilical cord in only a few seconds after birth led to fewer complications, such as neonatal jaundice, polycythemia, postpartum haemorrhage or respiratory issues. The amazing evolution of medicine as well as the establishment of extensive clinical trials has overturned old practices and beliefs.
Here`re the 3 big categories of benefits of delayed cutting (preferably when it still pulsates):
- Bigger weight at birth, larger volume of blood, oxygen and nutrients.
- Larger number of red blood cells (including stem cells and cells of immunity defense).
- The risk of anemia is 50% more decreased, because the iron deposits are more numerous.
What`s Iron Good For?
Iron is essential for the brain development, having a crucial role in the process of myelination and the production of neurotransmitters. That`s why iron deficiency anemia can be associated with cognitive delay and behavioral issues.
Andrew Gallagher, a pediatrician at the Royal Worcestershire hospital from Worcester (U.K.), who adopted the delayed cutting method even from 2009, says that “the practice of early cutting of the umbilical cord is harmful, because it doesn`t offer the baby the opportunity of recovering the blood from placenta that later leads to iron deficiency, which in turn causes serious issues. Iron deficiency affects the brain and the small children`s ability of learning, who this way will become slower in some of their actions, like speaking or the ability to learn.” – Read this!
Most doctors continue to clamp the umbilical cord right after birth, no matter if we are talking about a C-section or vaginal birth. This particular practice is found in most hospitals around the world, although the recommendation that doctors should wait for 2 or 3 minutes before doing this procedure has appeared already for several years now.
Taking Care of the Umbilical Cord
After around 10 days from birth, the cord`s stump dries and falls, leaving behind a small wound, which will soon heal on its own. The region remains very sensitive, so you have to be very careful when washing or changing the baby`s diapers.
It`s essential to keep the stump clean and dry. Fold the baby`s diaper under the belly button so that the stump is left exposed to the air and doesn`t come in any contact with the urine. To clean his skin, wipe your baby with a clean towel soaked in warm water. You could make his first bath after the fall of his navel.
In certain cases, instead of a stump, there`s a small, red scar tissue formed, also called umbilical granuloma, which generally heals on its own. At the very same time, you may see a couple of blood drops on the diaper. Don`t worry, it`s perfectly normal! Ask your pediatrician for advice if you are concerned about this.
Some doctors recommend mothers to apply compresses soaked in alcohol on the umbilical cord`s stump, once or twice per day. This practice is invalidated by the latest research, which has shown that healing occurs sooner, if the navel is exposed to air.
There are situations in which there`s an infection of the cord fragment occurred. Call your doctor immediately if:
- You notice traces of blood larger than 5 cm on the umbilical cord`s stump. – More details!
- You applied pressure to the navel twice, for 10 minutes, but the bleeding didn`t stop.
- There are red streaks on the navel.
- There`s red skin around the navel and the redness has a tendency to stretch even further on the abdomen.
- Rectal temperature of the infant is over 38° C.