Waiting to cut umbilical cord helps baby's iron

Delaying cord clamping reduces the risk that the baby will have iron deficiency anaemia without substantial side effects, the authors told the BMJ.


The World Health Organization dropped early clamping from its guidelines some years ago.


But there are no formal guidelines for NHS staff about when the cord should be cut.


An audit a few years ago found many UK hospitals advocate early clamping, as soon as the baby is delivered.


Mounting evidence suggests this may not be best practice and could be causing health problems.


Globally, about a quarter of preschool children have iron deficiency anaemia, the most severe form of iron deficiency. In Europe, the prevalence is 3-7%.


Some had their umbilical cords clamped after three minutes and others had them clamped less than 10 seconds after delivery.


Babies who experienced delayed clamping had better iron levels at four months of age and there were fewer cases of neonatal anemia, Magnus Domellof, a professor of pediatrics at Umea University and his co-authors said in Wednesday's issue of the British Medical Journal.


The researchers estimated that for every 20 babies having delayed clamping, one case of iron deficiency would be prevented.


"As iron deficiency in infants even without anemia has been associated with impaired development, delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anemia," the study's authors concluded.


Iron deficiency anemia is a major public health problem in young children globally that is linked with poor brain development.


Worldwide, about a quarter of preschool children have iron deficiency anemia, the most severe form of iron deficiency, the researchers said. In Europe, the prevalence of iron deficiency anemia is three to seven per cent.


The findings suggest that the timing of clamping should be documented, Dr. Patrick van Rheenen, a consultant pediatrician at the University of Groningen in the Netherlands, suggested in a journal editorial accompanying the study.


"The balance of maternal risks and infant benefits of delayed cord clamping now clearly favours the child. How much more evidence is needed to convince obstetricians and midwives that it is worth while to wait for three minutes to allow for placental transfusion, even in developed countries? Andersson and colleagues' study is convincing enough to encourage a change of practice," van Rheenen concluded.