Changing where a baby is held after birth could lead to improved uptake of procedure that reduces infant iron deficiency

April 17, 2014

Changing where a newborn baby is held before its umbilical cord is clamped could lead to improved uptake in hospitals of delayed cord clamping, leading to a decreased risk of iron deficiency in infancy, according to new results published in The Lancet.

Delaying clamping of the until around two minutes after birth allows for blood to pass from the mother's placenta to the baby, and has previously been shown to reduce the risk of in infancy.

However, current recommendations – based on studies conducted 35 years ago – suggest that for effective placental transfusion to occur, the baby needs to be held at the level of the placenta (introitus position), which is cumbersome, uncomfortable for the person holding the baby, and interferes with immediate contact between mother and baby.

Since these issues could be contributing to low compliance with this procedure in hospitals, ultimately resulting in higher than necessary levels of iron deficiency in and children, a group of researchers in Argentina tested whether the transfer of blood in delayed cord clamping procedures is affected by the position in which the baby is held immediately after birth.

In the study, which was conducted in three university affiliated hospitals in Argentina, 197 babies were held in the introitus position while undergoing delayed cord clamping, as per usual practice, but 194 babies were instead immediately placed on the mother's abdomen (tummy) or chest.

By measuring the babies' weights at the point of birth, and immediately after the delayed cord clamping procedure, the researchers were able to measure the volume of blood which had transferred from the placenta to the child.

They found no statistically significant difference between the two groups in the volume of blood transferred, indicating that placing the baby on the mother's chest or abdomen is no less effective than the more awkward introitus position in delayed cord clamping procedures.

According to lead author Professor Nestor Vain, of the Foundation for Maternal and Child Health (FUNDASAMIN) in Buenos Aires, Argentina, "Iron deficiency in newborn babies and children is a serious public health problem in low-income countries, and also prevalent in countries from North America and western Europe. Our study suggests that when umbilical cord clamping is delayed for 2 minutes, holding the baby on the mother's chest or abdomen is no worse than the currently recommended practice of holding the baby below this level. Because of the potential of enhanced bonding between mother and baby, increased success of breastfeeding and the compliance with the procedure, holding the infant by the mother immediately after birth should be strongly recommended."

Writing in a linked Comment, Dr Tonse Raju of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, USA, says, "Introduction of delayed cord clamping into practice has been sporadic, with logistical issues being one possible reason. Intuitively, to keep the 's position below the level of the placenta in situ should maximise the volume of placental transfusion. However, trying to hold on to a wet, vigorously crying, and wriggling infant at the perineum for 2 min, in gloved hands, is awkward and can be risky. When the mother is waiting anxiously to hold her baby and the father is taking photographs, 2 min could seem like an eternity."

Dr Raju adds that "The study by Nestor Vain and colleagues in The Lancet should bring a sigh of relief from those trying to incorporate delayed umbilical into practice…The results are convincing and show that gravity did not have an effect on volume of placental transfusion."

Explore further: Later cord clamping after birth increases iron levels in babies

More information: Paper: www.thelancet.com/journals/lan … (14)60130-6/abstract

Related Stories

Later cord clamping after birth increases iron levels in babies

July 10, 2013
Delaying clamping of the umbilical cord after birth benefits newborn babies, according to a systematic review published in The Cochrane Library. The authors found babies' blood and iron levels were healthier when the cord ...

Delayed cord clamping protects newborn babies from iron deficiency

November 16, 2011
Waiting for at least three minutes before clamping the umbilical cord in healthy newborns improves their iron levels at four months, according to research published in the British Medical Journal today.

ACOG: Delaying cord clamping advised for preterm infants

December 3, 2012
(HealthDay)—Evidence supports the benefits of delayed umbilical cord clamping for preterm infants, while for term infants, the evidence is unclear, according to a Committee Opinion published in the December issue of Obstetrics ...

Are we cutting umbilical cords too soon after birth?

July 30, 2013
The most common surgical procedure in the world today – one that every human alive today has undergone – is the clamping and cutting of the umbilical cord at birth. The need for clamping and cutting the cord is not in ...

Recommended for you

At the cellular level, a child's loss of a father is associated with increased stress

July 18, 2017
The absence of a father—due to incarceration, death, separation or divorce—has adverse physical and behavioral consequences for a growing child. But little is known about the biological processes that underlie this link ...

New comparison chart sheds light on babies' tears

July 10, 2017
A chart that enables parents and clinicians to calculate if a baby is crying more than it should in the first three months of its life has been created by a Kingston University London researcher, following a study of colic ...

Blood of SIDS infants contains high levels of serotonin

July 3, 2017
Blood samples from infants who died of Sudden Infant Death Syndrome (SIDS) had high levels of serotonin, a chemical that carries signals along and between nerves, according to a study funded in part by the National Institutes ...

Is your child's 'penicillin allergy' real?

July 3, 2017
(HealthDay)—Many children suspected of being allergic to the inexpensive, first-line antibiotic penicillin actually aren't, new research indicates.

Probiotic supplements failed to prevent babies' infections

July 3, 2017
(HealthDay)—Probiotic supplements may not protect babies from catching colds or stomach bugs in day care, a new clinical trial suggests.

Starting school young can put child wellbeing at risk

June 22, 2017
New research has shown that the youngest pupils in each school year group could be at risk of worse mental health than their older classmates.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.