1/18/11

What every parent should know about cord blood banking and delayed cord clamping!

Many expecting parents do not know that when they plan to bank their newborn baby’s cord blood that the birth attendants are more likely to cut the umbilical cord early (within 30 seconds of birth) in order to ensure an adequate amount of cord blood is collected for the cord blood bank. This is not ideal, as the umbilical cord should never be cut until it has completely stopped pulsing. A recent study at the University of South Florida confirms that giving the baby all the cord blood improves outcome, even for healthy, full term infants. Allowing all the cord blood to flow into the baby may take in excess of 3 full minutes. Cutting it prior to this point can deprive the baby of much needed oxygen in those crucial minutes as the baby transitions to breathing on its own. (via A Warning: Fetal Cord Blood Banking)

Also, let's look at this study conducted at Hospital de Gineco Obstetrica in Mexico City, where over 350 mother/baby pairs were part of the study.

This study, as well as several others, have provided solid evidence of the benefits of delayed clamping. The main benefits being:
  • Increased levels of iron
  • Lower risk of anaemia
  • Less transfusions and
  • Less incidence of intraventricular haemorrhage
A two-minute delay in cord clamping increased the child’s iron reserve by 27-47 mg of iron, which is equivalent to 1-2 months of an infants iron requirements. This could help to prevent iron deficiency from developing before 6 months of age.

David Hutchon, a consultant obstetrician at Darlington Memorial Hospital went so far as to call premature clamping of the umbilical cord “criminal” for at risk and vulnerable babies. This concern was borne out by a large scale study in 2007 of 1900 newborns where delay of cutting the umbilicus for 2 minutes reduced anemia by half and low iron levels by one third.

You may be thinking "If it's better for me and my baby, why is common practice to immediately clamp the cord?" Well, according to this study: ‘Attitude of obstetricians towards delayed cord clamping’ as published in the Journal of Obstetrics and Gynaecology the reason the obstetricians who haven’t changed over to delayed cord clamping give is "Difficulty with implementation in clinical practice".

All that needs implementation is PATIENCE! Is it really too difficult to wait at least even 2-5 minutes after the birth for a simple procedure that adds to the health of mom and baby?

Back to the cord blood banking, let's look at how likely is it that your baby will need stored stem cells...

According to Dr Sarah Buckley, in her well researched book Gentle Birth, Gentle Mothering (2005):

  • The likelihood of low-risk children needing their own stored cells has been estimated at 1 in 20,000
  • Cord blood donations are likely to be ineffective for the treatment of adults, because the number of stem cells are too small
  • Cord blood may contain pre-leukemic changes and may increase the risk of relapse
  • Autologous cord blood is only suitable for children who develop solid tumours, lymphomas or auto-immune disorders
  • All other uses are speculative
As you can see the uses for the cord blood are rare.

Consider what the American Academy of Pediatrics says about cord blood banking:

"Families may be vulnerable to emotional marketing at the time of birth of a child and may look to their physicians for advice. No accurate estimates exist of the likelihood of children to need their own stored cells. The range of available estimates is from 1:1000 to 1:200 000.4 Empirical evidence that children will need their own cord blood for future use is lacking. There also is no evidence of the safety or effectiveness of autologous cord blood transplantation for the treatment of malignant neoplasms (Table 1). For these reasons, it is difficult to recommend that parents store their children's cord blood for future use." - Cord Blood Banking for Potential Future Transplantation: Subject Review - July 1999


Dr. Stuart Fischbein's Video on Delayed Cord Clamping





If you are set on banking your baby's cord blood, you can still delay the cord clamping!

Speak to your OB or midwife about your desire to let the cord finish pulsing before it is clamped and the caregiver can then get the cord blood from the placenta! Once the placenta is delivered, the birthing staff can obtain plenty of cord blood to meet this need. It can take a bit more time and effort to retrieve the cord blood from the fetal side of the placenta versus the umbilical cord. However, it can be done!

Make sure to discuss your preferences about delayed cord clamping with your provider before the birth in your prenatal visits.


Sources and Resources:
Cord Clamping Information Site
ACOG Revises opinion on cord blood banking
Cord Clamping Articles (Source of several links and excerpts from this post)
A Warning: Fetal Cord Blood Banking (Source of several links and excerpts from this post)

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