Hang on, doc! Let that baby hang on a little longer.

Here’s an article from yesterday’s New York Times about the benefits of delayed umbilical cord clamping, finding that even a few minutes’ delay reduces the likelihood that the baby will develop low-iron months later.

Here’s the background on this issue:  When a baby is born, he is still attached to the placenta by the umbilical cord.  At first, he continues to get oxygen and nutrients from the mom’s body through the cord — you can see the mom’s pulse beating in the cord.  After several minutes, if left alone, the cord will stop pulsating (and stop delivering oxygen and nutrients), and soon thereafter the placenta will come out.  

In the 1950s it became common OB practice to clamp and cut the cord immediately after the birth — while it was still delivering oxygen and nutrients to the newborn.  There was no medical reason to do this, but it saves a few minutes of the doctor’s time and, in an era where so many women asleep during the birth, quick cord clamping allowed nurses to whisk the baby off to the nursery for immediate care.  

In recent years, though, we’ve begun to see a return to the idea of delaying cord clamping until the cord has finished delivering its goods — why not let the baby’s first experience of the world be lying on mom’s belly gazing up at her, while receiving all that additional oxygen and nutrient-rich blood?  It just makes sense.   

The only reason to cut the cord right away is habit.  (Sometimes OBs speculate that immediate cord clamping prevents jaundice, since the newborn gets less of mom’s red blood cells.  But the study found no difference in jaundice for either group). 

What about the benefits?  By the time the babies were four months old, the babies whose cords were cut early had higher rates of iron deficiency, which suggests that premature cord-clamping has longer-term health and nutrition implications.  

That’s cool in and of itself, but there’s another wrinkle — iron deficiency is a reason I hear frequently that moms start their babies on solid foods before the half-year mark. Most moms know that AAP and WHO recommend that infants get only breastmilk for the first six months, but the moms are also pummeled with advertising of infant iron supplements.  No one wants her baby to be anemic, but how do you balance that against the universally acknowledged recommendations to delay solid food for six months? 

Well, maybe we could avoid that whole tangle, and reduce the number of babies who need iron supplements at all, by our choices in the first three minutes after the birth.