Delayed Clamping of the Umbilical Cord to Reduce Infant Anaemia By Dr Atul Chopra & Dr Rahul Jain

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Delayed Clamping of the Umbilical Cord to Reduce Infant Anaemia By Dr Atul Chopra & Dr Rahul Jain

Feb 13, 2018

Anaemia in infants causes increased child mortality as well as impaired cognitive, motor and behavioral development. About 66 percent of preschool children living in our part of the world suffer from anemia. The question that the medical community has been dealing with for years is if there’s a way to prevent this anemia. Turns out, it’s possible. The World Health Organisation (WHO) recommended delaying of cutting the umbilical cord, the lifeline that connects the baby in the womb with its mother, by up to three minutes as that increases the supply of nutrients, including iron, to the newborn baby. The umbilical cord runs from an opening in your baby’s stomach to the placenta in the womb. The average cord is about 50 cm long. The placenta is the supplier of nutrition from the mother to baby in the womb. So when the umbilical cord is cut or clamped, the vascular connection or nutrient supply also cut off. When mothers follow the recommendation to exclusively breastfeed for the first six months of life, their breast milk provides only a small amount of iron to the infant. That means babies have to depend on their own iron stores from birth to meet the high requirements for iron during this period of growth and development. The WHO says that a delay in clamping the cord allows the blood (the baby’s food) from the placenta to the baby to continue for an additional 1 to 3 minutes after birth. This brief delay in cutting the cord can increase the iron stores of the young infant by over 50 percent at six months of age among babies born at full-term. In fact, it can provide up to 75 mg of iron (a 3.5-month supply) in the infant’s first six months of life. Children born at term to iron-deficient mothers and babies with birth weights of less than 3,000 grams (or 6.6 pounds) have been the biggest beneficiaries of this procedure. Delayed Clamping of the Umbilical Cord to Reduce Infant Anaemia: By Dr Atul Chopra & Dr Rahul Jain Currently, however, this intervention is in limited use as there’s not enough information in the public space about its benefits or drawbacks. A newborn baby contracting jaundice or getting polycythemia (increased number of red blood cells causing blood to thicken) were some of the initial concerns that hindered the medical adoption of this technique. However, recent studies have knocked these concern out. On the contrary, its benefits — increased iron stores at birth and less infant anemia, decreased intraventricular hemorrhage (bleeding in the brain), fewer infant infections and fewer blood transfusions in premature baby — has made delayed cord clamping as the routine mandatory recommendation by WHO. The current recommendation by WHO is to delay cord clamping for 1-3 minutes or till the cord stops pulsating and has to be practiced for all deliveries – barring babies who require active resuscitation at birth. We at Rosewalk practice delayed cord clamping (1-3 minutes) for every baby born at our facility. By Dr. Atul Chopra Head – Paediatrics & Neonatology Rosewalk Healthcare & By Dr. Rahul Jain Junior Consultant – Paediatrics & Neonatology Rosewalk Healthcare ROSEWALK TEAM

Dr. Ram Gopal Holla

Consultant - Obstetrics and Gynecology

Panchsheel Park

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