Cutting the cord too soon 'bad' for babies
Mounting proof that may make infants anaemic and affect brain growth, experts tell UK health service in urging reversal of policy since 1960s
Childbirth experts are urging Britain's health service (NHS) to reverse the policy it has pursued since the 1960s of clamping and cutting a baby's umbilical cord as soon as it is born, citing mounting evidence that this may leave newborn babies deprived of vital blood from the placenta.
Medical bodies, senior doctors and the National Childbirth Trust (NCT) want maternity staff to stop routinely clamping the cord within seconds of the baby's arrival and instead leave it untouched for anything from 30 seconds to whenever it stops pulsating naturally, usually within two to five minutes.
They believe that infants may be at risk of becoming anaemic by being denied the chance to receive as much as a third of their blood volume from the placenta through the cord. Anaemia can later be associated with brain development and can affect cognitive ability.
At present, delivery of most of the 800,000 babies born each year in Britain is followed by early clamping, after which the cord is cut and the baby is briefly assessed before being returned to its mother.
This has been standard procedure across the NHS for about 50 years and is backed by the National Institute for Health and Care Excellence (NICE), which advises the NHS in England what medical practice it should follow.
NICE's current guidance recommends "early clamping and cutting of the cord" to medical professionals as a key element of the "active management" of the third stage of labour, just after the birth, unless the woman has had a low-risk pregnancy and specifically requests "physiological management", in which the cord is allowed to stop pulsating and the placenta is delivered naturally.
That advice is under review, as more hospitals are switching from immediate clamping to delaying it, amid growing evidence that early clamping can later lead to a baby developing iron-deficiency anaemia. About 10 per cent of British toddlers are iron-deficient.
Prompted by uncertainty among doctors about when to clamp, the National Institute for Health Research has decided to fund Britain's first trial comparing the pros and cons of immediate versus delayed clamping in more than 100 births of babies born before 32 weeks at eight hospitals.
Belinda Phipps, chief executive of the NCT, said: "When a baby is born, about a third of the baby's blood is still in his or her cord and placenta.
"With no good evidence to support it, it is accepted practice to accelerate the arrival of the placenta with an injection and clamp and cut the cord immediately, depriving the baby of this blood."
Influential bodies such as the World Health Organisation now urge delay, while research published by medical journals such as the British Medical Journal has also helped prompt a move away from immediate clamping.