Ask the Midwife: Delayed Cord Clamping and Cord Blood Banking… Friends or Foes?

Childbirth, Choices, Midwifery

doppler smallCan I still do cord blood banking if I request delayed cord cutting?

Not such an easy question.

The technical answer is yes, but the quality in which both parts are executed needs to be considered.

What are the benefits you are looking for from delaying the cord clamping for your baby? Why are you choosing to bank your cord blood?

What is delayed cord clamping?

Delayed cord clamping is when the umbilical cord is allowed to continue pulsing after birth for a minimum of 30 to 60 seconds. Research tells us that in order to see benefits from delayed cord clamping there should be a delay of at least one minute, three minutes being preferred for preterm infants. Many believe the longer the delay, the greater the benefits. Ideal timing is still being debated.

What are the benefits?

Although the majority of strong research supporting delayed cord clamping is on preterm infants with benefits including better circulatory stability, less intraventricular hemorrhage, improved organ repair, and reduced risk of necrotizing enterocolitis, term infants have been found to benefit from increased blood volume and hemoglobin concentrations, reducing the need for blood transfusions and preventing iron deficiency in the first 6 to 12 months of life.

Cord Blood Banking

In order for stem cells from cord blood to be used, an adequate sample of cord blood must be obtained; this usually takes a few minutes. The best samples are obtained while the cord is still pulsing allowing for an adequate sample volume. An umbilical cord typically stops pulsing anywhere between 30 seconds and 30 minutes following birth.

Research tells us that there is a 1 in 2,700 chance your cord blood stem cells will be needed to treat your child or a relative. Since it has been discovered that the majority of diseases cannot be treated with one’s own stem cells, research continues to be done to find uses for cord blood. Thus far the strongest research on cord blood banking does not support it secondary to it not being cost effective.

The Experts

The American Congress of Obstetricians and Gynecologists (ACOG), The American College of Nurse Midwives (ACNM), The American Academy of Pediatrics (AAP), and the World Health Organization (WHO) all recommend delayed cord clamping. None of these organizations recommend cord blood banking. In fact, ACOG clearly states that ‘the routine practice of umbilical cord clamping should not be altered for the collection of umbilical cord blood banking’.

The Answer

Yes, delayed cord clamping and cord blood banking can both be done, but at what cost? You make the decision.

Rita Wagner, CNM

Rita Wagner is a faculty member of the Department of Obstetrics and Gynecology at Mt. Sinai Roosevelt in New York City.

 

Submit your questions to askthemidwife@choicesinchildbirth.org.