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Cutting Umbilical Cord Early Eliminates Stem Cells

GeneralSoh writes "Delaying clamping the umbilical cord at birth may have far-reaching benefits for your baby, according to researchers at the University of South Florida's Center of Excellence for Aging and Brain Repair — and should be delayed for at least a few minutes longer after birth. This new recommendation published in the most recent Journal of Cellular and Molecular Medicine (14:3) notes that delaying clamping the umbilical cord allows more umbilical cord blood and crucial stem cells to transfer from mama to baby."

42 of 139 comments (clear)

  1. How will they know when to cut it? by Yvan256 · · Score: 5, Funny

    Is there an upload progress bar on the umbilical cord?

    1. Re:How will they know when to cut it? by crow · · Score: 5, Informative

      Yes, there is. It will stop pulsing. I've heard of cases where the baby was having trouble breathing, so they kept it going for half an hour until the breathing was right. As long as the cord is pulsing, the baby is still getting everything he needs through it. In most cases, the cord will shut down on its own in a minute or two.

    2. Re:How will they know when to cut it? by planckscale · · Score: 2, Interesting

      Will it continue to pulse while only attached to the placenta? For example, is it possible or beneficial for both the baby and placenta to be outside the mother for a while?

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    3. Re:How will they know when to cut it? by Anomalyx · · Score: 2, Insightful

      I would assume the pulse is a result of the mother's heartbeat, and therefore would require everything to stay attached in order to continue to do so.

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    4. Re:How will they know when to cut it? by ParanoiaBOTS · · Score: 2, Informative

      Will it continue to pulse while only attached to the placenta? For example, is it possible or beneficial for both the baby and placenta to be outside the mother for a while?

      Yes, it only pulses while attached. Basically everything is still hooked in to the mothers circulatory system at that point, and the pulsing you are seeing is actually the mothers heart pumping blood through the cord. There is something called Wharton's jelly that exists within the umbilical cord which, if left alone, will cause the cord to "clamp" itself off anywhere from 5-20 minutes after the birth. Check it out: http://en.wikipedia.org/wiki/Umbilical_cord#Physiological_postnatal_occlusion

    5. Re:How will they know when to cut it? by Anonymous Coward · · Score: 5, Informative
      No - it has its own pulse - there is no direct connection of the maternal/foetal blood vessels.

      And I held and cut my own kids' cords - home births both of them, and the midwife said to leave clamping & cutting until the cord stopped pulsing, so I had to hold the cord until I felt it stop.

      Surprisingly tough, too - it's like a rope of three blood vessels strengthened with gristle.

    6. Re:How will they know when to cut it? by wringles · · Score: 2, Interesting

      There's actually a pulse even after the umbilical cord is clamped. Pulse in the umbilical cord is generated by the fetus' or baby's heartbeat, not by the placenta. The placenta has no pumping motion.

      After the baby is delivered, it is actually not "getting everything it needs" through the placenta. Even were the placenta still attached to the uterine wall, blood flow to that organ diminishes greatly soon after delivery -- otherwise, life threatening maternal blood loss might occur. Of course, an unattached placenta is not contributing with any substantial amount of metabolites to the baby.

      As a medical curiosity, I'd like to point out that the first picture of the original article shows a true knot of the umbilical cord. Of course, it's a curiosity and not a tragedy only because the knot wasn't tight enough to kill the fetus.

    7. Re:How will they know when to cut it? by UnderCoverPenguin · · Score: 2, Informative

      Actually, it is connected to the baby's blood vessels. The branch vessels that they connect to collapse shortly after birth to seal off the cord.

      Just after the birth of my daughter, the blood continued flowing in the cord for several minutes, leaving mother and child connected. Once the flow stopped, my wife's body started to try to expel the placenta even as I was trying to cut the cord.

      --
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  2. Reminds me of my mother by elrous0 · · Score: 4, Funny

    And they said she was crazy for keeping me attached for a year and breastfeeding me until I was 9. WHO'S LAUGHING NOW, NOSY SOCIAL WORKERS???

    --
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    1. Re:Reminds me of my mother by rev_sanchez · · Score: 4, Funny

      My sister's cat is going to feel pretty silly about gnawing through all of her umbilical cords and eating the placentas. Next time I'll be sure to let Mittens know about the stem cells.

      --
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    2. Re:Reminds me of my mother by interkin3tic · · Score: 3, Insightful

      My sister's cat is going to feel pretty silly about gnawing through all of her umbilical cords and eating the placentas. Next time I'll be sure to let Mittens know about the stem cells.

      To be fair, she probably thinks we're the silly ones for wasting all those tasty stem cells on our measly one-offspring litters.

  3. Re:ORLY? by canajin56 · · Score: 4, Insightful

    Oh, if only they had done extensive research on it, instead of just saying "Sounds reasonable, lets publish!" then they would have caught that major flaw! Too bad you weren't around to keep them honest!

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  4. Re:ORLY? by asukasoryu · · Score: 4, Insightful

    I would think that newborns are at a critical developmental stage and need all the help they can get. If I sucked out a significant portion of your blood, it would set you back a bit and you've been around more than 9 months.

    --
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  5. "...delayed for at least a few minutes longer..." by willoughby · · Score: 4, Insightful

    A few minutes longer than.. what?

  6. Also: Jaundice! by LanMan04 · · Score: 5, Informative

    When my son was born a few years ago, the Doc didn't clamp the cord very quickly. Our baby also ended with a pretty decent case of jaundice and had to be under the "bili lights" for a few days, extending our hospital stay.

    This can sometimes happen when the baby gets a big dose of red blood cells because he's a lot lower than the placenta (gravity) or because the cord isn't clamped very quickly. All those red blood cells die in a day or two, baby cannot break down/metabolize the dead RBCs correctly, and POOF, jaundice.

    Just be careful. Jaundice can cause pleasant things like brain damage in neonates (due to immature blood/brain barrier).

    http://en.wikipedia.org/wiki/Bilirubin#Toxicity
    http://en.wikipedia.org/wiki/Kernicterus

    --
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    1. Re:Also: Jaundice! by jtorkbob · · Score: 2, Interesting

      Interesting correlation. My daughter stayed unclamped for a couple of minutes, I think mainly due to the chaos of a very rapid labor, and she also had to be treated for jaundice. Have you read any studies on this correlation? I would hope this study would have spotted something like that.

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    2. Re:Also: Jaundice! by maxume · · Score: 3, Informative

      Apparently it is pretty common:

      http://en.wikipedia.org/wiki/Neonatal_jaundice

      (first paragraph says 70% of the time. Other reading says 50% of the time for full term newborns.)

      --
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    3. Re:Also: Jaundice! by Anonymous Coward · · Score: 4, Interesting

      Really?? Funny causation.

      I was born premature and needed a blood transfusion due to *insufficient* RBC. I also apparently had a decent case of jaundice. Funny how low RBC seems to have "caused" same jaundice as high RBC you are talking about? Or maybe there is another reasons?

      http://en.wikipedia.org/wiki/Neonatal_jaundice

      Now if you just read that you would have *maybe* figured out that there are multiple causes of neonatal jaundice and what your doctor did or didn't do probably had *nothing* to do with it.

      Just be careful. Not enough RBC can cause pleasant things like brain damage in neonates.

    4. Re:Also: Jaundice! by skelterjohn · · Score: 2, Insightful

      I hope you are not presenting your anecdotal evidence as proof of your claim... because...it's not.

    5. Re:Also: Jaundice! by drinkypoo · · Score: 2, Insightful

      My guess would be the midwife kept the child elevated more in this case than the other two, avoiding the problem of excess red blood cells entering the child. Did she lay the baby on your wife's breast or anything like that?

      It's kind of amazing (and by kind of I mean not at all) how when you do what is natural, it all works out. It's almost like we evolved to have live birth or something.

      --
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  7. Re:Keeping stem cells by asukasoryu · · Score: 2, Insightful

    Is it more important to get your kid of to a good start or save those stem cells in case you need them later? Besides, there should still be some left over.

    --
    There are more things in heaven and earth than are dreamt of in your philosophy.
  8. Re:ORLY? by JoshuaZ · · Score: 3, Informative

    The kid's been attached to it for 9 months, and the last 2 minutes make _THAT_ much difference?

    The cord is then under very different circumstances. At that point it is no longer bathed in a protective moistening medium and it is no longer getting nearly as much oxygen. Cutting the cord further reduces the oxygen level and gives it more surface area to dry out.

  9. Re:ORLY? by Itninja · · Score: 4, Insightful

    There are quite a few things relating to circulation that don't happen until a few moments after birth (i.e. blood pressure, heart rate, heart valve changes). Perhaps a stem cell transference has something to do with that...

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  10. Re:ORLY? by couchslug · · Score: 4, Funny

    "The kid's been attached to it for 9 months, and the last 2 minutes make _THAT_ much difference?"

    To be safe, use the Helicopter Parent method and leave it on until age 18.

    --
    "This post is an artistic work of fiction and falsehood. Only a fool would take anything posted here as fact."
  11. Re:ORLY? by Anonymous Coward · · Score: 4, Interesting

    Yes!

    When the baby is pushed out through the birth canal it is *compressed* and blood is *sqeezed out* from the baby into the umbilical and placenta. I can't believe it took researchers so fucking long to figure out *basic physics*.

    I was born premature and apparently needed a blood transfusion. The reason for the latter is probably because some doctor didn't want to wait a minute or so and wanted to be more "efficient". So DO NOT allow a doctor to clamp the chord for a minute or two after the baby is born. The baby needs that blood to thrive.

  12. Here's the actual paper by damn_registrars · · Score: 3, Informative

    You can access the actual research paper through this pubmed (national institutes of health) link. You may need to access it through your local university library to get further than the abstract. If you follow through as far as the link from the publisher (Wiley Interscience) you'll see that the paper was actually accepted and published online back in February.

    --
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    1. Re:Here's the actual paper by bradinthehouse · · Score: 2, Informative

      Also, while you're on the pubmed site, you might be interested in searching for other papers about the benefits of "delayed cord clamping" vs "early cord clamping." There are only a few cases where early cord clamping is beneficial, apparently. I was able to find many more articles on why delayed cord clamping is beneficial than I was on why early cord clamping is beneficial.

      For those who like evolution: It's also interesting to think that for millions of years, man did not clamp immediately after birth. Unattended women wouldn't bother. And yet, here we are!

      If you think that for every evolutionary tale there must be a creationary (whoah, what?) tale: do you think that $deity really made humans in such a way as to be entirely dependent on doctors to clamp as soon as a baby is born? Surely he would have taken care of that piece of awesomeness by introducing some new aspect of nature to handle it without our human intervention!

  13. Oh great by tweek · · Score: 2, Funny

    I find this out 6 weeks late. When did having kids become like buying technology?

    Seriously though, there are some cases where that might not be possible. My first son was an emergency c-section. I don't know how long it was before he started breathing but it felt like forever.

    Thing2 was a scheduled c-section and I had him in my arms almost immediately. I honestly don't know how quickly they clamped.

    --
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  14. Birthing centers already do this by MobyDisk · · Score: 4, Interesting

    My wife and I decided to have our child at a birthing center, and this was one of the reasons.

    I was very skeptical of not delivering in a hospital, but after doing some research I was intrigued. We went to the orientations at both a local hospital, and at a local birthing center. In both orientations I asked how long they leave the umbilical cord attached. The hospital doctors didn't see any reason not to cut it immediately, and kind of looked at me like "oh, you are one of THOSE people." The midwife at the birthing center said something like "We follow the most recent lifelong study completed by in which recommends leaving the cord on for due to the increased supply of stem cells." where X was something between 2 and 5 minutes, I forget the number now.

    The linked article does a great job of pointing out that this isn't new. What is shocking is that most OBs don't know it. The only disadvantage of this is that it makes it harder to harvest fetal stem cells from the placenta. In our case, I don't think our donation met the minimum requirements (although we sent it in anyway). I love the idea that our son got a head start because we did what science has already known to be correct, and that perhaps someone else's life could be saved by the donation.

    If you plan on having a child, it is worth every moment to do your research. And don't blindly trust the doctors.

    1. Re:Birthing centers already do this by kd5zex · · Score: 4, Insightful

      What is shocking is that most OBs don't know it.

      It's not that they don't know, it's more likely most don't give a damn.

      And don't blindly trust the doctors.

      Fantastic advice, OBs often capitalize on the stressful situation and play the "dead baby card" quite often to do things their way.

  15. Re:currently in practice by tobiah · · Score: 4, Interesting

    It's also old news that giving birth on your back without moving around is just about the most painful and inconvenient way to do it, but birth wards continue to promote this because it is also the most convenient position for the doctor.

    --
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  16. Re:currently in practice by blackfrancis75 · · Score: 2, Interesting

    I think that's a pretty important consideration, given the high incidence and terrible consequences of complications during childbirth.

  17. Re:I loved my umbilical cord so much by PPH · · Score: 2, Funny

    You and David Carradine.

    --
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  18. Re:currently in practice by Lumpy · · Score: 2, Interesting

    United states has one of the highest infant mortality rate in the world. Sounds like our Best medicine money can buy, actually sucks pretty bad.

    --
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  19. Re:ORLY? by interkin3tic · · Score: 4, Informative

    There are quite a few things relating to circulation that don't happen until a few moments after birth (i.e. blood pressure, heart rate, heart valve changes). Perhaps a stem cell transference has something to do with that...

    There are several valves in the embryo's heart (such as the foramen ovale) which allows a lot of the blood passing through the heart to avoid the lungs. A lot of the blood coming into the heart before birth is oxygenated from the umbilical cord, so it can get pumped right out without going to the lungs.

    When the lungs become functional, pressure changes cause at least some of those valves to close immediately, so that the blood is now forced to go through the lungs before getting pumped back out to the body. These valves should close almost immediately to avoid deoxygenated blood being pumped out. That's really too quick to be directly affected by the stem cells. They -might- have something to do with later changes, where those valves permanently fuse shut, I don't know.

  20. Re:currently in practice by whizzard · · Score: 2, Informative

    United states has one of the highest infant mortality rate in the world

    You may want to check some actual facts. As of 2009, the US was 46th out of 224. This definitely isn't something to brag about, but it's nowhere near the "highest". It's not even 3x the lowest...

  21. Re:currently in practice by Draconius42 · · Score: 4, Informative

    could it be because our doctors have the skill to allow babies to be born that would be stillborn elsewhere, but then subsequently die from complications? This is a misleading statistic that doesn't take the whole picture into account.

  22. Re:Nice one, Timothy! by Kilrah_il · · Score: 3, Informative

    The bigger problem is that no blood is actually passed "from mama to baby". The maternal and fetal circulations are (almost) completely separated. Except for few red blood cells that accidentally pass (esp. around birth and trauma), the placental barrier keeps the two circulations separate. Oxygen, nutritional material and waste are passed by diffusion, with no contact between the two blood pools. The reason for this is that the baby's blood type may be different than the mother's (because of paternal genes) and if the blood would have mixed, than there would have been an immune reaction against the baby's blood.
    Delayed vs. early clamping affects the distribution of blood between the newborn baby and the placenta. The major determinant for this is the relative hight of each other, due to the rule of communicating vessels.

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  23. Re:ORLY? by Lobachevsky · · Score: 5, Funny

    I don't know, I think newborns should be exposed to the free market system. If they cannot offer goods and services, they must not receive them. Providing free food, free shelter, and free healthcare to newborns is a slippery slope to a welfare state. /s

  24. Re:ORLY? by wringles · · Score: 4, Informative

    "Probably" just doesn't cut it. While delayed clamping of the umbilical cord may have a number of benefits to premature newborns, there are several other reasons for neonatal anemia (and hence, your need for a transfusion of RBCs) that have nothing to do with the timing of clamping.

    Also, several of the reasons for prematurity may cause birth with low Apgar scores. When a baby is born with low/zero heart rate or does not breathe soon after delivery, keeping it attached to the placenta is not going to give you better results than prompt clamping and institution of proper resuscitation.

    Please try to exercise more common sense when you leave your opinions in a public forum. Oh, forget that last sentence, this is slashdot, after all.

  25. My wife is a Certified Professional Midwife by Ice+Station+Zebra · · Score: 2, Insightful

    And she has been saying this for years. Along with, don't take the baby away right after birth, skin to skin contact right after birth is important and let the kid nurse. Have your babies at home, you go to the hospital when you are sick and pregnancy is not a disease.

  26. Re:ORLY? by davester666 · · Score: 2, Funny

    Well, they willingly exchange pee for breastmilk...

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