letting the cord pulsate leads to jaundice???

[*noni*e*]

ok so i had decided (thought i had) to let the cord stop pulsating so our little princess got all of her blood, before they gave the injection to expell the placenta, if i had the injection at all... yesterday though i was watching pregnancy for dummies on tv or it might have been the day before but anyway the dr on it said if they dnt cut the cord in time the baby can recieve too many blood cells and this causes jaundice... has anyone heard of this?? or know if theres any truth to it??

[Trillian]

Noni, I have heard many good things about letting the cord pulsate, but I haven't heard that it can give them jaundice? I have a few articles I will post for you that I got from here just so you can read up on it a bit from different sources.

Delaying cord clamping reduces anemia
Source: Pediatrics 2006; 117: e779-86

Investigating the effects of the timing of cord clamping on neonatal venous hematocrit.

Delaying cord clamping may lower rates of anemia in newborns, results of a randomized controlled trial suggest.

Although the umbilical cord is usually clamped immediately after birth, there is no evidence to support this approach, and it may even deprive the newborn of some benefits, say José Ceriani Cernadas (Hospital Italiano de Buenos Aires, Argentina) and co-workers.

To find out, they assessed the effects of clamping the umbilical cord within the first 15 seconds (group 1), 1 minute (group 2), and 3 minutes (group 3) of birth in a study of 276 neonates born at two obstetrical units in Argentina. The infants were delivered at term without complications.

Delaying cord clamping increased the venous hematocrit value—the relative volume of blood occupied by red blood cells—in the babies at 6 hours of life within the physiologic range (53.5 percent, 57.0 percent, and 59.4 percent in groups 1, 2, and 3, respectively). Anemia, defined as a venous hematocrit value lower than 45 percent, was significantly less common in groups 2 and 3 than group 1.

Cernadas et al say delaying clamping should be implemented to increase neonatal iron storage at birth.

Iron deficiency in early life has been linked to cognitive impairment, and anemia is one of the most serious childhood conditions, especially in the developing world.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~
Trial finds delay in cord clamping protects babies
(as reported in the Courier Mail recently)

A 30 second delay in clamping a premature newborn's umbilical cord protects against bleeding in the brain and infection, groundbreaking new research shows.

The study, which involved 72 babies, could prompt a reassessment of the standard practice of clamping the cord immediately after birth.

Delayed clamping has been shown to increase the volume of blood transferred to the baby from the placenta.

Researchers from the University of Rhode Island, in the US, followed 36 babies assigned to immediate cord clamping and 36 assigned to delayed cord clamping.

All were less than 32 weeks gestation and their prematurity meant they were at increased risk of brain haemorrhage and infection.

In the weeks after birth, 36 percent of the immediate group had suffered bleeding into the brain, compared with 14 per cent of the delayed group.

Nine of the immediate group but none of the delayed group developed infections while in the intensive care.

"It may be that the small amounts of additional blood preterm infants obtain by delaying cord clamping helps to stablise cerebral blood flow and provide additional stem cells to establish adequate immunocompetence" says the report in this month's America Pediatrics journal.

HTH

[BellyBelly]

All the studies, information and myths are here:

Cutting the Cord - Don't Cut The Cord!

[*noni*e*]

thanks guys, its funny to hear a trained professional tell you that u know? he was an ob or something i think...

[Trillian]

And this is from the Mayo Clinic (USA) about Infant Jaundice;

Causes

Babies are born with a generous supply of red blood cells, which help transport oxygen. Over time, these red blood cells break down, forming bilirubin in the process.
Bilirubin is normally transported to the liver, where it's processed before being eliminated from the body. But newborns initially have more bilirubin than their livers can handle, and the excess causes their skin and, sometimes, the whites of their eyes to turn yellow. This type of jaundice, called physiologic jaundice, typically appears on the second or third day of life.
Although any newborn can develop physiologic jaundice, it occurs more often, and is sometimes more severe, in premature babies because their livers are even less developed than are those of full-term infants.
Sometimes a baby may develop jaundice for other reasons. If jaundice is present at birth or appears within 24 hours, it may be the result of:

• Severe bruising
• An infection in your baby's blood (sepsis)
• An incompatibility between your blood and your baby's

Jaundice that develops in or lasts past the second week of life may be due to:

• A liver malfunction
• A severe infection
• An enzyme deficiency
• An abnormality of your baby's red blood cells

Risk factors

Boys tend to be at higher risk of infant jaundice than are girls. Asian and American Indian infants also are more likely to have jaundice. Other factors that may put your newborn at risk of jaundice include:

• Premature birth. Because your premature baby may not be able to process bilirubin as quickly as full-term babies do, he or she is at higher risk of jaundice. Your preemie may also feed less at first and have fewer bowel movements, which means less bilirubin is likely to be eliminated in your baby's stool.
• Bruising during birth. Sometimes babies are bruised during the delivery process. If your newborn has a bruise, he or she may have a higher level of bilirubin from the breakdown of more red blood cells.
• Blood type. If your blood type is different from your baby's, your baby may have received antibodies through the placenta that cause his or her blood cells to break down more quickly.
  Blood groups are determined according to whether you have certain protein molecules on the surface of your blood cells. The rhesus (Rh) factor is one of these blood groups. If you have the Rh factor in your blood cells, you're considered Rh positive. If you don't, you're Rh negative. There's nothing inherently wrong with being either Rh positive or Rh negative. But problems can arise when an Rh-negative woman is pregnant with an Rh-positive baby.
  During pregnancy, fetal cells cross the placental barrier and mix with the mother's cells. If the mother's immune system detects the baby's opposing Rh factor, it produces antibodies against it. These antibodies then enter the baby's circulation through the placenta and umbilical cord and attach to the baby's red blood cells, causing them to break apart and release bilirubin.
  To minimize the likelihood of problems, Rh-negative women receive injections of Rho (D) immune globulin (RhoGAM), which prevents the mother's body from producing unwanted antibodies during the pregnancy and immediately following birth.
• Breast-feeding. Breast-fed babies have a higher risk of jaundice, but for most newborns the risk is slight and is far outweighed by the benefits of breast-feeding. In addition, if a mother's milk is slow to let down, her baby may not gain weight as readily, which makes jaundice more pronounced. A slow start to breast-feeding may also lead to some dehydration in the baby, which may raise the bilirubin level.
  Breast-feeding more than the daily usual of eight to 10 times, which will encourage your baby to have more bowel movements, might reduce the risk. Breast-milk-related jaundice normally appears four to seven days after birth and may last for several weeks.

So it doesn't actually say anything about the cord blood increasing the risk of it, but maybe someone else might have a better idea.

[BellyBelly]

They all still have their own opinions, some think waterbirth is dangerous, some say homebirth is too, but you have to remember they are trained in things going wrong. Did you know that at last count in Australia, infant mortality was actually up? And we have no options for homebirth here and most people are choosing care in hospital without continuity of care.

There are Obs that do breech birth, waterbirth and promote it etc, but it all boils down to their training and lack of experience in normal birth like breech vaginal birth...

[Liz]

Breast-milk-related jaundice normally appears four to seven days after birth and may last for several weeks.

Tallon had this! The paed said because breastmilk is so easily digested the bilirubin isn't pushed out of the system as quickly, kinda gets re-absorbed with the breastmilk iykwim. He said it's completely harmless, they can't -really- explain it, but to keep on breastfeeding! hehe.

As for jaundice relating to cutting the cord.. I've never heard that before. Sounds to me like the MORE red cells they have the better, if jaundice is caused by redcell breakdown.

[*noni*e*]

wow guys u all have so much info i feel like i know absolutely nothing haha..
guess there is lots to think about, i just thought it was strange that he was saying this and the midwives never said anything when i expressed to them that i wanted to cord to pulsate... ughh decisions decisions..
shannon funny they wouldn't let u write pr1ck

[Trillian]

Noni, have you started thinking about what you would like in your birth plan, or if you even want one? If you are adamant about having things done a certain way, it really pays to have it written down so they know your intentions and they can't go against your wishes by automatically cutting the cord etc unless there is a medical emergency to do it earlier.

And don't worry about thinking you know nothing - I had three babies before I knew all of this stuff LOL.

[chocolatecatty]

I was given the line about jaundice too....silly young midwife also poopoohed my aspirations of a natural birth. Was quite offensive given the amount of research I did (which she of course wouldn't know about)...but a bit of encouragement would have been nice!

Just be careful right after the birth when they (despite having read your birth intentions) ask you if you'd like the placenta injection....I said oh whatever, not knowing it meant they then cut the cord on the sly! Not impressed at all, given it was a natural birth up til that point!

[BellyBelly]

It took me two babies to find out all this too LOL! Lucky ducks finding this out for your first

[*noni*e*]

lol yeah i am going to the birth centre so the midwives help you write your birth plan at your visits coz they would like you to have one... i have heard lotsa ppl caught by that injection thingy.. i dnt mind having it but have said to the midwife it will be after the cord stops and it is cut so that will def go in the birth plan along with other things..
and yes i am extremely greatful for finding belly belly and all you wonderful ppl who can tell me birth dosn't have to be a horrible drug induced drugged out epesiotemy hell that i will have nightmares about for the rest of my life (what alot of ppl tend to like to tell me)

[morv]

I was told that the baby would get jaudice if I let the cord pulse by an ob. Needless to say I didn't go back to him.