How to boost your baby’s iron stores at birth

If you’re making plans for your birth, hopefully you’ve heard about delayed cord clamping. If you’re not making birth plans this may not be the post for you.

I did lots of research to prepare for the birth of my daughter earlier in the year. We are  lucky to have access to so much information and evidence on birth and pregnancy. Researching all options, means we can make fully informed decisions on the birth we want, whatever happens, because as anyone who has had a baby knows, it doesn’t always go to plan.

Delayed cord clamping

Through my research I came across this TEDx by Dr Alan Greene. In it he describes how the standard practice of clamping the umblical cord, immediately after birth, can result in your baby missing out on about 30% of his/her blood supply, which is effectively outside the body in the cord and placenta.

When your baby is first born, the cord continues to pulse: pumping blood from cord and placenta into your baby’s circulatory system. By delaying cord clamping by just 90 seconds you are ensuring baby starts life with optimal levels of iron rich red blood cells, immune boosting white blood cells and stem cells.

Dr Greene rightly calls it Optimal cord clamping. He explains it all much better than I can …

If you watch the film you can see optimal cord clamping makes so much sense that it seems bizarre that it is not standard practice in the NHS, or indeed Worldwide.

Also, if for any reason baby’s having problems breathing initially – keeping the cord intact means they are getting their oxygen supply from the placenta.

What the evidence says

The UK government’s Scientific Advisory Committee on Nutrition (SACN) published their report on Iron and Health in 2010. In it they drew on research indicating that babies who underwent delayed clamping had, on average, 32% more blood (Nelle et al, 1995) and therefore higher iron levels (30-50mg) (Pisacane, 1996).

They also reported on a Mexican study (Chaparro et al, 2006) where researchers found little difference in haemoglobin (made from iron – a constituent of red blood cells needed to transport oxygen) levels in babies who underwent immediate cord clamping compared to delaying the clamping. However, babies whose cords remained intact for longer at birth had higher  serum ferritin* concentrations. The World Health Organisation  (2007) considered this evidence to be of low quality however, they did recommend delaying clamping by up to 3 minutes.

A review by Cochrane (McDonald and Middleton, 2008) found that delayed cord clamping was associated with significantly higher haemoglobin concentrations at birth. While these levels were not maintained at 6 months,  serum ferritin concentrations were significantly higher at 3 and 6 months. They also found that significantly fewer babies undergoing immediate cord clamping had to undergo phototherapy for jaundice compared with optimal cord clamping.

So in summary they stated that “Delaying clamping cord at delivery is associated with higher systemic iron depots in the first 6 months of life; however, it might also increase the risk of jaundice requiring phototherapy.” They  recommend that further studies are needed to research the benefits, risks and long term effects associated with delayed cord clamping.

Calls to action

  • Dr Alan Greene wants optimal cord clamping to become standard practice, Worldwide. He has started a campaign called Ticc Tocc, the aim is to spread the word about optimal cord clamping.
  • There is also a petition calling for the National Institute of Clinical Excellence (NICE) to change their guidance to recommend delayed cord clamping as standard practice in the UK : http://www.change.org/petitions/national-institute-of-clinical-excellence-implement-delayed-cord-clamping-immediately
  • And if you’re writing your birth plan, remember to include delayed cord clamping.**

* Serum ferritin levels indicate the levels of iron stored in tissue.

**If you have a planned caesarian, you can still plan to have delay cord clamping and skin to skin contact. Search online for “natural caesarian” for more information.

This post is for Claire (you probably already know about this) – good luck.  And Holly and Sarah too.

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