WEBVTT - 133. Quick Kick: What is Delayed Cord Clamping?

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<v Speaker 1>The information in this podcast is provided for education and

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<v Speaker 1>research information only.

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<v Speaker 2>It is not a substitute for professional health advice. Welcome everyone,

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<v Speaker 2>I'm Bridget Maloney and today we're going to do a

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<v Speaker 2>quick kick and it's going to be about delayed cord clamping.

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<v Speaker 2>Back in twenty twenty we recorded episode thirty seven all

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<v Speaker 2>about the umbilical cord. We still get questions about delayed

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<v Speaker 2>cord clamping, so this quick kick we're going to talk

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<v Speaker 2>about what it is and what to expect. When we

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<v Speaker 2>recorded the EPP four years ago, delayed cord clamping was

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<v Speaker 2>becoming routine for vaginal births and most caesarean sections. You

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<v Speaker 2>can still jump onto Google and see people saying that

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<v Speaker 2>doctors are against delayed cord clamping and that as a

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<v Speaker 2>birthing mum you have to advocate for this. However, delayed

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<v Speaker 2>cord clamping is now recommended by professational bodies like the

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<v Speaker 2>Royal Australian and New Zealand College of Obstetricians and Gynecologists

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<v Speaker 2>or RANSKOG and the World Health Organization. What isn't yet

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<v Speaker 2>routine practice is delayed cord clamping in premiature births. Previously

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<v Speaker 2>the standard practice for premier babies was to clamp the

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<v Speaker 2>umbilical cord immediately after birth so the baby could be dried, wrapped,

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<v Speaker 2>and if necessary, resuscitated with ease. Two Australian studies have

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<v Speaker 2>shown that delaying cord clamping for one to two minutes

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<v Speaker 2>and that's all it takes for a premature baby and

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<v Speaker 2>keeping particular care to keep the baby warm can increase

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<v Speaker 2>the chance of survival of the premie shortly after birth.

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<v Speaker 2>There needs to be further research for how best to

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<v Speaker 2>do this with the sickest of premature babies. These are

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<v Speaker 2>the ones that are born really early. But this is

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<v Speaker 2>a change of practice that has slowly been reflected in

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<v Speaker 2>obstetric guidelines. As you're listening to this quick kick, it

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<v Speaker 2>might be worthwhile to remember that in non premature births,

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<v Speaker 2>there are still some situations where delayed cord clamping is

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<v Speaker 2>not routine, and that is is if there's an issue

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<v Speaker 2>with the placenta, or the court or mum needs immediate

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<v Speaker 2>attention because of a postpartum hemorrhage, or in some cases

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<v Speaker 2>where the baby needs resuscitation. We love going back to

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<v Speaker 2>old apps and picking out these quick kicks, so let's

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<v Speaker 2>do that. Now and here what doctor pat has to

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<v Speaker 2>say about delayed cord climbing.

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<v Speaker 1>The benefits are probably something we're just starting to learn

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<v Speaker 1>more about now.

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<v Speaker 2>Yeah, I've read something. I've got the stats are wrong,

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<v Speaker 2>but it can have that baby's iron stores for the

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<v Speaker 2>first few months of flight.

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<v Speaker 1>Yeah, more iron, more blood volume. Is a fair bit

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<v Speaker 1>of volume in that because it's not that much blood

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<v Speaker 1>and newborn baby anyway, So what's sitting in the cord

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<v Speaker 1>is actually a.

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<v Speaker 2>Useful the percentage of the baby's blood.

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<v Speaker 1>And then exactly the benefit of the stem cells watch

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<v Speaker 1>this space. Yeah, So it's easy to do, and really

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<v Speaker 1>the only scenario where it really can't theoretically be done

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<v Speaker 1>is if the parents wish to donate or collect the

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<v Speaker 1>cord blood for storage.

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<v Speaker 2>Yeah. That was my next question, because.

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<v Speaker 1>You can't elp get into the baby and storage. Yeah,

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<v Speaker 1>it's one or the other. Yeah, so that's a problem.

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<v Speaker 1>And then the other scenario that makes it difficulty is

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<v Speaker 1>if there's some other sort of emergency going on. So

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<v Speaker 1>four example of thormans having a postpartum hemorrhage, then the

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<v Speaker 1>first thing you want to do to get that hemorage

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<v Speaker 1>under controls to get the percenter out yes, and that's

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<v Speaker 1>difficult to do with baby still attached, So you might

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<v Speaker 1>clamp and cut the cord forg go the benefits of

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<v Speaker 1>the delayed cord clamp and then put traction on the

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<v Speaker 1>remaining bit of the court teble percenta come out. And

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<v Speaker 1>that's a scenario that can happen at vaginal birth, and

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<v Speaker 1>unfortunately it's a bit more common at caesarean section birth

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<v Speaker 1>because the serian section is a bloody operation. You know,

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<v Speaker 1>there's there's blood around, and if the uterus is bleeding

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<v Speaker 1>too much at caesar immediately after the baby comes out,

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<v Speaker 1>then again, the way to stop that is to get

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<v Speaker 1>the plucenter out. So that might require the baby to

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<v Speaker 1>be the cord clamped and the baby passed over the

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<v Speaker 1>pediatrician a little earlier than we wanted. But if we

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<v Speaker 1>can control that bleeding by other means, by putting clamps

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<v Speaker 1>on things, then we can wait. Did that last night?

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<v Speaker 1>Just waited until the at of seas last night, just

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<v Speaker 1>waited until the cord had stopped pumping. Yeah, and all

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<v Speaker 1>of the blood was as much as possible if the

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<v Speaker 1>cord blood was down in the baby. Maybe took a minute.

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<v Speaker 2>Yeah, and it's not long that's the other thing.

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<v Speaker 1>It's yeah, and then clamp and cut and as long

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<v Speaker 1>and the baby was crying and mum wasn't bleeding, so

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<v Speaker 1>what's the rush?

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<v Speaker 2>Yeah?

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<v Speaker 1>Yeah, And that's becoming a standard at vaginal births and

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<v Speaker 1>increasingly acceptable at sesaian section.

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<v Speaker 2>Yeah. Yeah. And it's still worthwhile that woman putting it

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<v Speaker 2>in a birth plan though, isn't it just to make

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<v Speaker 2>sure that everybody's on that page.

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<v Speaker 1>Yeah, absolutely, because when I say standard, I mean not

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<v Speaker 1>everywhere and not every day. Yes. So if it's something

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<v Speaker 1>that mums have read something about and like the sound

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<v Speaker 1>of as a potential healthy thing that can do for

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<v Speaker 1>the baby that's not risky, then we should do that.

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<v Speaker 1>So let us know.

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<v Speaker 2>Yep. So this you mentioned just briefly about the cord blood.

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<v Speaker 2>So there's two things you can do with the cord blood.

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<v Speaker 2>You can either donate the cord blood and then that

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<v Speaker 2>goes into like a public cord blood bank.

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<v Speaker 1>Yes, so they collect some for each research purposes and

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<v Speaker 1>some for a public run cord bank.

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<v Speaker 2>Which can be used later on for.

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<v Speaker 1>Yeah, four matched donations. So potentially if a child got

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<v Speaker 1>a leukemia or something, then it may be possible in

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<v Speaker 1>some circumstances to use a donation of cord blood stem

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<v Speaker 1>cells from a bank.

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<v Speaker 2>And somebody doing that might be motivated by altruism or

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<v Speaker 2>why would somebody want to do that?

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<v Speaker 1>Yeah, altruistic donation, that's what it's all about. And not

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<v Speaker 1>every hospital collects for that purpose though, So collections tend

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<v Speaker 1>to be done in big city hospitals where they're set

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<v Speaker 1>up for it and where they've got a huge number

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<v Speaker 1>of births per year and can collect a lot of blood.

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<v Speaker 1>So if you are at a smaller community hospital, regional

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<v Speaker 1>country hospital, whatever, and they don't offer that service, don't

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<v Speaker 1>panic because the service has enough blood.

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<v Speaker 2>Yes, yeah, they're getting enough.

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<v Speaker 1>From city hospitals for that purpose.

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<v Speaker 2>But somebody might have it in their birth plan that

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<v Speaker 2>if for some reason I can't have delayed cord clamping,

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<v Speaker 2>then I'm willing to do cord blood donation. Is it

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<v Speaker 2>something that you have to consent for?

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<v Speaker 1>Yes, but don't panic if it's not offered at your hospital.

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<v Speaker 2>Yes, yea, yeah, I think that's important. And then some

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<v Speaker 2>you know, you see at advertised some people there's big

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<v Speaker 2>companies that will restore your cord blood. Yeah, thanks for listening.

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<v Speaker 2>These quick kicks are chosen from our back catalog of

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<v Speaker 2>episodes because of frequently asked questions we get. If you

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<v Speaker 2>have a burning question, please pop into our speak pipe,

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<v Speaker 2>great week. Keep well by fein out