Marianne,

Dr. Kathryn Dewey from the University of California, Davis presented a
session this past fall at our LLL HCP seminar about complementary
foods for infants. One of the points she mentioned is that delayed
(about 3-5 mins after birth) clamping of the cord allows enough blood
to flow to the baby that they build an iron store that will last 3.5
months. Given that unnecessary iron supplements can be dangerous, and
physicians are often concerned about the iron levels in breastmilk
(which, she explained, are very very low even if they are
well-utilized), it seems like a very important event to occur.

Additionally, the research that suggests that bilirubin levels are
higher in babies who experience delayed clamping is inconclusive
according to Dr. Dewey. And, as Dr. Newman says, if it's normal to be
jaundice, then maybe we should be worrying about the babies who aren't
yellow enough.

I also contend that if most people who delay clamping are more
naturally oriented, they are likely to be breastfeeding mothers (so,
in the US I'm thinking that mostly--almost exclusively--it is
homebirth/birth center births where this happens), and as we know,
breastfed babies are more likely to be jaundice.

Yes, a baby who experiences a delayed clamping has a higher blood
volume. But, if it's a natural mechanism we must ask ourself if that
is a problem or a norm.

And I agree that even if other mammals are chewing off the cord, it
isn't while the blood is still actively transferring--it is well
after.

Gina
www.safepassagebirth.com

On Mon, Mar 3, 2008 at 4:06 PM, Marianne Vanderveen-Kolkena
<[log in to unmask]> wrote:
> Hi all,
>
>  On our volunteers list, we were discussing a case of high hemoglobin levels due to late clamping of the umbilical cord.
>  Apparently, opinions differ on whether it is a risk or an advantage to clamp the cord only when the pulse is gone. When Hb gets too high, the blood gets too thick, which can be a risk.
>  I was puzzled by what was brought in and, in line with many mails here (thanks, Diane a.o.), started hypothesizing about how other mammals/primates do that, about when they bite the cord, and whether there might be a positive side to the blood being somewhat thicker (like we have learned that there is a positive side to somewhat increased bili levels). The primary question was supplementation *because of* the viscosity of the blood. I'd reckon high Hb may lead to active hemolysis and therefore much bilirubin, which necessitates good bf management, but certainly not justifies a contraindication and supplementation with formula, considering gastric emptying times of AIM. The longer these times, the longer it takes for the bilirubin to be excreted in the stools, so jaundice gets more likely.
>  Any experiences on this matter? Does adding fluids reduce viscosity and if yes, what fluid is to be preferred...? (Yeah... surprise me... mother's milk, right?! hahaha)
>

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