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)

Kindly,

Marianne Vanderveen, Netherlands

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