Delayed Cord Clamping Makes Stronger Babies

Numbers for sudden unexplained infant deaths, or cot deaths, have reached the lowest all-time record in England and Wales, according to new figures.

Experts have jumped in to attribute this to many factors including: fewer women smoking, warmer than average temperatures throughout the year, and a greater awareness of safer sleeping practices (back to sleep).

But another reason has been suggested by Amanda Burleigh at Optimal Cord Clamping #WaitforWhite. “Could this be a decreased incidence of immediate cord clamping perhaps?” she asks. “More babies are now getting their full quota of blood and other unknown goodies.”

Delayed cord clamping is finally becoming the default practice with babies receiving a third more of their blood if the cord is left until it goes white.

More blood equals more oxygen pumping around the baby's little body, which means an increased capacity for better breathing. This means the difference of around 150ml in their little bodies from a total available blood bank amount of 450ml.

In November 2014, NICE, the UK agency that provides national healthcare guidance, recommended that hospitals defer cord clamping from 1-5 minutes - the result is that now the majority of hospitals in the UK and Ireland don’t cut cords until they stop pulsating (around 3 minutes).

Whilst there is scant evidence linking cord clamping with improved neo-natal outcomes, the body of research is growing gradually.

Recent Swedish research suggests that it helps to improve children's fine-motor and social skills by age 4 years because of the way it boosts iron levels between the critical growth spurt period of 4- to 6-months. The extra store of iron prevents iron deficiency, which has been linked to developmental problems in both motor control and mental skills.

Sudden infant death syndrome (SIDS) struck 128 times in 2014 (ONS figures only show England and Wales), compared to 165 babies who died the previous year. When ONS first started recording these numbers, that number was 207 in 2004.

Overheating is a known risk factor for cot death and during cold winters the risk of the baby getting too hot under extra clothing and blankets is increased.

Here are some of the measures parents can take to lower the risk of sudden infant deaths:

• Always place baby on their back to sleep
• Avoid smoking when pregnant or around the baby.
• Place baby in a separate cot or Moses basket in the same room as you for the first six months.
• Use a good condition, firm, flat and waterproof mattress for baby.
• Don’t sleep on a sofa or in an armchair with your baby.
• If you smoke, drink or take drugs or are extremely tired, don't sleep in the same bed as the baby.
• Avoid letting the baby get too hot.
• Don't cover baby's face or head while they are sleeping or use loose bedding.

References:
Andersson, Ola. Uppsala University, Sweden. Published in JAMA Pediatrics. (May 26)
Office for National Statistics (ONS). Birth and Death Statistcis for 2004: England and Wales. (Aug 2016)

Just think of a bagel

Most of us know that women need their cervix to open up by 10cm to be able to give birth to babies.

I found an interesting visual a friend shared on Facebook to demonstrate the journey the cervix takes in opening, using every day spherical food objects.


Not to scale!

The comments from people included: "If only it was just a bagel I have to get out of there!" and "I was a bagel in THREE AND A HALF HOURS WITH NO PAIN RELIEF".

Hospitals are fixated with VEs - Vaginal exams - so they can write down how many cms women are dilated by during labour.

Current guidelines recommend that VEs are offered to women at regular intervals of 4 hours to assess labour progress, but they only give progress for the second that they are being done.

They are not an accurate gauge of when a woman will give birth. I had one client recently who said she went from 3cms to 9cms in 5 mins which totally took the midwife by surprise.

Vaginal exams are also not very good predictor of when labour will start as women can be 6 cms dilated for weeks before labour begins.

They can increase the risks of infection, even when done carefully and with sterile gloves because they push the normal bacteria up towards the cervix. There is also increased risk of rupturing the membranes (accidentally breaking the waters). And let's face it, nobody ever said how much they liked having one done - it's the hospital equivalent of being 'fisted'!

The upshot is there is no science behind VEs. And because every midwife has different sized fingers, the measurements can vary from midwife to midwife. So if your midwife ever says to you during labour: "You're still only 3cms" - say to yourself instead "yes, I'm dilating - I'm a slice of Banana" (see visual), because positive thinking can get you a very long way in labour.

Just remember, a bagel isn't that much bigger than a banana. And if you don't like bagels, maybe you could visualise a donut or a scone instead, yum yum!