Wednesday 27 May 2015

Delaying Cutting a Baby's Umbilical Cord by Three Minutes Could Speed Up Their Development Later in Life

Waiting a few minutes to clamp the umbilical cord after birth could boost a child’s co-ordination and social skills, according to new research. A study found waiting at least three minutes to cut the cord after birth led to improved development in boys. They not only had a more 'mature' pencil grip, but also better scores on tests for certain social skills. This is because delaying clamping allows more iron-filled blood to transfuse into the baby, which is important for its development.

Previous studies have linked low iron levels in babies to impaired learning, speaking and understanding, and conditions like ADHD. For the new study, the researchers followed up on 263 Swedish children born at full term to healthy mothers about four years earlier. As newborns, the children had been part of a larger study in which a total of 382 babies were randomly assigned to either early cord clamping (within 10 seconds of birth) or late cord clamping (at least three minutes after birth).


Four years later, they found the children were similarly intelligent - regardless of when their cords had been clamped - but there were some notable differences. ‘When you just meet a child, you wouldn't see or notice any differences,' lead author Dr Ola Andersson, of Uppsala University in Sweden, told Reuters Health.

'But we could see the differences in fine motor function.'

Fine motor function is is the coordination of small muscle movements, usually involving the synchronisation of hands and fingers with the eyes. It is distinguishable from gross motor skills, which are involved in movement and coordination of the arms, legs, and other large body parts and movements. Fine motor skills are required for actions such as picking up objects between the thumb and finger and writing carefully.

In the study, a psychologist assessed the children using tests of IQ, motor skills and behaviour. Parents reported their children’s development in communication, problem solving and social skills in a questionnaire.

The researchers found that overall, there was no difference in brain development and behaviour scores for babies whose cord were clamped early or late. There was no difference in overall IQ scores between the two groups of children either.

But more children in the delayed cord clamping group had a mature pencil grip on the fine motor skills test. They also had better skills on some social domains, compared to those whose cords were clamped early. Divided by sex, the researchers only found noticeable differences in boys, not in girls.

Iron deficiency is much more common among male infants than among females, Dr Andersson said. 'Girls have higher iron stores when they are born,' he said. Delaying cord clamping by three minutes allows an extra 3.5 ounces of blood to transfuse to the baby, which is equivalent to a half a gallon of blood for an adult, he added.
 
'There's a lot of iron in that volume,' he said. 'Even three minutes can have quite a lot of effect on the iron in the blood in the body for a long time after birth.'

The World Health Organisation recommends waiting at least one minute after birth, or until visible pulsing stops, to clamp the umbilical cord. In the UK, the health watchdog NICE advises waiting one minute to cut the cord but to support a woman if she requests the cord is clamped later than five minutes.

The latest American College of Obstetricians and Gynecologists opinion, from 2012, supports delayed cord clamping for premature infants, but says there is insufficient evidence to prove a benefit for full-term babies. The new study provides evidence of benefit for full-term babies in a developed country where nutritional deficiency is extremely rare, Dr Andersson said.

Dr Heike Rabe, of the Brighton and Sussex Medical School and University Hospitals, who co-authored an editorial published with the study, says waiting longer to clamp the cord echoes.

She said: 'When a baby transitions from inside the womb to outside the womb, if you think about what nature does, it is not to clamp the cord immediately.’ ‘About 60 years ago doctors started clamping the cord as early as possible, believing it may reduce the risk of haemorrhage for the mother, but we now know that is not the case.’

She added: ‘Today, it is a big psychological hurdle for doctors to change how they have always done things, which in this case is to clamp the cord as soon as possible, she said. ‘Many mothers in developing countries are anaemic, so babies are also anaemic.

The new study found only a small difference at age four, but if the study was carried out in India it might show a marked difference, as there is excellent nutrition in Sweden, she said. (Dailymail)

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