Evidence for an extra few minutes

Do you know that it is considered "delayed" cord clamping if it is more than 30 seconds after baby is out?


One of my students asked me for some research to present to her OB that suggests delayed cord clamping is beneficial, since the OB's opinion is that it is better to clamp and cut immediately due to increased risk of jaundice. As a side note, I would like to say that I always recommend my students also do their own research and then consult their personal health care provider to be the best consumer of health care and advocate for your family as possible. Secondly, props to my student for asking about these issues early on to figure out what is best in your situation and what your provider recommends. And thirdly, yay for a doc who is willing to listen to what the "research shows." This is a great example of how medical opinion varies and that in some cases, while the studies do "show," there may be either a delay in the change of the practice or even resistance. 


So, to help you my students and consumers of health care on your way to discovering for yourself what is best for you and your family, I wanted to share links to some studies that that you may find interesting, in addition to a previous post of mine.

• Very interesting video of grand rounds at University of South Carolina - 2011 Dr. Nicholas Fogelson presenting data to show positive physiologic and clinical outcomes. I watched the whole thing and really recommend it, if you (or your provider) are on the fence about allowing the intervention of "early" cord clamping.
• World Health Organization - current commentary in their Reproductive Health Library recommends delaying of cord clamping, with the caution of taking into consideration that there is a increased incidence of jaundice requiring phototherapy which may not be available in underdeveloped countries.
• Journal of Midwifery and Women's Health - 2001 literature review showing many benefits in the first week through 2 months of age.

Sneaky ways to increase protein

Brewers Diet for pregnancy (recommended by The Bradley Method&#174) includes 80-100g of protein every day to help a plethora of diseases and risk factors! It can be hard to do if you are not used to eating this much protein or if you are vegetarian or vegan. Go to the website for more info (click "Vegetarian" on menu to the left to find vegetarian or vegan modifications) or here are some suggestions below:

source

• Ezekiel Bread: available at regular grocery stores, it is an organic, flourless, sprouted wheat whole grain bread (buns, cereals, etc.) and comes in a variety of flavors (sesame, cinnamon raisin, etc). While it only has 4g of protein per slice, it is a COMPLETE protein (most breads are not)
• Milk shakes: from non-fat dry milk (reconstituted), ice, fresh/frozen fruit, and/or yogurt
• Roasted soy nuts: buy in local grocery stores or health food stores or make your own. Soak soy beans in water in refrigerator for 2 nights, changing water once (use discarded water for soups or plants). Drain and roast in 300 degree oven on lightly oiled and salted pan until light brown.
• Cheese, cheese, cheese! Add grated cheese to eggs, sandwiches, casseroles, salads, snacks, on whole wheat crackers and celery.
• Cottage cheese: is a cheap and great source of protein! Add to gelatin salad, scrambled eggs, casseroles such as lasagna and other Italian dishes, make vegetable and cracker dips out of blended cottage cheese with onions and spices.
• Non-fat dry milk: add to hamburgers, meatballs, meatloaf, casseroles, and breads.
• Yogurt: blend with gelatin for interesting fruit salad, use in place of sour cream for dips.
• Soy flour: Add to bread (1/4 c.) when baking.
• Eggs: Keep hard boiled eggs and deviled eggs in refrigerator for snacking or make custard for dessert.
• Sunflower seeds: add to sandwich spreads (chicken salad) and sprinkle on salads.
• Wheat germ: buy at grocery or health food store and add to cereal, breads, cookies, baked goods, serve over ice cream.
• Brewers yeast or nutritional yeast (nutritional yeast does not contain the essential mineral Chromium): Brewers yeast is a complete protein and can be used to increase needed B vitamins to help combat fatigue. Good for milk production too!
• Liver: best source for just about everything! Cook and grind to combine with hamburger.
• Granola: make your own from whole grain cereals (oatmeal, 4 grain cereal), wheat germ, coconut, nuts, sesame seeds, sunflower seeds, oil, honey, vanilla, cinnamon.
• Combining vegetable proteins to make complete proteins: rice + legumes, corn + legumes, wheat + legumes, wheat + sesame + soy beans, rice + sesame, rice + Brewers yeast, vegetables + mushrooms or nuts or sesame seeds.
• Beans and corn: marinated salad of kidney beans, corn, celery, onion and Italian dressing. Serve chili with cornbread. Mexican food!
• Dietary Iron: good sources are liver, organ meats, whole grains, beans, pean and corn - necessary for blood manufacture, for increased blood volume of mother and baby. Oxygen-carrying component of blood (hemoglobin) dependent on iron. Also, baby stores iron in liver for postpartum life (draws on it for first 9 months!)

Adapted from The Bradley Method Teacher's Manual pg 249

Delayed cord clamping - a benefit, months later

These types studies have been out for years, but it is encouraging to see that more mainstream media is getting the word out there, click here to read more from the NY Times. 

The general finding from this particular study relating to iron levels, was the babies had a lower incidence of iron deficiency months later if the cord was clamped 3 minutes or later, instead of within 10 seconds. You may think, that is not much time difference, but it is to the baby's iron supply! Or you may wonder, do practitioners actually clamp the cord that quickly... and the answer is, you betcha. If you have not made a request for delayed cord clamping and/or discussed what your doctor's (or her/his partners within the group practice) general practice is, you may find the the cord is clamped in one fell swoop, just as your baby is inhaling its first breath of air. Also, you may want to request that the doctor leave orders that if the baby is born before she arrives to "catch" him/her, that it is ok that the nurses delay cord clamping, otherwise they may just do it right away, as away to begin to quickly check off all the things that they need to "get done."

Talk to your doctor about your preferences, include your desires in your birth plan, and feel free to ask about these types of studies, if necessary.