Cutting umbilical cord too early could put babies at risk

Cutting newborn babies' umbilical cords too early may leave them deprived of vital blood from the placenta, causing anaemia which can harm brain development, according to research published in the Guardian newspaper today.

The research was released by the British National Health Service (NHS).

UK health body NICE's current guidance recommends "early clamping and cutting of the cord" to health professionals as a key element of the "active management" of the third stage of labour, just after the birth, unless the woman has had a low-risk pregnancy and specifically requests "physiological management", in which the cord is allowed to stop pulsating and the placenta is delivered naturally.

That advice is under review, as more hospitals are switching from immediate clamping to delaying it, amid growing evidence that early clamping can later lead to a baby developing iron-deficiency anaemia. About 10% of UK toddlers are iron-deficient.

NICE is now reviewing its cord-clamping guidance, which it originally published in 2007. Doctors hope its new advice, due in June 2014, will lead to delayed clamping replacing immediate clamping as the NHS's standard procedure.

Professor Mark Baker, director of Nice's centre for clinical practice, said: "Nice is currently updating its guidelines for the care of women and their babies during childbirth, which includes the timing of cord-clamping, as evidence and intelligence collected during the review process [since its 2007 advice] indicated an update was needed. Our priority is to ensure that mothers and babies get the best possible care."

Prompted by uncertainty among doctors about when to clamp, the National Institute for Health Research has decided to fund the UK's first trial comparing the pros and cons of immediate versus delayed clamping in more than 100 births of babies born before 32 weeks at eight hospitals.

Andrew Gallagher, a consultant paediatrician at the Worcestershire royal hospital in Worcester, which adopted delayed cord-clamping in 2009, said: "Immediate cord-clamping is a harmful practice because it denies the baby the blood from the placenta, and means that later on they are more likely to become iron-deficient. That matters because iron deficiency can cause serious problems. It affects the brain and learning capacity of toddlers ... [who] are going to be slower to learn, for example to speak and to understand."