Cut­ting the um­bil­i­cal cord im­me­di­ate­ly af­ter birth–cur­rent­ly stan­dard prac­tice–puts the ba­by at risk of iron de­fi­cien­cy, ex­perts say.

Of­fi­cial guide­lines are cur­rent­ly be­ing ex­am­ined–and pro­fes­sion­als and cam­paign­ers say they should change.

Leav­ing the cord at­tached for a few min­utes al­lows the blood in the cord to trans­fer to the ba­by,

The Na­tion­al In­sti­tute for Health and Care Ex­cel­lence (NICE) says it will pub­lish new guide­lines next year.

The ex­ist­ing guid­ance on cord-clamp­ing was pub­lished in 2007, when the con­sen­sus was that cut­ting the cord im­me­di­ate­ly was the best op­tion–some­thing which had been the case for decades.

But since then, re­searchers have ques­tioned whether that is still the case.

A pa­per from the Roy­al Col­lege of Ob­ste­tri­cians and Gy­nae­col­o­gists (RCOG) pub­lished in 2009, stat­ed that ba­bies whose um­bil­i­cal cords are clamped im­me­di­ate­ly have low­er iron stores for up to six months.

Low iron lev­els have been linked to brain de­vel­op­ment prob­lems.

The sug­ges­tion is that the cord should not be cut un­til it has stopped pul­sat­ing nat­u­ral­ly–any­where be­tween two and five min­utes af­ter birth.

Some hos­pi­tals have al­ready changed their prac­tice.

Com­ment­ing on the cur­rent re-eval­u­a­tion of the guid­ance, an RCOG spokesman said: "The col­lege rec­om­mends that the um­bil­i­cal cord should not be clamped ear­li­er than nec­es­sary and should al­ways be based on clin­i­cal as­sess­ment of the sit­u­a­tion.

"Re­search has shown that de­layed cord clamp­ing of more than 30 sec­onds may ben­e­fit the new­born in re­duc­ing anaemia.

"It al­so al­lows time for the trans­fu­sion of pla­cen­tal blood to the new­born, es­pe­cial­ly in cas­es of pre­ma­ture birth."

But she said there could be some cas­es where com­pli­ca­tions meant it was bet­ter to clamp the cord im­me­di­ate­ly.

Be­lin­da Phipps, chief ex­ec­u­tive of the Na­tion­al Child­birth Trust (NCT) said: "When a ba­by is born about a third for the ba­by's blood is still in his/her cord and pla­cen­ta.

"The NCT would like to see the de­fault po­si­tion be­come leav­ing the cord for a few min­utes un­til it stops pul­sat­ing, un­less the moth­er choos­es to have an in­jec­tion to speed the ar­rival of her pla­cen­ta or un­less the blood loss from the moth­er means her uterus must be en­cour­aged, with drugs, to con­tract and ex­pel the pla­cen­ta quick­ly."

(BBC)

Folds in pla­cen­ta linked to autism

A rel­a­tive­ly high num­ber of ab­nor­mal folds and cell growths in the pla­cen­ta could be a strong in­di­ca­tor of an in­fant's risk for de­vel­op­ing autism, ac­cord­ing to new re­search at the Yale School of Med­i­cine.

The re­search team ex­am­ined 117 pla­cen­tas from in­fants of at-risk fam­i­lies–those with one or more pre­vi­ous chil­dren with autism. These fam­i­lies were par­tic­i­pat­ing in a study called Mark­ers of Autism Risk in Ba­bies–Learn­ing Ear­ly Signs. Then the re­searchers com­pared these at-risk pla­cen­tas to 100 con­trol pla­cen­tas.

The at-risk pla­cen­tas had as many as 15 tro­phoblast in­clu­sions, while none of the con­trol pla­cen­tas had more than two tro­phoblast in­clu­sions.

Ac­cord­ing to the re­searchers, a pla­cen­ta with four or more tro­phoblast in­clu­sions con­ser­v­a­tive­ly pre­dict­ed a 96.7 per cent prob­a­bil­i­ty of the in­fant be­ing at risk for autism.

Cur­rent­ly, one out of 50 chil­dren are di­ag­nosed with an autism spec­trum dis­or­der in the Unit­ed States each year, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC).

How­ev­er, this di­ag­no­sis is typ­i­cal­ly made when these chil­dren are three to four years of age or old­er. By then the best op­por­tu­ni­ties for in­ter­ven­tion have been lost be­cause the brain is most re­spon­sive to treat­ment in the first year of life. (psy­ch­cen­tral.com)

MORE IN­FO

Tro­phoblast in­clu­sions

�2 Spe­cialised pla­cen­tal cells known as tro­phoblasts make up the two lay­ers of the pla­cen­tal sur­face–the out­er, syn­cy­tial tro­phoblast lay­er and the in­ner, cy­totro­phoblast lay­er.

�2 As they mul­ti­ply, the two lay­ers nor­mal­ly fuse, caus­ing bulges in the pla­cen­tal sur­face that be­come new vil­li con­nect­ing the pla­cen­ta to the uterus.

�2 Ab­nor­mal­i­ty oc­curs when the mul­ti­ply­ing cells in the in­ner lay­er most­ly fail to fuse with the out­er lay­er. That caus­es the pla­cen­tal sur­face to curl in­ward, form­ing div­ots called tro­phoblast in­clu­sions. (moth­ertalk­ers.com)

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