Ask the Doctor with Dr. Jill Hechtman MD FACOG, Medical Director Tampa Obstetrics
Q: What is delayed umbilical cord clamping?
A: Once a baby has been delivered, the umbilical cord must be clamped and cut to separate mom and baby. In the past, early clamping was defined as within 1 minute of birth and late clamping was defined as after 5 minutes. Recently, it was recommended that in preterm infants (less than 37 weeks), we delay cord clamping for at least 30 seconds and ideally, 60 seconds, when conditions are appropriate. This delay allows for an increase in the amount of blood that gets to the baby from the mom. The American College of Obstetricians and Gynecologists (ACOG) has released a new Committee Opinion that it appears to be beneficial to delay cord clamping in all infants.
In babies born at term, the delayed cord clamping appears to improve hemoglobin levels and improves iron stores in the first several months of life. Improved iron stores may have a favorable effect on development of the infant. In premature infants, the benefits are the same plus it improves circulation and red blood cell volume, and leads to fewer blood transfusions and a lower incidence of necrotizing enterocolitis and intraventricular hemorrhage. Delayed cord clamping can be done whether you have a vaginal delivery or a cesarean section.
In term infants, one of the risks that can be associated with delaying the cord clamping could be jaundice. In most hospitals, mechanisms are in place to identify and treat neonatal jaundice.
In certain instances, doctors are unable to delay cord clamping. Examples would be in cases where the umbilical cord is tight around the baby’s neck, and in times of fetal distress.
Q: There are so many options for prenatal vitamins! Are all prenatal vitamins created equal?
A: Technically, no, they are not the same. They can be chewable, in gummy form, have different concentrations of specific vitamins and fish oils, and some are made to be easier on the stomach than others. That being said, vitamins that are in the United States do have the necessary added vitamins that are needed for a healthy pregnancy. The most important vitamins are: Iron, calcium and folic acid.
Iron is necessary to improve your hemoglobin, which helps carry oxygen in your body, and prevents anemia. Calcium helps build strong bones in the baby and prevents maternal bone loss, and folic acid is beneficial in preventing neural tube defects like spina bifida.
Depending on your health history and diet, your doctor may recommend additional supplementation.
I think it is important to note that a healthy diet should provide the majority of the vitamins needed for a healthy pregnancy. When taking your prenatal vitamins it is best to start taking them before you conceive. Ideally, three months will provide adequate stores of vitamins in your body. So for women of childbearing age, it does not hurt to take a daily prenatal vitamin. There are hundreds of different prenatal vitamins on the market, so discuss with your healthcare provider which is best for you, keeping in mind that expensive does not always equal better.
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