What on earth we are supposed to do with the Umbilical cord?
We live in the era of “Ground breaking researches and new therapies”. Cord blood research and Stem cell therapy are the buzz words that carry the “wow” factor, as good as “AI “(Artificial intelligence) in the field of Technology
Whilst scientists looked at umbilical cord blood as the “holy grail” that could offer cure against most incurable diseases, Ironically they have failed to look into the most primitive of issue of, when to stop the umbilical cord blood flow, by clamping and severing it, to separate the baby from the mother.
Let us get some perspective on the umbilical matter in the natural world.
In chimpanzees, after giving birth, the mother leaves the cord alone and nurses their off springs with the cord and placenta attached until the cord dries out and separates naturally. It takes a day for this process to complete.
Though the behaviour sounds so strange, in some animals, the mother will nibble through the cord, thus separating the placenta from the offspring. The cord along with the placenta is very often eaten by the mother, to provide nourishment and to dispose of tissues that would otherwise attract predators.
As far as humans are concerned, there seems to be an extreme and intense urge to severe the cord, as soon as the baby is born. It is perceived as race against the time, and umbilical cord gets severed within seconds, in most instances. If we think logically, this is quite a strange behaviour of humans.
Medical fraternity has woken up to this idea recently, and alternate option has been considered and put into practice.
The postulations that delaying the cord clamping( upto 2 minutes), could potentially help the newborn babies, was put to test. The presumption is that the delay in clamping the cord would allow the baby its due amount of blood, in the most natural way, and therefore would benefit the baby greatly.
Various studies showed both short term and long term benefits. Short term benefits such as increased blood volume, higher blood pressure and thereby increased cardiovascular stability and better survival rates have been attributed to delay in cord clamping.
Long term benefits such as better neuro developmental outcomes, reduced incidence of long term lung problems and problems of vision in premature babies, have also been reported.
But those studies were small and difficult to be accepted as proof of positive outcomes, attributable to delayed cord clamping.
However, very surprisingly, the most recent and the largest study ever done, in Australia and New Zealand , the APTS ( Australian Placental transfusion Study), has clearly shown that there was no clear benefit in the group of babies who were subjected to delayed clamping of the cord, compared to those babies whose umbilical cord were clamped immediately.
No one knows the reason why the benefits of delayed clamping are not shown in the latest study. Perhaps Human babies have adapted to the strange habit of frantic hurry of clamping and cutting the cord.
Those children in the Australian study will be being followed up to find out how well they would be doing in the long run. We will have to wait until then to ascertain, if there is, at least, some long term benefits of delayed cord clamping.
At present, what do we do with the umbilical cord?
The answer to that question remains a “mystery”
Dr M Saravanan
Rio childrens and Maternity Hospital Madurai