Physiological cord clamping

Oxford midwives (1991) found more jaundice, but no other research has.

Most of the research into delayed cord clamping doesn't specify when or if uterotonics (syntometrine etc) were given which is not very helpful, the ones that did found no significant differences between giving it before or after

Resus (uk) recommend leaving the cord unclamped if possible if the baby needs resuscitating

Immediate cord cutting is not evidence based and there are no known benefits to it. I am hoping NICE will stop recommending it in the next incarnation of the intrapartum care guidelines!!

Can anyone guess what my last essay was on?? LOL

Sorry, my mistake it's not in the recommendations themselves, but what they say is:
Delaying cord clamping for at least one minute is recommended for newborn infants not
requiring resuscitation.
287
At present there is insufficient evidence to define an
appropriate time to clamp the cord in babies apparently needing resuscitation. However,
this may be because time is the wrong defining parameter and perhaps the cord should
not be clamped until the baby has started breathing.
From resus 2010
http://www.resus.org.uk/pages/GL2010.pdf#search="cord clamping"

From personal experience with my last baby - I asked for delayed cord clamping until cord stopped pulsating. Once cord was cut I had synto injected. Within 24 hours my baby had signs of jaundice and spent the following week in neonatal unit confined to a bili bed. They could find no reason for this at the time so I have always wondered if my decision to delay caused a week of stress and worry stuck in the hospital (not ideal when I wanted a home birth and had a one year old at home).

The latest research:
http://www.bmj.com/content/343/bmj.d7157?tab=full
showed no link between cord clamping and jaundice.

Also, the cochrane review where the link is stated has been much criticised for itummary
First we would like to thank Susan J McDonald and Philippa Middleton on completion of the huge task of reviewing all of the literature on delayed cord clamping in term infants. This is a daunting task and they are to be commended.

However, we do have two serious concerns that we feel significantly weaken this Cochrane review. Our first concern is that the evidence for an increase in 'jaundice requiring phototherapy' is based upon one 12 year old unpublished trial done by the lead author of this Cochrane Review (McDonald) in Australia. When that one trial is removed from data (offered in Analysis 1.15) the variable of 'jaundice requiring phototherapy' does not reach significance. A recent meta-analysis found in JAMA did not agree with the outcome that delayed cord clamping (DCC) leads to 'jaundice requiring phototherapy' (Hutton and Hassan, 2007). We question the emphasis given to the outcome drawn from this one study.
(Erickson-Owens and Mercer, 2008)
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004074.pub2/full

So don't feel bad about it Veggie

Hello everyone,

I am doing my dissertation on delayed cord clamping and am just after your thoughts on active management and delayed cord clamping and what you practice in your local unit?

Thank you

Thanks for your reply. When you refer to the risk of the additional shut of blood what do you mean and what have you heard? Its just interesting to hear others views and what evidence practice is based upon. X