Delayed cord clamping

[RNlove17]

Has anyone seen an increase in patients requesting this? Approximately how often do you have patients requesting it?

[klone, MSN, RN]

Depends on if they're midwife or OB patients. Most of the midwife patients request it, most of the OB patients don't.

[DalekRN]

I work at a very busy hospital on the northeast US and its standard practice at every delivery here.

[Katie71275]

NEVER seen it yet. Granted I'm a new nurse, but it seems our patient population doesn't care or isn't interested in it. I don't think our midwife patient's do either. It's on my list of things to discuss with the residents.

[perfexion, ASN, RN]

I haven't seen a sudden increase. I work in antepartum so I've read a lot of birth plans. It seems to be kinda standard. I don't know how often that request is actually honored in labor though. I heard it may cause polycythemia in the newborn so I discourage it.

[klone, MSN, RN]

I heard it may cause polycythemia in the newborn so I discourage it.

Don't you think you should research it before recommending against it to your patients? That seems kind of irresponsible. They rely on your expertise for advice and trust that it's valid and based on actual evidence.

Delayed cord clamping decreases iron deficient anemia, increases infant hemoglobin, and there has not been an associated increase of hyperbilirubinemia and if polycythemia was found, it was found to be completely benign. In fact, in preterm infants, delayed cord clamping is associated with better apgars and better respiratory status, less IVH, fewer cases of sepsis, and many hospitals are moving towards delayed clamping of the cord as standard of care for all preterm deliveries, even as young as 24 weeks gestation.

[katierobin23]

In my hospital, delayed clamping is also standard practice. I see the benefits of it, but I also see the downsides. I'm in the NICU, and trying to get a blood sample on a kid that was delayed is really difficult and causes more distress to the baby. We'll get into an artery but the blood just won't flow because it's so thick, so we have to stick again. (It's not an issue if the baby gets umbilical lines, but most of them don't.)

The other thing is the bilirubin and polycythemia. Typically it isn't an issue, the baby just needs a little phototherapy...but we just did an exchange transfusion on a baby whose H&H was astronomically high. Granted, the baby probably had other things going on that caused that, but delayed clamping certainly didn't help.

The study I read a while ago showed that the benefits and risks were kind of a wash...the anemia at 4 months of age wasn't really a big deal, but the risks of doing it weren't usually significant....so might as well do it in case it helps. I'll have to try to dig that up again so I can re-read it

[melmarie23, MSN, RN]

It's standard practice where I work. We mostly gave OBs and family practice MDs

[OB-nurse2013, BSN, RN]

Our midwife pt.'s do this but not our reg pts. We don't normally care from the midwife pt.'s because they actually have their own unit so we only get them as overflow.

[SweetLife]

InJoy just had a webinar on Thursday and Penny Simkin talked about the benefits of delayed cord clamping. It is on their website now.