Those who defend early clamping also claim that clamping the umbilical cord helps stimulate the baby’s first breath, and therefore eases newborn transition. But is sooner necessarily better? The few researchers who have pondered this question have determined that a delay may be normal if not beneficial. Although babies who experience immediate cord clamping take their first breaths sooner than those whose cords are left intact, experimental studies have demonstrated that the exchange of gas in the newborn’s lungs becomes effective only after several breaths. This suggests that, during these first breaths, the baby is still exchanging gases via blood flow through the placenta while physiologic changes occur to enable effective gas exchange in the lungs. Thus, undisturbed blood flow through the umbilical cord creates a margin of safety for adapting to air breathing, a margin removed when clamping the cord prematurely cuts the baby off from its mother. The quick gasp and sharp cry taken to be a sign of newborn well-being may be another iatrogenic norm: not normal at all, but nature’s emergency back-up plan to ensure survival.

Passage from chapter 17: Newborn Transition: Don’t Just Do Something; Sit There!
photo credit: Andrea Lythgoe,, Sandy, UT