The umbilical cord serves as the lifeline between a mother and her baby throughout pregnancy, facilitating the transfer of nutrients, oxygen, and waste. This connection is severed shortly after birth by clamping and cutting the cord. However, leaving the umbilical cord unclamped raises questions about its implications.
The Initial Blood Transfer After Birth
After birth, if the umbilical cord remains intact, a natural blood transfer, known as placental transfusion, occurs from the placenta to the newborn. The placenta continues to pulsate for a few minutes, delivering oxygen-rich blood, stem cells, and iron to the baby. This transfer is significant, with approximately 80 mL of blood moving to the newborn within the first minute and potentially reaching 100 mL after three minutes. This process helps the newborn transition from placental circulation to its own independent circulatory system.
Understanding Delayed Cord Clamping
Delayed cord clamping (DCC) is the practice of waiting for a short period, typically between 30 seconds and 3 minutes, or until cord pulsations cease, before clamping and cutting the umbilical cord. This allows for a greater transfer of placental blood to the infant. Major health organizations now recommend this practice due to its recognized benefits for both full-term and preterm infants.
For full-term babies, DCC leads to increased iron stores by 6 months of age, higher hemoglobin levels, and a reduced risk of iron deficiency anemia. For premature infants, delaying cord clamping for 30 to 60 seconds can decrease the need for blood transfusions and may reduce the risk of serious complications like intraventricular hemorrhage (bleeding in the brain) and necrotizing enterocolitis (a severe intestinal condition).
The Practice of Lotus Birth
Lotus birth, also known as umbilical cord non-severance, is a practice where the umbilical cord is left attached to the baby until it naturally detaches from the placenta, typically occurring 3 to 10 days after birth. Unlike delayed cord clamping, this practice involves no cutting of the cord. Those who choose lotus birth often cite philosophical or spiritual reasons, such as honoring the perceived spiritual connection between the placenta and the newborn.
Practitioners may believe it provides a gentler, less invasive transition for the baby. Some also suggest it promotes undisturbed bonding between the mother and infant and can lead to a calmer newborn. After birth, the placenta is often washed, salted, and wrapped in absorbent material to help it dry out and reduce odor while awaiting natural separation.
Potential Concerns of Unclamped Cords
Leaving the umbilical cord entirely unclamped, as in lotus birth, introduces several potential risks and practical considerations. The placenta, once delivered, is dead tissue with stagnant blood, making it prone to bacterial colonization and infection. This risk of infection can spread to the baby, potentially leading to conditions such as omphalitis, an infection around the umbilical cord area, or systemic infections like sepsis.
Beyond infection, other concerns include the possibility of hyperbilirubinemia (jaundice) in the newborn due to the increased red blood cell volume, and polycythemia, an abnormally high percentage of red blood cells. Practical challenges also arise, such as managing the decomposing placenta, which can develop an odor, and the physical inconvenience of keeping the baby and placenta attached for several days. The general medical community maintains a cautious stance on lotus birth, primarily due to the lack of scientific evidence supporting its benefits and the documented infection risks.