By: David Kaufman MD, FAAP
Babies are little miracles of nature. Inside the womb, they are nourished and cared for by a high-efficiency system that's perfectly attuned to their needs.
Poets have called the
umbilical cord "the string of life," and for good reason. This soft, coiled tube connects the mother and baby physically—and moms across time have seen it as an emotional link with their unborn children too.
The umbilical cord attaches to an organ known as the placenta, which grows inside the uterus during pregnancy. Together, they draw essentials of life from the birth mother's system, sending nutrients and oxygen to the baby. At the same time, the cord and placenta take waste products away for safe elimination.
Here are more facts about the umbilical cord and how it supports babies before—and after—they're born:
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1. It's a lifeline that varies in length quite a bit.
The umbilical cord begins as a bundle of blood vessels that form early in pregnancy. Inside the cord, one umbilical vein carries oxygen and nutrients to the baby. At the same time, 2 arteries carry blood back into mom's body after the "goods" are delivered.
You might guess that all umbilical cords come in one size, but they're as unique as the tiny humans they support. Cords typically range between 40 and 70 centimeters (about 15 ½ and 27 ½ inches) in length. A substance known as Wharton's jelly coats the rope-like cord, safeguarding it from twisting, bending or changing shape under pressure.
2.The umbilical cord & placenta contain one-third (33%) as much blood as the baby's body does.
The exact amount of blood in the placenta and umbilical cord depends on the baby's size. A 7-pound baby would have a blood volume of 300 milliliters (10 ounces), for example, and another 100 ml (3 ½ ounces) of their blood still in the cord and placenta. Once the baby takes their first breaths and their lungs fill with air, more blood flows into the lungs.
A practice called delayed cord clamping—waiting to clamp or cut the cord for 1 to 5 minutes—lets more of that blood move from the placenta into the baby's body. In that time, a 7-pound baby can receive about 60 milliliters (2 ounces) of extra blood. This helps all babies—whether born early or full-term—by boosting their blood volume and giving their bodies more iron. Iron is especially important for brain development during the baby's first year.
Even after delayed cord clamping and cutting, some blood still remains in the cord and placenta. This leftover blood can also help babies who may need blood tests or treatments shortly after birth (read more about this below).
3. Blood from the baby's umbilical cord can reduce blood draws needed for essential tests
Some newborns need blood tests to diagnose problems such as
sepsis (a condition that can be life-threatening). These include babies
born preterm or any infant needing care in the neonatal intensive care unit. Those with congenital anomalies (previously called birth defects) may also need tests to see how their systems are functioning. But drawing blood from a newborn's delicate systems can hurt—and lead to dangerous blood loss.
A process called postnatal umbilical cord blood sampling (PCBS) can be especially helpful for newborns who need a lot of blood tests. Instead of drawing blood directly from the newborn, PCBS uses the blood remaining in the umbilical cord after birth to run essential tests.
Using PCBS is shown to be as effective, reliable and accurate as traditional blood draws. Studies also show that collecting blood via PCBS helps stabilize blood pressure. It also helps reduce the need for medicines and transfusions in a premature baby's first few days of life. And because the umbilical cord has no nerves, your baby will feel no discomfort.
PCBS can be used for tests such as complete blood cell counts, blood cultures and other such as newborn screenings and genetic testing for both preemies and full-term infants. It can also be better at detecting infection, since more blood can be sent for lab testing with PCBS compared with a blood draw directly from infants.
4. Banking or donating cord blood can help your child—and other children, too.
All that blood in the umbilical cord after birth also contains stem cells. Donating or banking cord blood can make these stems cells available for transplant. Stem cell transplants can help treat children with cancer, immune disorders, metabolic problems and more. This procedure is less invasive than bone marrow transplants—and saves many lives each year.
Learn more about banking and donating cord blood
here.
5. The umbilical cord stump needs air (no bandage required).
After the umbilical cord is cut, a little stump remains above the baby's belly button (called the umbilicus). It takes about 1 to 3 weeks until the little umbilical stump falls off. Until the umbilical stump falls off, it is important to keep it clean and dry.
Being open to the air and outside the diaper helps the it heal. Stick to sponge baths during this time so the stump doesn't get wet, which can lead to infection. Check the stump at every diaper change. Watch for signs of infection (omphalitis) like yellow or white pus, swelling or redness around the belly button. If you see any of these, call your baby's doctor right away.
Also, the stump should stay dry. If you notice any bleeding or drainage that's yellow or brown, it's best to reach out to your baby's pediatrician.
Wondering what else to know? Talk with your birth team and pediatrician.
You may have a long list of questions, from how to dress your newborn
for the trip home to the essential
tests they'll have right after birth. Whatever's on your mind, consider meeting with
your baby's pediatrician. They'll be glad to offer helpful insights that may ease any concerns you have as you wait for the big day.
More information
About Dr. Kaufman David Kaufman MD, FAAP, lead author of the AAP clinical report, Postnatal Cord Blood Sampling, is board-certified in pediatrics and neonatology. He is on the American Academy of Pediatrics Committee on the Fetus and Newborn and Professor of Pediatrics at the University of Virginia School of Medicine. His interests are in infection prevention and improving outcomes for preterm infants in the NICU.
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