Health: Challenging the rush to cut the chord

RECOGNITION: From left, Midwife Amanda Burleigh, with retired Obstetrician David Hutchon, Consultant Paediatrician Andrew Gallagher, and Consultant Obstetrician Andrew Weekes at the Medical Futures Awards..

RECOGNITION: From left, Midwife Amanda Burleigh, with retired Obstetrician David Hutchon, Consultant Paediatrician Andrew Gallagher, and Consultant Obstetrician Andrew Weekes at the Medical Futures Awards..

0
Have your say

It is a practice which most new mums don’t even think about, but one Leeds midwife is determined to let more women know about.

Katie Baldwin reports on her work and the acclaimed innovation she and a team of medics have devised.

AS a mum and community midwife, Amanda Burleigh had always had a special interest in the health of children.

Having two sons with special needs made the issue even more important to her.

She said it was noticing the increasing numbers of youngsters with similar needs as well as conditions like asthma. autism, deafness and allergies that led her to think about what the causes could be.

Looking into the issue took her to the work of an American medic who was convinced the way babies were born had a link to Autistic Spectrum Disorders.

The umbilical cord connects the baby to the mother’s placenta and while the baby is developing, supplies it with oxygenated, nutrient-rich blood.

During birth, general practice in this country is to clamp the umbilical cord almost immediately after an infant is delivered and then cut it.

But when Amanda came across the work of the doctor in the US, she set about looking for evidence herself about whether there were benefits for leaving the cord attached for longer.

She said: “Over the years there has been much research done and amongst all the positive evidence it has been proven that premature babies definitely benefit from leaving the cord intact.

“Research in Bradford this year proved that a baby will gain up to 200g from delivery to birth if the cord is left intact. This 200g is comprised of blood rich in oxygen and stem cells.”

As interest in the benefits of delaying cord-clamping has grown, some hospitals across the country have changed their policies on the issue so they don’t cut the cord in healthy, full-term babies for two minutes.

Other major bodies, including the World Health Organisation, have also changed their advice about how soon the cord should be cut after birth, while Amanda said that Unicef had also recently said that a form of anaemia could be caused by immediate cutting of the cord.

“This statement opened the gateway for me to again approach my managers with the work I have been doing over the past six years,” Amanda added.

“Immediate cord clamping involves cutting and clamping the cord as soon as the baby is born, before the first breath has taken place and before the baby is stable. I have just completed an audit at both hospitals which shows that three quarters of the babies have their cord cut within the first minute of delivery.”

Because of her interest in the area, Amanda became the only midwife on a national team of experts who have designed an award-winning resuscitation trolley which can be used while the baby is still attached to the cord.

Amanda, from Shadwell, said the equipment could help save the lives of vulnerable babies.

“The bedside trolley is a small portable version of the large resuscitation units,” she said.

“It allows doctors and midwives to check for vital life signs and provide resuscitation at the mother’s bedside whilst the baby is still safely connected to its mother via the umbilical cord. The intact cord provides the baby with an ongoing oxygen supply and maintains the baby’s blood volume.”

Figures show around 10 per cent of newborns need some form of resuscitation soon after birth and currently equipment is in the corner of the room as it is too big to be used by the mother’s bedside.

“This means the baby has to be taken away from mother to be checked, necessitating the clamping and cutting of the umbilical cord, so doctors and midwives have to choose between delaying cord clamping against the need for immediate resuscitation. With the award-winning trolley they can do both,” Amanda, mum to 17-year-old Sam and 14-year-old Max, said.

Beneficial

“Delayed cord clamping is believed to be beneficial for all babies, but particularly in the case of premature babies or those who are short of oxygen after labour.”

The BASICS (Bedside Assessment, Stabilisation and Initial Cardiorespiratory Support) Trolley has already been hailed as an important breakthrough as it won Best Innovation In Service Redesign in the Cardiovascular Innovations Awards category at the prestigious Medical Futures Award in London.

Now its designers are hoping it could become standard equipment in the NHS and around the world.

Amanda said she was delighted with their success.

“It has been fantastic to work with such a high calibre team who are as passionate and determined to make immediate cord clamping a thing of the past as me,” she said.

“Winning the award has been a recognition of the raising awareness of the benefits of delaying cord clamping in all babies.”

She is continuing to speak to the mums she supports about the benefits of delaying the cutting of the umbilical cord and some are asking for it as part of their birth plan.

“A number of clients have also helped us move forward by submitting case studies of their experiences,” she added.

“They in themselves are pioneers and are helping make changes too.”

* For more information about the award-winning BASICS trolley, visit: www.medicalfutures.co.uk

Dr Sara Munro, chief executive of Leeds and York Partnership NHS Foundation Trust.

Mental health stigma backlash over Leeds escape game that has 'upset hospital staff and patients'