The umbilical cord is an incredible structure, it is the connection between the mother and baby. It is beautifully adapted and designed to do exactly the job it needs to do, help us grow our baby.
I love this photo so much. From the other night, a planned Caesarean for lots of reasons. You can see that my assistant is asking me whether it is time to cut the cord as we wait for the last of the blood to pump out of the cord into the baby. This is delayed cord clamping and this is possible in most births whether vaginal or Caesarean.
In this episode we talk about:
A little bit about the anatomy
How the umbilical is protected from compression
True and false knots in the umbilical cord
Cord accidents and what we can do to prevent them
What happens if a cord is wrapped around your baby’s neck
When there is a cord prolapse
Delayed cord clamping
Cord blood storage
Brigid: [00:00:36] Welcome everyone. This is episode 37.
Dr Pat: [00:00:39] Welcome back everybody.
Brigid: [00:00:40] Yes. And we're going to talk everything about the umbilical cord
Dr Pat: [00:00:43] We've got this far without talking about the cord?
Brigid: [00:00:45] Yes. You know why? Because when we were very much starting out and we were recording in our bedroom. Yeah, we did an umbilical cord ep.
Dr Pat: [00:00:54] Oh, that's the one we did back then?
Brigid: [00:00:56] Yeah. But, um, it was all badly recorded
Dr Pat: [00:01:00] technical issues.
Brigid: [00:01:01] Yep. That's where we think, well, we're not experts at this. So we come to this incredible studio and have Tom help us out.
Yeah. It also gets us here too. Doesn't it Pat
Dr Pat: [00:01:09] Been for the best all round!
Brigid: [00:01:10] Yes. Alright good. So what we're going to get straight into, I think is because the umbilical cord is fascinating. I love looking at the umbilical cord. If I had to get over my slight phobia about looking at sort of bloody pictures, but yeah.
Nice. And it's Vital
Dr Pat: [00:01:25] Well, of course that's the connection.
Brigid: [00:01:27] Yep. So Pat, let's start at the anatomy of the umbilical cord.
Dr Pat: [00:01:32] Yeah, it's actually, it's quite an interesting structure and sort of beautifully adapted or designed to do exactly what it needs to do. In that cord is a vein, usually a vein in two arteries.
And the vein is for bringing oxygenated blood from the placenta down to the baby. And then the two arteries pump blood back the other way back up towards the placenta, deoxygenated blood. So the opposite of what it's like in you and I, yeah. So the vein is larger and soft and the two arteries are smaller and hard and they're surrounded by some stuff called Wharton's jelly, which is like a shock absorber.
Cause the cord gets a little bit battered at around. Baby grabs it and squeezes it.
Brigid: [00:02:17] It would be like a little toy in utero. Wouldn't it?
Dr Pat: [00:02:19] Yeah. We've seen that on ultrasound all the time. They'll grab the cord if it comes past them, they'll grab it. Oh, wow. And so it needs to be a little bit of a shock absorber. We don't want the babies squeezing, cutting off their own lifeline and it gets a little bit battered around by fetal movements and in labor.
Yeah. So it's got that nice shock absorption to it. And of course it runs from the placenta, ideally from somewhere around the middle of the placenta, but occasionally over near the edge, down to the baby's belly button.
Brigid: [00:02:45] And does the strength of the attachment of the umbilical cord to the placenta? Does that differ or does that matter?
Dr Pat: Some variations in anatomy and some of those are related to poor fetal growth. Yeah, right. So if he gave you a 20 week scan and they can see that the cord inserts right into the middle of the placenta and everything looks for a standard and normal, then typically we wouldn't really need to rescan that woman unless there was another problem.
But if you've got something called a peripheral cord insertion, where the cord inserts right over on the edge of the placenta, then there's some association between that and third trimester growth problems, we typically will have another look.
Brigid: [00:03:23] And so that's definitely picked up on ultrasound.
Dr Pat: [00:03:25] Yeah. It's part of what they should be looking for in a second trimester, part of the worksheet that the sonographer goes through, tick off that they've got all the boxes ticked and where the cord inserts is important.
Brigid: [00:03:37] I've got a beautiful photo of an incredible thick, healthy looking umbilical cord.
Dr Pat: [00:03:47] Yeah. So that's, they're the ones we like to see, and it can be really quite thick sometimes remarkably so, the cord is much bigger than you think.
And then there are sometimes when we see the cord unusually small
Brigid: [00:04:04] You mean thin?
Dr Pat: [00:04:05] Yeah, exactly.
And sometimes that's just normal, just the way it is. But other times it can be associated with other problems. So babies with a smaller cord might be too small as well.
Brigid: Right. Okay. And so how do you assess, like, if, is that sometimes when you say it could be a problem, like what is the problem around thin sort of scrawny looking cord?
Dr Pat: Well, the cord is normal if it's doing what it's supposed to do. So if the baby's happy and growing well, and remember we can measure the blood flow in the cord with ultrasound using Doppler technology. Doppler is technology related to how moving things reflect sound. And ultrasound is sound waves. And if we pointed at the cord, we can graph how the sound waves are reflected by movement within the cord. And that can tell us a lot about how the flow is and the flow in those arteries in the cord will change.
If the placenta is too gritty, too small, too high resistance. And we often will see that in conditions like pregnancy induced hypertension. So mum's blood pressure's too high or preeclampsia. That's potentially too small or not being well nourished by the placenta and in the third trimester, that's part of that whole process.
If we're worried about a baby, if the baby's not growing properly we are continually asking ourselves in the third trimester, is this baby better off, out than in.
Brigid: [00:05:34] So what is a cord accident? I've heard you talk about cord accidents before
Dr Pat: [00:05:39] ah, cord accidents. That's different. That's a, that's a, um, a very, very sad situation where the baby can get tangled up in their own cord
Brigid: [00:05:47] during the birth or
Dr Pat: [00:05:48] no, during the pregnancy itself.
Yeah. So it's a rare, but still seen and is a cause of stillbirth.
Brigid: [00:05:56] Wow. And so how can a baby get tangled up in their cord?
Dr Pat: [00:06:01] Well, I think probably what happens is that the cord might get looped around the baby's neck and maybe twice, and then maybe it gets tight and then the fetus kind of panics and move even more, arms and legs can get involved in the baby can get wound up tightly caught up in their own cord.
Brigid: [00:06:19] No, God, I can just imagine there's a wave of panic. That's just gone over all of our listeners, right?
Dr Pat: [00:06:22] That's right. It's, it's a sort of a nightmarish scenario. It is real, but it's rare.
Brigid: [00:06:28] Yeah. Uh, are some people more prone to having a cord accident.
Dr Pat: [00:06:33] Look, I don't think so. I just think that it's just one of those things that might be seen.
And occasionally the cord around the neck might be picked up on ultrasound. But remember that the complexity is that that's not always abnormal.
Brigid: [00:06:46] Yes, that's right. Some people that some babies are born with the cord around their neck every day.
Dr Pat: [00:06:50] Yeah. Yeah. So that's, if it's not tight and it's not troubling the baby, then it's not really an abnormality.
Brigid: [00:06:57] Is it a problem with the, again, back to the anatomy? Is it a problem? If somebody has got a really super long umbilical cord?
Dr Pat: [00:07:03]
Yeah. Cord length is an interesting thing. It might relate to the risk of complications. If it's super long, the baby might be more likely to get tied up in it. And if it's very short, it might also be related to another rare complication, which is something called a uterine inversion where the baby comes out and then we'd try to get the placenta out.
And if the cord is very short, then excessive traction on the cord might cause the uterus to kind of turn inside out. Yeah. Yeah. Wow. And that's associated with postpartum haemorrhage
Brigid: [00:07:35] and you keep saying rare, like, do you know the stats on that?
Dr Pat: [00:07:38] Look, these are things that we, both of those problems are things we might see once a year, once a year.
Brigid: [00:07:42] Yeah. Yeah. And I mean, gosh, you're delivering hundreds of babies a year.
Dr Pat: [00:07:47] Yeah. Yes. But also in all of Ballarat. So, you know, a once a year occurrence, in a 2000 baby town. Yeah.
Brigid: [00:07:56] Is there anything a woman can do to keep her cord healthy?
Dr Pat: [00:08:00] I don't think specifically. It's a good question.
I don't think specifically, I think just, um, it's part of being well in pregnancy. So managing blood pressure. Yeah. If it's there having the blood pressure checked. Yeah. Eating well, exercising, those sorts of things that we know. Non-smokers. So the really thin, potentially insufficient cord is something we might see in a heavy smoker who also had a correspondingly small and insufficient placenta, and unfortunately, a correspondingly small and potentially unwell baby.
Brigid: [00:08:34] Oh, dear. Okay. And what about cord knots? Like I've seen pictures of cord knots.
Dr Pat: [00:08:40] Yeah. That's another thing that people worry about, but it is less serious than it looks. So there's something called a true knot where it baby swim around and actually tied a knot in the cord. Yeah. But they're not often very tight.
Brigid: [00:08:51] Yep. And they can slip. I've seen it, it slips up and down the umbilical cord.
Dr Pat: [00:08:55] Yeah, that's right. When the baby's out, cord is clamped, you can put your finger into it and just slide it up and down the cord. So that's how loose it is. Yeah. And a loose cord knot is something we'll note and that's called a true knot.
It's an actual knot and yes, they can be a cause of problems in labour. So for example, if the knot was tight-ish and it was affecting the flow of blood down the cord, then we might see that represented as an abnormal, fetal heart rate tracing with a CTG. And sometimes if we had a very abnormal CTG in labour and we knew that everything else was okay - it was a well grown baby at term, mum was laboring well, and contractions weren't coming too hard or fast, but nonetheless, yes, the CTG was highly abnormal. At the subsequent birth by Caesarean section, you might notice a knot in the cord. So that's a true knot. And then there's another, there's another thing called a false knot, which is just a lump in the cord that looks like a knot, but it's not.
Brigid: [00:09:54] And all of these things, you kind of wouldn't know so much until the baby was born and you we're able to look at the umbilical cord.
Dr Pat: [00:10:00] Yeah. So we examined the cord, just like we examine the placenta.
It's always cool to have a look at the cord and the placenta, but also there's a potential that we might find abnormalities. It might be worth sending the cord and the placenta off for a pathological examination and all of that might be relevant to the woman's plan for next time.
Brigid: [00:10:18] Yeah. Okay. My brain is still back stuck on the cord accident because that I did have that fear during my pregnancy.
I don't know. It's, it's something that you kind of know whether it's a myth. I remember my mum saying, look, Brigid, what are you doing? Hanging your washing up. Cause if you put your arms above your head, you're going to make a knot!
Dr Pat: [00:10:38] yeah. Some of those sort of, you know, myths about pregnancy. Some of them seem to be rooted in common sense. And some of them, you have no idea how that got started. Yeah. So I can't imagine how that would make any difference at all. And I'm sure that's not true.
Brigid: [00:10:51] Oh, it got me out of doing washing so happy!
Dr Pat: [00:10:52] Yeah. But I think some of these things, rare complications that are kind of everyone's at the same risk.
It's very rare and we just hope it doesn't happen to us. I think we sometimes look for ways. Around that, like, if I do this, I'll be at lower risk and that might be how some of those things got started. People thinking, well, I need, I need something to make me feel like I'm at less risk, but, uh, I don't think there's anything that you can do or not to that the decreases that chance.
One of the things I guess you can do is that it's part of the importance of knowing better baby's movements. So we've covered in another episode. It was,
Brigid: [00:11:31] I looked it up episode 11.
Dr Pat: [00:11:32] Yeah. About fetal movements. And these days we've moved away a little bit from being obsessed with how many there are to the pattern and what we really want women to do after about 20 weeks is to become aware of the pattern of fetal movements. That seems to be very important and a healthy baby that's not tied up in its own cord should ideally have a pattern of movement that the woman can rely on. So if my baby always moves when I'm having breakfast and it always does.
Then things are fine. If it doesn't, I better start provoking some movements. And if I still can't, I better call my care providers. And that's what we were looking for. So theoretically, if a baby had a cord problem that might manifest itself in its early phases as decreased fetal movements, and theoretically might only progress to stillbirth if we didn't do anything about it.
Brigid: [00:12:25] And I think we've said it before in that just go back and have it listen to that episode, episode 11.
Brigid: [00:12:30] it's pretty, Oh man, it's vital. And also between pregnancies. So you can't really compare yourself to other people and their pregnancies and you can't really compare each pregnancy because all are different. Between our third and fourth boy was so marked.
And I think I might've even said that in the ep and what the difference was was the third boy. He was just a gymnast and I was always reassured. He was always flipping around and, you know, kind of making a nuisance of himself, but the fourth boy, I think he slept most of the time. He just didn't move did he? And so I'd say, okay, Pat at lunchtime can we have a little listen?
Uh, yeah, so it, but one thing that did provoke movement always with Rex was a shower. He would always move in the shower.
Dr Pat: [00:13:15] So that's perfect, that's what I'm talking about.
Brigid: [00:13:17] Yeah. That's pretty important that we get that right. Well, I'm going to move on then. I feel a bit more better. Yep. Yep.
So the other thing that is a bit of an exciting lights and sirens sort of moment is a cord prolapse, isn't it?
Dr Pat: [00:13:31] Yeah. So that's a sort of a, hopefully an end of pregnancy thing. It's rare. It's potentially dangerous, but yeah. Usually well managed and that's where, waters break and that cord comes out instead of the head.
Brigid: [00:13:46] And why is that a problem?
Dr Pat: [00:13:47] Well, it's not always a huge problem for the baby in that it's obvious if the cord's hanging out. You know, if she's in the hospital, we deal with her immediately. If she's out of the hospital to come straight to the hospital, cause everyone knows it's not normal for the cord to be hanging out and things tend to get managed quickly and well, but what the cord will do, if it's outside the body is get cold and spasm and that can affect the flow down the cord and really upset the baby.
Brigid: [00:14:13] Yeah. Yeah. And sometimes that happens in really fast labours and sometimes those really fast labours can happen at home accidentally.
Dr Pat: [00:14:21] Yes, theoretically it is something that could happen at home and, you know, the appropriate management of that would be to put it back in the vagina. So great loops of it don't tend to come out just a little bit. Yeah. And the warmest placed for the cord to be, would be back in the vagina. So, so you can push it back in and hold it there and call the ambulance
Brigid: [00:14:39] And the ambos are excellent.
Dr Pat: [00:14:42] If it happens in the hospital, it's all always terribly exciting. Well, usually it can't really be fixed. We need to have birth by Caesarean section. Yeah. You can't push it. Back up past the head enough. Exactly. So, um, so the midwife that finds the cord hanging out will typically push it back in and then sit there on the trolley, keeping it in a while we run around, whiz around to theater and do a Caesarean section.
Brigid: [00:15:05] Wow. What up on the trolley with the woman? Yeah.
Dr Pat: [00:15:07] Oh my God. Very dramatic,
Brigid: [00:15:08] very dramatic.
Dr Pat: [00:15:09] Sometimes a cord prolapse will happen in the setting of a premature birth. Yes.
Brigid: [00:15:14] Cause there's more room?
Dr Pat: [00:15:16] Yeah, that's right. The head isn't down, maybe. It's not down at all or maybe it's down, but still floating really high.
Yeah. So the head hasn't formed a nice plug in the pelvis, like a term baby does. And there's plenty of room for the cord to flop around in front of the head and come down the vagina.
Brigid: [00:15:31] Yep. And so in your career, how many times would you have dealt with a cord prolapse
Dr Pat: [00:15:37] three or four?
Brigid: [00:15:38] Yeah.
And people like, I mean, what do we work out the other day? You've nearly delivered 3000.
Dr Pat: [00:15:42] Plus babies, something like that. So, you know, there's yeah. So you can see that it's a, you know, even in all my time at the teaching hospital where I did my training, it's, you know, busy hospital, like the Royal women's back then about 6,000 births a year.
And it wasn't something we saw that often. Yeah.
Brigid: [00:15:58] But what you do see a lot of is the cord wrapped around the neck.
Dr Pat: [00:16:03] Absolutely. Yeah. And that's really a normal thing for the cord to be loosely around the baby's neck. When the head comes out at a vaginal birth and, you know, people sort of worry about that, but if everything's been going good, the fetal heart rate trace in labour or intermittent listening to the fetal heart with a handheld Doppler, that's all been normal.
Then what it means is the cord's around the neck, but it's not tight and it's not upsetting the baby. And
Brigid: [00:16:29] And it’s not as if it’s cutting their throat off, that's not where they're getting their oxygen from anyway.
Dr Pat: [00:16:34] That's right. So we're not, it's not a matter of compressing the airway. It's that the cord, if it's very tight around the neck a few times one, yeah.
Brigid: [00:16:42] Yes. It might not have the oxygen and the oxygenated blood running in it
Dr Pat: [00:16:46] Flowing properly. That's right. So the cord is actually really quite beautifully designed though, so that even if your head comes out and the cord, even if the cord is trapped between the baby's front shoulder and the mother's pubic bone.
If you can imagine that the way that the two arteries within the cord run in a sort of a helical structure, sort of twisted structure, they're able to keep pumping. So it's hard to obstruct the cord or altogether, which has got stuck, because it gives you plenty of time then to feel over the head to see if there's any cord there
yeah. And if there is, yeah. Loosen it off and flop it over the baby's head so that it's no longer around the neck and then ask the woman to push again and free the front shoulder.
Brigid: [00:17:26] So Pat's moving his hands around again people. We might have to make this visual one day.
Dr Pat: [00:17:31] So that's, um, that is something that a daily event on labor ward and.
And not a pathological thing.
Brigid: [00:17:36] Yeah. Right. I mean, that does become family folklore a little bit. What about if it's wrapped, say twice, which we've seen,
Dr Pat: [00:17:42] Even so, if it's not tight, it shouldn't be a problem. But it's interesting if someone, if there's an abnormal, fetal heart rate trace during the pushing phase. Yes.
But the woman is fully dilated, so she doesn't need a Caesarean section she'd be better having an instrumental birth to bring the pushing phase to a close quicker. Yeah, because we're worried about the baby, but the baby is so far down and almost out that an instrumental birth is better than a Caesar.
Then you go ahead and do that instrumental birth, vacuum, forceps whatever's required. It's interesting how often cord around the neck once or twice is the presumed explanation for the poor fetal heart rate trace. Yeah. Yeah. And you’ll realise, that's why we're struggling. Yeah.
So, because we are talking about the cord, I thought it'd be interesting to then talk about delayed cord clamping, because this seems to be, I mean, gosh, we talk about a woman being empowered with knowledge, and this is definitely one thing that a woman can advocate for just.
Talk us through what happens.
Dr Pat: [00:19:57] So delayed cord clamping is just the practice of basically waiting until the cord stopped pumping blood in the direction of the baby before you clamp it and cut it. And, uh, you know, we used to, we used to be in too much of a hurry to do that, I think, and, and there's plenty of good blood inside the cord, and it's rich in STEM cells.
And it turns out that they're better off in the baby than in the bin with the cord. So,
Brigid: [00:20:24] or if someone's chosen to take it home,
Dr Pat: [00:20:26] Well, yes, that's right, but the baby can use it. So when it first sort of started happening, I guess maybe seven, eight years ago, a lot of obstetricians, including myself thought that it was fine.There wasn't a downside to do it, but we didn't really think there was going to be much upside. We're also worried that might've increased the rate of jaundice. If you've got a baby, that's got if you like too much blood, then the excess blood will break open and release the yellow pigment. And that's what jaundice is, so we thought that if we gave the baby too much blood, by that way, that we've increased the rate of jaundice and it's turned out to not have a very important effect on the number of babies with jaundice.
And any extra jaundice that it does cause it's relatively easy to treat with those lights.
Brigid: [00:21:11] The benefits outweigh the risks.
Dr Pat: [00:21:13] Yes, absolutely. And the benefits are probably something we're just starting to learn more about.
Brigid: [00:21:18] Yeah. If it's something I've got, the stats all wrong, but it can have that baby's iron stores for the first few months of life?
Dr Pat: [00:21:25] Yeah. More iron, more blood volume is a fair bit of volume in that. Cause there's not that much blood in a newborn baby anyway. So what's sitting in the cord, it's actually a useful tool, a
Brigid: [00:21:33] big percentage of the baby's blood
Dr Pat: [00:21:35] then exactly the benefit of the STEM cells? Watch this space!
Yeah. So it's easy to do. And really the only scenario where it really can't theoretically be done is if the parents wish to donate or collect the cord blood for storage.
Brigid: [00:21:49] Yeah. That was my next question.
Dr Pat: [00:21:51] Cause you can't empty it into the baby AND store it. It's one of the other. Yeah. So that's a problem. And then the other scenario that makes it difficult is if there's some other sort of emergency going on.
Yeah. So for example, if the woman's having a postpartum hemorrhage, then the first thing you can do to get that hemorrhage under control is to get the placenta out. And that's difficult to do if the baby's still attached. So you might clamp and cut the cord, forego the benefits of the delayed cord clamp, and then put traction on the remaining bit of the cord to help the placenta come out.
And that's a scenario that can happen at vaginal birth. And unfortunately it's a bit more common at a Caesarean section birth because the Caesarean section is a bloody operation. You know, there's, there's blood around and, and if the uterus is bleeding too much at Caesar immediately after the baby comes out, then again, the way to stop that is to get the placenta out.
So that might require the baby to be the cord clamped. And the baby passed over the pediatrician a little earlier than we wanted, but if we can control that bleeding by other means by putting clamps on things, then we can wait. Did that last night had a Caesar last night just waited until the, um, the cord had stopped pumping and all of the blood was as much as possible of the cord blood was down in the baby.
Maybe took a minute and
Brigid: [00:23:07] It's not long, that't the other thing is,
Dr Pat: [00:23:09] and then a clamp and cut and as long, and the baby was crying and mum wasn't bleeding. So what's the rush.
Brigid: [00:23:15] Yeah. Yeah, yeah.
Dr Pat: [00:23:17] And that's becoming a standard at vaginal births and increasingly acceptable at Caesarean section.
Brigid: [00:23:22] Yeah. Yeah. And it's still worthwhile the woman putting it in a birth plan though.
Isn't it? Absolutely sure that everybody's on that page.
Dr Pat: [00:23:29] Yeah, absolutely. Because when I say standard, I mean not everywhere and not every day. So if it's something that mums have read something about and like the sound of as a potential healthy thing that can do for the baby, that's not risky, then we should do that.
So let us know.
Brigid: [00:23:44] Yup. So this, you mentioned just briefly about the cord blood. So there's two things you can do with the cord blood. You can either donate the cord blood, and then that goes into like a public cord blood bank.
Dr Pat: [00:23:55] Yes. So they collect some for each research purposes and some for a publicly run cord bank.
Brigid: [00:24:01] Yep. Yep. Which can be used later on for?
Dr Pat: [00:24:05] matched donations. So potentially if a child had a leukemia or something, then it may be possible in some circumstances to use a donation of cord blood STEM cells from a bank.
Brigid: [00:24:18] Yeah. And body doing that might be motivated by altruism or why would somebody want to do that?
Dr Pat: [00:24:26] Yeah. Altruistic donation. That's what it's all about. And not every hospital collects for that purpose though. Yeah. So collections tend to be done in big city hospitals where they're set up for it and where they've got a huge number of births per year and can collect a lot of blood. Yeah. So if you are at a smaller community hospital, a regional country hospital, or whatever, and they don't offer that service don't panic because the service has enough blood.
Yes. Yeah. They're getting enough from city hospitals for that purpose.
Brigid: [00:24:51] But somebody might have it in their birth plan that if for some reason I can't have delayed cord clamping, then I'm willing to do cord blood donation. Is it something that you have to consent for?
Dr Pat: [00:25:02] Yes, but don't panic if it's not offered at your hospitals.
Brigid: [00:25:05] Yeah. Yeah. That's important. And then some, you know, you see it advertised some people there's big companies that will store your cord blood.
Dr Pat: [00:25:13] Yeah. This is the one I'm probably least in favor of. I don't mind saying. I don't usually try to talk people out of it, but I do suggest that they think carefully about the likely return on that investment.
This costs a lot of money and of all the cord blood that's privately banked. I think that you have to have a look at how many people have actually needed to use it, and whether that's value for money. It's one of those insurance things that if you've done it. Yeah. And your baby runs into trouble later on.
You'll be glad you had it, but for most people who never use it, it's very expensive.
Brigid: [00:25:48] It is very expensive. I did look it up. And so I think these are prices from a company. And I think it's, if you want 20 years of storage, it's about three and a half thousand dollars upfront. Yeah. But if you're paying it off in payments over those 20 years, it's like nearly six grand.
Dr Pat: [00:26:04] If you pay it off in installments. Yeah. And I think one of the potential problems is if you've paid a lot of money, for example, to store it over the first 10 years, then you might think that there's a fair bit of sunk cost in that. So you might keep going. Yeah,
Brigid: [00:26:18] but this is a choice again,
Dr Pat: [00:26:19] like if this is,
Brigid: [00:26:20] if this is something, maybe you've had a family member with leukemia, I don't know whether, is leukemia hereditary.
Dr Pat: [00:26:25] Oh, well in kids, mostly not so. I think that if you go into spending that sort of money on that sort of product, it might be wise to learn a little bit about the frequency of these diseases so that you're not buying an expensive insurance policy for something that's actually terribly rare. Yeah.
Brigid: [00:26:43] Cause there's, you know, there's expenses all along the way and you've just gotta weigh everything up and say, well, what's important for me and our family.
Dr Pat: [00:26:49] Absolutely. So I'm not against it per se, but I am in favor of some critical thinking about whether that's the right way to go.
Brigid: [00:26:56] Yup. Yep. Great. Well, I hope everybody has enjoyed listening to everything about the umbilical cord.
Dr Pat: [00:27:01] We’ve thrown a few things in there that aren't sort of strictly related, but they've all got the cord in common!
So it just seemed like a neat way of discussing that amazing structure. That that is the cord, that connection between mother and baby and covering some of those things that people read about and come up.
Brigid: [00:27:17] Yep. All right. So, uh, continue with the conversation with us when we post this let's chat over on Instagram, which is at grow underscore my underscore baby.
Dr Pat: [00:27:26] We love hearing from you guys.
Brigid: [00:27:27] Yeah. Send us a DM. Tell us what you think about everything the umbilical cord
Dr Pat: [00:27:31] and we'll talk to you next time. See you now.