The debate about when to cut the umbilical cord has been the focus of many research studies of late. For years, providers clamped and cut the umbilical cord within 5-20 seconds after birth. This is quickly becoming an outdated practice. Today we’ll discuss the proven benefits of delayed cord clamping to your baby.
What happens when the umbilical cord is cut?
At birth, the baby is attached to mom via the umbilical cord, which is attached to the placenta. At a certain point in the delivery, the baby is separated from the placenta by clamping and then cutting the umbilical cord.
What is delayed cord clamping?
Delayed cord clamping is waiting to cut the umbilical cord while additional blood flows to the baby from the blood-rich placenta. Without intervention, blood will circulate from the placenta and through the cord for several minutes after birth. This delay in cord clamping can result in about 30% more blood volume for the baby (2).
How long should we wait to cut the umbilical cord?
Most studies suggest that about half of the blood from the placenta has transfused into the baby within 1 minute. By 3 minutes, more than 90% of the blood has transfused (3). With this in mind, the World Health Organization recommends that cord clamping occur no earlier than 1 minute after birth. Waiting between 1-3 minutes is ideal (4). Some encourage providers to wait until the cord has stopped pulsing on its own.
The American College of Obstetricians and Gynecologists instructs obstetricians to delay umbilical cord clamping for at least 30-60 seconds (5). While this slight delay offers some benefit to baby, it is still not in line with the vast amount of research that suggests that a minimum delay of 1-3 minutes is most beneficial to the baby (1).
What are the benefits of delayed cord clamping?
Increased Iron Stores:
Delayed cord clamping has been shown to reduce and prevent iron deficiency in a baby’s first year of life (1,5). The increased blood volume leads to an elevated level of red blood cells — cells that contain iron. Iron helps to carry oxygen to the body and is vital for healthy brain and behavioral development (7). Delayed cord clamping leads to a decreased risk of anemia and greater levels of long-term iron storage in babies (3).
Increased Stem Cells:
The blood that transfuses from the placenta during delayed cord clamping is rich in immunoglobulins and hematopoietic stems cells (1). These are the stem cells that give rise to all of the other blood cells. They are a vital element of blood development and immune health (8). These stem cells also help to repair injury to other cells and decrease inflammation shortly after birth. They may likely have health benefit for children later in life, as well (9).
Better Outcomes for Preterm Babies:
For preemies, delayed cord clamping may be even more important. Research shows that delayed clamping in preemies is associated with improved circulation, better establishment of red blood cell volume, decreased need for blood transfusion, and lower rates of hemorrhage (5). Some studies have even shown that in babies born before 32 weeks, delayed cord clamping is associated with better motor function as toddlers (10).
What are the risks of delayed cord clamping?
Risk of Jaundice:
There is a slight risk that a baby is more likely to develop jaundice after delayed cord clamping. Here’s how the theory goes: More blood volume = more red blood cells for baby’s liver to break down = more bilirubin (a byproduct of the breakdown of red blood cells) = increased risk of jaundice. Despite this logical flow of ideas, clinical trials have not connected delayed clamping with a significant increase in the risk of developing jaundice in the first 2 weeks of life. For those babies that did have elevated bilirubin levels, some studies suggest that they are not more likely to need phototherapy. Other studies suggest that they were more likely to need phototherapy (1,6). Without a conclusive answer, it’s wise to exercise caution and monitor baby’s bilirubin level in the days following the birth.
Effects Quality of Blood Banking:
If you are planning to bank umbilical cord blood, delayed clamping can affect the quality of the collection. There will likely be less volume of blood to store and less stem cells counts in the collected blood. However, without a medical need to bank the blood, the benefits of delayed clamping are arguably greater than the benefits of saving the blood for a possible future use (5).
The benefits of delayed cord clamping are highly compelling, with little to no risk to mom or baby. If this subject is important to you, talk with your doctor or midwife about when they cut the umbilical cord. Be sure to include your preferences on your birth plan to help remind your provider on the big day. Continue to learn more about common hospital interventions by participating in a high-quality natural childbirth class. Best of luck to you as you prepare for an amazing birth!
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