Most people do not even know that delayed cord clamping by even a few short minutes can bring such amazing long term benefits for your baby.
Clamping and cutting the cord is one of the most beautiful aspects of childbirth. It is in that moment that the direct link between mother and child is severed. The baby stops receiving nourishment directly from the mother’s body and must start learning how to feed through breastfeeding and/or bottle feeding. This has emotional significance for many parents, which is why the father often cuts the cord.
You may not think much about when or how the cord is clamped and cut, but researchers are discovering that timing this act can make a significant difference in the health and development of the newborn child. There are possibly some benefits for the mother as well, so let’s take a closer look at the concept of delayed cord clamping. If you or someone you love will have a baby in the future, this is something to talk to your doctor about and possibly include in your delivery plan.
What Is Delayed Cord Clamping?
During pregnancy, the growing baby is connected to the placenta through a cord. A steady flow of blood circulates between the baby and placenta, so a lot of the baby’s blood is located within the cord and placenta at any given time. Once the baby is delivered, that flow of blood continue until the cord is clamped and cut. The cord will continue to pulsate as blood is transfused from the placenta to the baby’s body.
If the cord is clamped immediately, a lot of the baby’s blood remains in the cord and placenta. Medical professionals now realize that this means giving up a lot of stem and immunity cells while robbing the baby of the last opportunities to receive nourishment and oxygen from the placenta.
Delayed cord clamping is the process of waiting to clamp and cut the cord. Medical professionals can deliver neonatal care immediately after the birth while waiting for the cord to stop pulsating. Once the placenta is delivered, the baby has received that final transfusion of blood, and it’s time to clamp and cut the cord. This process is often referred to as the placental transfusion, and it is often complete within five minutes of birth.
The World Health Organization (WHO) defines delayed cord clamping as clamping that occurs after the first minute of birth. After substantial research into the benefits and risks of clamping before and after the one-minute mark, they issued a recommendation that medical professionals clamp the cord within one to three minutes of birth.
They take it one step further by recommending that the cord is never clamped before the one-minute mark unless a baby needs immediate ventilation, in which case the cord must be cut so that emergency care can be delivered immediately.
Delayed Cord Clamping Benefits for Premature Babies
According to the American College of Obstetricians and Gynecologists (ACOG), delaying cord clamping for at least 30-60 seconds comes with some powerful benefits for ALL infants but especially for pre-term babies because of:
- Improved transitional circulation – The transition from circulating blood through the placenta to circulating through the body alone is difficult for many premature babies. Circulating blood to the organs is essential for the baby’s short and long-term health, and the transition tends to happen smoother when the baby receives that final transfusion of blood from the placenta.
- Higher volume of red blood cells – Babies born prematurely often have fewer red blood cells than babies born full term, and their red blood cells break down quickly. They may also lose more blood due to the testing that occurs after birth. The blood received back from the placenta after birth boosts the baby’s red cell supply so that they are less likely to run low. This final transfusion of blood also gives the baby a boost of iron, which reduces their risk of anemia.
- Reduced need for blood transfusion – Studies have shown that pre-term babies with extremely low birth weight are less likely to need a blood transfusion in the first six weeks of life when delayed cord clamping is performed. The placental transfusion that happens naturally in the minutes following birth is all that most babies need to thrive.
- Lower risk of necrotizing enterocolitis – This is a medical condition that causes bloating and swelling in the abdomen due to damaged intestinal tissue. The tissue can die if the condition isn’t treated promptly, and pre-term babies are at greater risk. Reducing this risk is a powerful way to help premature babies thrive.
- Lower risk of intraventricular hemorrhage – This term refers to bleeding in the brain caused by hemorrhage. The lower the birth weight of a newborn, the greater their risk of suffering a hemorrhage that causes this bleeding.
It turns out that many of the health risks experienced by pre-term babies are combatted naturally by simply allowing the baby to stay connected to the placenta for up to five minutes after birth.
What About Full-Term Babies?
Healthy babies born full term don’t have as many short-term health risks and challenges as pre-term babies, but the ACOG still recognizes that they can benefit from the increased stores of iron that come with delayed cord clamping. All newborns deserve that added protection against the development of anemia.
While studies are conflicting when it comes to how much full-term babies may benefit from receiving that final transfusion of blood, it is still generally accepted that waiting at least 30 seconds to clamp the cord is recommended for all babies.
Some researchers are now looking beyond the first year of life to determine the long-term benefits of delayed clamping. Some initial studies have found that babies may benefit from enhanced social skills and improved fine motor skills later in life when clamping is delayed for at least three minutes. Many professionals are using this research to argue that waiting to clamp the cord is to the advantage of all babies even if they are already at a healthy weight and don’t have the struggles that come with premature delivery.
Medical professionals are more likely to suggest delayed cord clamping when a baby is premature and needs those added benefits that come from the final placental transfusion. That doesn’t mean that parents shouldn’t ask about delayed clamping for full-term babies. When there is no health risk for the baby or mother, it doesn’t hurt to give every baby the short and long-term advantages that may come from receiving that natural transfusion.
Benefits of Delayed Cord Clamping for the Mother
Delaying the clamping of the cord until after a mother delivers the placenta is believed to reduce the risk of some childbirth complications. The intact cord can speed up the process of placental delivery while lowering the chances of distress and other complications that may otherwise occur before and during that process.
There has been some concern in past years that waiting to clamp the cord could lead to unnecessary bleeding for the mother, increasing her risk of hemorrhage. Research has proven this incorrect as the extra amount of bleeding is minimal for most women. While most of the benefits of delayed cord clamping remain with the baby, there is little risk to a healthy mother who wants to wait in order to give her baby the advantage.
Most medical organizations and governmental bodies leave it up to the medical team to assess the health of the infant and mother when determining how long to wait for clamping and cutting. If the mother is experiencing issues that require immediate attention, there is a chance that waiting won’t be considered a safe option for her.
Delayed Cord Clamping – What are the Risks?
According to the ACOG, delayed cord clamping does place infants at greater risk of jaundice. This is a temporary medical condition that causes the baby’s skin to turn a yellowish color due to excess bilirubin in the blood. While in the womb, the placenta removes the bilirubin for the baby. After delivery, the baby’s liver takes over this job. It can take some time for the liver to adjust, so some babies experience jaundice symptoms for a week or two after birth.
Delayed cord clamping may allow the placenta to pass some of the bilirubin back into the baby along with that final transfusion of blood, which is why babies are at greater risk of jaundice when cord clamping is delayed. The good news is that this is a temporary condition that doesn’t cause pain or developmental delays. Doctors can easily treat the condition, so the risks are minimal for most babies.
While there are no other health risks, many parents are now weighing the benefits of delayed cord clamping with the benefits of banking umbilical cord blood for future use. Allowing the blood to return to the baby means that there is less blood in the umbilical cord to collect, reducing your chances of successfully storing that blood. The question is whether you give your baby the benefits of those blood cells now or save them in case they are needed later in life.
The stem cells collected from umbilical cord blood can later be used to fight against cancer and some other diseases, so it’s important to talk to your doctor about what is the best delivery plan for your baby’s short and long-term health. We’ll talk more about this issue at the end of this guide.
Common Myths About Delayed Cord Clamping
We have already discussed one of the biggest myths about delayed cord clamping: It puts the mother at increased risk of hemorrhage due to excessive blood loss. Research has shown that this simply isn’t reality, and there are few risks involved for a healthy mother not experiencing complications during labor and delivery.
Here are some additional myths and the reality behind them:
- You can’t place your newborn baby on your chest or stomach immediately after birth because the blood won’t flow upward from the placenta to the baby. This is simply false. Many women have the pleasure of cradling their babies at their breast for the first few minutes of life while their babies receive that final placental transfusion. As long as the cord isn’t clamped, oxygen and blood will continue to flow between the baby and the placenta.
- Delayed cord clamping can lead to polycythaemia, which is a condition that leaves the baby with dangerously high levels of red blood cells. While this is often blamed on delayed clamping, it is almost always a result of ineffective placenta functioning during pregnancy. Fewer than 5% of all newborns suffer from this condition, and in most cases, the treatment is simply to provide fluids.
- If your baby needs help breathing after birth, you cannot wait to clamp the cord. This isn’t necessarily true, and it goes back to your doctor assessing the health of the baby and making a decision in the moment. While some babies need serious medical attention and cannot wait to be separated from their mother, it is possible to help some babies breathe without clamping the cord immediately. If you know that your baby may need help breathing after birth, discuss the option of delayed clamping with your doctor before you go into labor.
- Delayed cord clamping is only possible with vaginal births. The cord must be clamped and cut regardless of how your baby enters this world, so timing that procedure is important even for cesarean births.
Some would say that the compatibility of delayed clamping and umbilical cord blood storage is another myth. This is an area of great controversy, so it’s best to talk to your doctor if you’re interested in collecting cord blood. Many cord blood banks insist that you can do both because clamping within three minutes of birth will still leave enough blood in the cord for collection.
Other medical professionals argue that you need to wait at least three minutes before clamping for the baby to receive the full placental transfusion, making these procedures incompatible. Every bit of extra blood received could benefit your baby, so you may want to consider the option of clamping in less than three minutes in order to benefit from delayed clamping and cord blood banking. Your doctor is the best person to help you make this decision for your baby.
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