What is Delayed Cord Clamping?
What is delayed cord clamping?
Delayed cord clamping is the prolongation of the time between the delivery of a newborn and the clamping of the umbilical cord. Delayed umbilical cord clamping is usually performed 25 seconds to 5 minutes after giving birth. DCC allows more blood to transfer from the placenta to the baby, sometimes increasing the child’s blood volume by up to a third. The iron in the blood increases the newborn’s iron storage, which is vital for healthy brain development.
What are the benefits?
Is linked to long-term neuro-developmental benefits (improving fine motor and social skills)
Less chance of baby needing a blood transfusion for low blood pressure and/or anemia
Increases hemoglobin and iron levels (when delayed for at least 2 minutes)
Decreases the chance of late-onset sepsis (a bacterial infection usually caused by environmental factors)
Decreases the risk of brain bleeds by 50%
Provides a higher respiratory rate, and lowers the risk of developing infant respiratory disease
Increases blood volume
A 2015 study looked at 263 4-year-olds. Overall, the children whose cords were clamped three or more minutes after birth scored slightly higher on an assessment of fine motor skills and social skills than the children whose cords were clamped 10 seconds or less after birth (study can be found here)
What are the potential risks?
There may be a slight increase in bilirubin levels increasing the chances of needing phototherapy for neonatal jaundice. Studies range from “no significant difference” to ‘a slight increase’ in the risk of jaundice. A study (McDonald and Middleton's), found that 3% of babies who experienced early cord clamping, compared to 5% of babies who experienced delayed cord clamping required treatment for jaundice. Despite the increased risk, WHO, ACOG and many other organizations around the world state that ‘the benefits of delayed cord clamping outweigh the risks of jaundice’.
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When is the ideal time to cut the cord?
When the cord stops pulsating - or at least 3 minutes after birth. It's pretty easy to tell when it's time to cut the cord. First of all, you can feel for a pulse by squeezing the cord near your baby's belly 'button'. You can also see the changes as well:
At first, the cord is dark blue and coiled like an old fashioned telephone cord and you can feel the pumping easily with your fingers. As the blood supply drains from the placenta into your baby, the cord becomes white and flat while the pulse in the cord becomes weak until non-existent. A great video to watch can be found here Penny Simkin on Delayed Cord Clamping
Are there any medical reasons to cut the cord early?
Yes, there are medical circumstances that may require more focus on the mother or baby. For example, placenta abruption, or even if the placenta is partially (and prematurely) separating from the uterus. When this happens, there is less oxygen transferring to baby, and baby may not benefit much or at all from the cord staying intact anyway. In some cases, the mother and baby may both need attention separately.
Sources:
Raypole, Crystal. “Delayed Cord Clamping: Benefits, Risks, and Recommendations.” Healthline, Healthline Media, 24 May 2019, www.healthline.com/health/pregnancy/delayed-cord-clamping.
“Delayed Umbilical Cord Clamping After Birth.” ACOG, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/12/delayed-umbilical-cord-clamping-after-birth.
“Optimal Timing of Cord Clamping for the Prevention of Iron Deficiency Anaemia in Infants.” World Health Organization, World Health Organization, 27 July 2015, www.who.int/elena/titles/full_recommendations/cord_clamping/en/.
