Why should I delay cord clamping?

Delayed cord clamping has become a big deal in the last couple of years. Many hospitals are now advocating for the delayed clamping of baby’s umbilical cord and the World Health Organisation recommends that cord clamping is delayed for at least 1 minute after birth. But why is it important? And are there any risks associated?

What is delayed cord clamping?

Delayed cord clamping is the practice of leaving the umbilical cord intact after the birth. Lotus birth is the most extreme form of delayed cord clamping whereby the cord and placenta are left attached to the baby until they naturally dry and fall off. This comes with a few more risks and the emphasis is less on the transfusion of blood and more on preventing trauma to the baby. In this post I’m going to be talking about the more widely practiced versions of delayed cord clamping where cutting the cord is left until after the birth of the placenta or until the cord stops pulsating and goes white.

Why delayed cord clamping is good for baby

Up to 30% of a baby’s blood supply is transfused to them by the placenta after birth.(1) This can be important in reducing the likelihood of the baby becoming anaemic up to the age of two years. Benefits are present even to babies born to mothers who are anaemic themselves ‘Iron stores and Hb in infancy can be improved in neonates born to anemic mothers by delaying cord clamping at birth’ (2) There are immediate effects too, in the period before breathing is established the oxygenated blood coming from the placenta can help keep baby’s oxygen levels normal.(3) Blood going to the baby during placental transfusion is rich in stem cells which may prove useful in the repair of organs damaged intrapartum (3) There are proven advantages to the pre-term baby too despite the fact that they’re least likely of all babies to have cord clamping delayed. DCC reduces the likelihood of transfusion due to blood pressure and can lead to a reduction in the relative risk of intraventricular haemorrhage (4)

Are there any risks associated with delayed cord clamping?

Following delayed cord clamping there is an increased risk of hyperbillirubemia which is the primary cause of neonatal jaundice. Studies have found that delayed cord clamping can lead to an increase in the likelihood that  newborn will need phototherapy. (5)

References:

1. Hutchon DJR. Immediate or early cord clamping vs delayed clamping. Journal of Obstetrics and Gynaecology, November 2012; 32: 724-729

2. https://www.indianpediatrics.net/feb2002/feb-130-135.htm

3. Van Rheenen P. Delayed cord clamping and improved infant outcomes. BMJ. 2011; 343:d7127

4. Rabe H, Reynolds G, Diaz-Rossello J. Early versus delayed umbilical cord clamping in preterm infants. The Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD003248.pub2. DOI: 10.1002/14651858.CD003248.pub2.

5. Timing of umbilical cord clamping after birth, ACOG Committee Opinion, Number 543; December 2012.

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