While preparing your birth plan for your baby’s big day, you may have stumbled upon the option of delaying the umbilical cord clamping after the birth of your baby. But what does that mean? What is delayed cord clamping? And what are the benefits and risks of doing it? Here are the different answers to those questions to help you choose if delayed cord clamping is something for you and your baby.
What is Delayed Cord Clamping?
It depends on who you ask…
World Health Organization (WHO):
According to the World Health Organization, delayed clamping is when the cord is cut 1-3 minutes after the birth of a baby—a practice they recommend for all births.1
Royal College of Midwives:
Some practitioners believe that the 1-minute mark is too early. They recommend extending the time to approximately 3 minutes. In this statement, the Royal College of Midwives said that “delaying for even one minute is a welcomed change . . . However, as transfusion is known to continue during the first 3 to 5-minutes of life, it is suggested that this process is allowed to complete without being interrupted.”2
NOTE: Placental transfusion is the system that provides the baby with red blood cells, stem cells, immune cells, and blood volume. Delayed cord clamping allows time for the placental transfusion, ensuring safe oxygen levels and blood volume in the baby.
International Childbirth Education Association:
The International Childbirth Education Association states, “Delayed cord clamping (DCC) is a practice by which the umbilical cord is not clamped or cut until after it stops pulsating. It may also include not clamping or cutting the umbilical cord until after the placenta is delivered.”3
As I stated before, the answer to ‘what is delayed cord clamping’ differs from person to person. Penny Simkin describes it very well and lists some of the benefits in this video below:
Many families are now choosing to delay the cord clamping for their babies. Before you decide, let’s review the benefits and risks of delaying this procedure.
Benefits of Delayed Cord Clamping
Many studies have proven multiple benefits of delayed cord clamping for the baby.
1. Neurodevelopmental Benefits
“It’s incredible to see what a difference an extra 3-minutes and one-half cup of blood can have on the overall health of a child, especially four years later,” the lead author of this study, Dr. Ola Andersson, told CNN.4
In this study, researchers found that “A couple of extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later … Children whose cords were cut more than 3-minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.”5
What I found interesting is that these benefits only apply to boys. “We don’t know exactly why, but speculate that girls receive extra protection through higher estrogen levels while being in the womb,” Dr. Heike Rabe, a neonatologist at Brighton & Sussex Medical School in the United Kingdom, told NPR. So if you are expecting a boy, this is an added benefit.
2. Decreased Risk of Anemia
The natural transfusion of blood via delayed cord clamping delivers a substantial amount of iron. One study found that waiting 2 minutes increased iron stores by 27-47 mg. That’s fantastic!6
According to the American College of Obstetricians and Gynecologists, waiting for 3-minutes may prevent iron deficiency during the first year of life: “Physiologic studies in term infants have shown that a transfer from the placenta of approximately 80 mL of blood occurs by 1-minute after birth, reaching approximately 100 mL at 3-minutes after birth.7,8,9,10 This additional blood can supply extra iron, amounting to 40–50 mg/kg of body weight. This extra iron, combined with body iron (approximately 75 mg/kg of body weight) present at birth in a full-term newborn, may help prevent iron deficiency during the first year of life.”11
3. Increased Blood Volume/ Smoother Cardiopulmonary Transition
According to Mark Sloan, M.D., whether a baby “is premature or full term, approximately one-third of its total blood volume resides in the placenta. This is equal to the volume of blood needed to fully perfuse the fetal lungs, liver, and kidneys at birth. In addition to the benefits that come with adequate iron stores … babies whose cords are clamped at 2 to 3 minutes have a smoother cardiopulmonary transition at birth.”12
This article states, “Another potential benefit of delayed cord clamping is to ensure that the baby can receive the complete retinue of clotting factors.”12 This means that the increased blood volume will naturally increase blood platelet levels needed for normal blood clotting.
4. Increased Levels of Stem Cells
Delayed clamping also results in an infusion of stem cells. This plays an “essential role in the development of the immune, respiratory, cardiovascular, and central nervous systems, among many other functions. The concentration of stem cells in fetal blood is higher than at any other time of life. ICC (immediate cord clamping) leaves nearly one-third of these critical cells in the placenta.”
Stem cells may also “help repair any brain damage the baby might have suffered during a difficult birth,” Dr. Rabe (mentioned above) told NPR.
5. Better Outcomes for Pre-Term Infants
“Preemies who have delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain, and have a lower risk of necrotizing enterocolitis, a life-threatening bowel injury,” said Dr. Rabe.13
Now let’s discuss some of the risks of delayed cord clamping.
Risks of Delayed Cord Clamping
Small studies have shown that delaying cord clamping increases the risk of jaundice. For example, a study found that 3% of babies who experienced early cord clamping required treatment for jaundice, compared to 5% of babies who experienced delayed cord clamping.14
It was once believed that delayed cord clamping increased the mother’s chances of suffering from postpartum hemorrhage. However, delayed cord clamping was not found to increase mortality rates for babies or mothers. Nor were there any significant differences between the groups for postpartum hemorrhage.
What About Cord Blood Banking?
Delayed cord clamping is not often compatible with cord blood donation or storage. Some collectors will say they need the cord cut immediately to collect the necessary amount. Some will only allow up to 60 seconds before they want the cord clamped. Neither of these options is long enough for most of the benefits to reach your baby. If you want your baby to have its full supply of cord blood, you may need to reconsider your plans to donate or store cord blood.
Delayed cord clamping offers many benefits to the newborn baby. Those include a higher number of red blood cells, stem cells, and immune cells at birth. In addition, delayed cord clamping may provide essential life support, restore blood volume, and protect against organ damage, brain injury, and death in compromised or premature babies.
After my research, I highly recommend considering this option if you are currently expecting.