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What is Delayed Cord Clamping, and Will it Help Your Newborn?

By Jennifer Lincoln, MD, IBCLC, Board Certified OB/GYN

At some point after your baby is born, your doctor or midwife will place two clamps on the umbilical cord. He or she (or your partner, if they want to) will then use scissors to cut between the clamps and separate your baby from the placenta. If you’re like many new moms, you might not have given thought to the best time to place those clamps and why this might matter for your baby, but there are some valuable things to know about cord clamping.

Delayed cord clamping is the practice of waiting to place clamps on the umbilical cord, rather than clamping it immediately after baby is born. Exactly how long the time period is from birth to the actual clamping is not strictly defined in delayed cord clamping, which may be one reason there is so much variability in practice among doctors and midwives. Most obstetric providers agree that delayed cord clamping constitutes waiting at least 30 to 60 seconds to clamp the cord.

Advocates of delayed cord clamping claim this practice allows the baby to receive more iron-rich blood from the placenta. Because of this, fewer newborns will suffer from iron-deficiency anemia. In preterm newborns, this effect is even more important because they are prone to needing blood transfusions for this kind of anemia. In addition, preterm infants who underwent delayed cord clamping at birth were less likely to suffer from intraventicular hemorrhage (or bleeding in the brain), which can lead to severe neurological and developmental problems. Delayed cord clamping also makes immediate skin-to-skin — with its many benefits — more likely, since mom and baby are still connected!

In light of some of these findings, in December, 2012, the American College of Obstetricians and Gynecologists (ACOG) released a statement in support of delayed cord clamping in preterm infants. However, until just recently, they felt enough evidence did not exist to make this recommendation for term infants.

As of December 2016, however, ACOG has updated its guidelines to recommend delayed cord clamping for all newborns, no longer reserving this practice for preterm babies only. They have changed their stance since more research has suggested that even term infants benefit from the extra blood they receive during delayed cord clamping. They have also been more specific in how long to wait, saying that waiting 30 to 60 seconds should be sufficient to reap the benefits.

ACOG does acknowledge that some drawbacks to delayed cord clamping may exist, such as an increased risk of jaundice and need for phototherapy. However, this is uncommon and since it is usually easily treatable, the benefits of delayed cord clamping often outweigh the risks. Additionally, for any babies who are not healthy and need immediate pediatric care, or in situations where a mother is bleeding excessively and must be tended to, delayed cord clamping should not be done.

If you are pregnant and interested in delaying your baby’s cord clamping at birth, be sure to talk with your doctor or midwife at a prenatal visit. Often you may be too distracted at the time of your baby’s arrival to remember to bring it up

Sources:

  • The American Congress of Obstetricians and Gynecologists
  • Committee Opinion #543: Timing of umbilical cord clamping after birth. RM McAdams
  • Time to implement delayed cord clamping
  • Obstet Gynecol 2014;123:549-52.

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