Delayed Cord Clamping
PREGNANCY
Evidence
The University of Sydney, University of Nottingham and the National Childbirth Trust.
Waiting for two minutes or longer to clamp the umbilical cord of a premature baby soon after birth could help reduce the risk of death, compared with immediately clamping the umbilical cord, or waiting a shorter time before doing so. Delaying clamping could decrease the child's risk of death by more than half relative to immediate clamping.
Education
What is delayed cord clamping?
During pregnancy, the umbilical cord connects your baby to the placenta and after birth, both the umbilical cord and placenta contain nutrient-rich blood. Delayed cord clamping (commonly referred to as optimal cord clamping) involves waiting to clamp the umbilical cord so your baby receives as much blood as possible from the placenta.
The benefits of delayed umbilical cord clamping
Evidence shows that for all babies – both premature and full term – delayed cord clamping is beneficial. Benefits include:
- Increased neonatal blood volume
- Improved neonatal and infant iron stores
- Decreased neonatal and infant anaemia
- More stable blood pressure in preterm babies
Ideally your doctor or midwife will “wait for white” – this means that the umbilical cord is white and there’s no longer blood flowing through. However, in a birth by caesarean section or in extreme prematurity there are more risks involved so generally speaking, your doctor will clamp and cut the cord at 60 second's post-birth.
Key benefits of delayed cord clamping for premature babies
If your baby is born prematurely (before 37 weeks) there are known benefits of delayed cord clamping. In preterm babies, delayed cord clamping has been shown to decrease the number of blood transfusions required and may decrease the chances of intraventricular haemorrhage (bleeding in the brain).
What are the risks of delayed cord clamping?
If there is a risk to the mother or the baby after birth, for example: the mother is experiencing a postpartum haemorrhage or the baby needs urgent medical attention, the cord will be cut and clamped immediately.
If you are planning delayed cord clamping with a caesarean birth, there are some risks you need to consider: once the uterus has been cut the bleeding needs to be monitored and if haemorrhaging occurs, your obstetrician will choose to clamp and cut the cord immediately. The operating theatre is also very cold so when a baby is held and cord clamping is delayed, the birth team needs to make sure the baby’s temperature doesn’t drop.
For full term newborns, increased blood volume can increase the bilirubin levels which can cause jaundice. Jaundice occurs when red blood cells break down and a chemical called bilirubin is released which turns the skin and the whites of the eyes yellow. Jaundice is a complication that’s monitored quite closely in newborn babies and is easily treated.
Empowerment
There are an increasing number of doctors who perform optimal cord clamping as standard practice, but it’s not always discussed in your antenatal appointments or if you have had your baby early.
If optimal cord clamping is important to you, talk to your healthcare team. Remember: Even if your baby is born early and you were unable to follow your birth plan, you can still make this choice if it is safe for you and your baby to do so.
Useful Links
World Health Organization - Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes.
https://www.who.int/publications/i/item/9789241508209
Australian Nursing and Midwifery Federation - Further evidence on benefits of delayed cord clamping.
https://anmj.org.au/further-evidence-on-benefits-of-delayed-cord-clamping/
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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances. To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
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