What is delayed cord clamping?

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Essential to human pregnancy, the umbilical cord provides a growing fetus with nutrients and oxygen crucial to development and growth. At birth, the cord is clamped and cut to separate the maternal-infant blood supply.

As of 2012, the World Health Organization (WHO) strongly recommend that “in newly born term or preterm babies who do not require positive-pressure ventilation, the cord should not be clamped earlier than 1 min after birth.”1

The ideal time to clamp the cord has been evaluated by several studies. According to The American Congress of Obstetricians and Gynecologists (ACOG), however, a consensus has not yet been reached.2

What are the benefits of delayed cord clamping?

Physical benefits

There are both immediate and long-term infant benefits for delayed cord clamping, including:1,2

  • Increased blood volume
  • Decreased necessity for blood transfusions
  • Decreased need for surfactant use and mechanical ventilation in premature and low birthweight babies
  • Decreased incidence of intracranial hemorrhage, necrotizing enterocolitis and late-onset sepsis
  • Increased hematocrit and hemoglobin
  • Increasedblood pressure, cerebral oxygenation and red blood cell flow in premature and low birthweight babies
  • Decreased incidence iron deficiencyanemia in term babies.

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Iron store improvement can also be experienced, especially when the cord is clamped after around 2-3 minutes.1

During this time, “placental transfusion” (transfer of placental blood) occurs, providing the infant with 6-8 months of iron reserve.1This extra iron is especially important in cases of “infants living in low-resource settings with less access to iron-rich foods and thus greater risk of anemia.”1

The effects of iron deficiency early in life can be permanent and include delayed psychomotor development, impaired language and motor skills, as well as coordination impairments.1

Notably, in 2011, approximately 273 million children under 5 years old were found to be anemic. Of these, 42% were iron deficient.1

Given these staggering statistics, delayed cord clamping should be further discussed with your health care provider to see if it is right for you and your baby.

Cognitive benefits

In addition to the many physical benefits of delayed cord clamping, a recent study suggests there may also be cognitive benefits. Observed benefits include improved neurodevelopment such as better social and fine motor skills, although no difference in IQ scores was found.3This improvement was noted in infants whose cord was cut after 3 or more minutes after birth and the findings were most statistically significant among males.3

Maternal benefits and risks

Delayed cord clamping may also be beneficial to the mother, potentially shortening the third stage of labor. Delayed cord clamping has also been seen to decrease the risk of retained placenta in trials.1 Theoretic risk of maternal hemorrhage is a concern when cord clamping is delayed, however, and is especially concerning under certain maternal circumstances, in which the benefits need to be considered against the potential risks.2

Potential risks associated with delayed cord clamping in the infant include jaundice and polycythemia.3

It is important that you speak with your doctor about delayed cord clamping and the potential risks versus benefits in your particular situation.

Recent developments on cord clamping from MNT news

Delaying umbilical cord clamping may improve child’s development

The first study to assess the long-term developmental outcomes of delayed cord clamping suggests boys may benefit if clamping is delayed by 3 minutes after birth.

Delayed cord clamping results in better immediate newborn outcomes

Though the right timing for cutting the umbilical cord – also referred to as clamping – is widely debated, a new study suggests delaying cord clamping by 2 minutes results in better development for the newborn during the first days of life.

Written by Lori Smith BSN MSN CRNP

 

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