It's always a little sad when we cut the umbilical cord. My baby grew quite attached to it.
You have a choice as to when to clamp and cut your baby’s cord and current studies show benefits if you choose to do that later rather than sooner.
The umbilical cord when your baby is first born is this thick, purple, throbbing highway of blood that is passing blood and oxygen from you to your baby.
This process continues for several minutes. Some studies show it continuing for longer than 5 minutes after birth. Eventually, the flow stops and the umbilical cord begins to look much more like a deflated balloon. The cord is no longer purple and blue but now a shade of white. It’s common to see clots of blood in the cord.
It has been policy at most hospitals and the recommendation of American College of Obstetricians and Gynecologists (ACOG) to immediately clamp and cut a baby’s umbilical cord immediately after birth, within 10-20 seconds.
But as more and more studies pour in showing the vast benefits of delayed cord clamping, hospitals and even ACOG are changing their recommendations and policies.
The International Federation of Gynecology and Obstetrics, American Academy of Pediatrics, The World Health Organization, and now ACOG agree that delayed cord clamping is best in almost every case.
It is recommended that you wait AT LEAST 1-3 minutes before cutting your baby’s umbilical cord. Ideally, wait until your baby’s cord has gone from the thick purple, pulsing cord to the white thin non-pulsing cord.
So, let’s talk about why.
Originally, in the 1960’s immediate cord clamping was introduced with the hopes of reducing maternal postpartum hemorrhage but it has shown to have no effect on those numbers.
In later years it was said that cords were immediately clamped and cut to reduce or prevent jaundice. Delayed cord clamping increases your baby’s blood volume levels. Their blood is made up of many things, one being red blood cells.
When red blood cells break down they leave behind a substance called bilirubin. Bilirubin is filtered out of the body by the liver. The issue being, that’s a lot of work for a new little liver. When the body has a build-up of bilirubin it’s called jaundice. Babies that have jaundice can have a yellow tint to their skin or eyes.
It’s important to remember that jaundice presents on a scale with minor jaundice giving cause for little to no concern. Even clinical levels of jaundice are simple to treat. Jaundice can sound like a scary word but knowing what it is and how it’s treated is simple.
It’s important here to say that while delayed cord clamping can increase bilirubin levels, it has not been found to increase clinical jaundice rates.
So, we know it’s not harmful. But are there benefits? The answer is an evidence-based YES.
I want to first remind you that the umbilical cord is your baby’s life line. By allowing them to continue to receive blood and oxygen, you give the care team more time to respond to any potential complications. Studies clearly show that even in the case of premature babies delayed cord clamping is best.
If we look here you’ll see the approximate amount of blood that is shared between the baby and the placenta at birth. If the cord is cut immediately around 1/3 of this precious placental and cord blood is trapped in the placenta and cord. If you allow the flow to continue, the placenta will drain most of the way. This gives your baby as much of that valuable blood as possible.
So, what are the benefits? Let’s lay them out!
Babies whose cords were cut longer than 1 minute after birth had lower rates of anemia, not only as newborns but again at 4 months.
A recent Swedish study found neurodevelopmental benefits of delayed cord clamping four years after birth, particularly for boys.
In addition to lower rates of anemia, babies who are allowed time after birth before cutting their cord have lower levels of iron deficiency for years after, better blood pressure, better newborn urine output, stronger cardiac function, and fewer blood transfusions in the newborn period.
It also decreases the prevalence of some pretty serious newborn complications
“necrotizing enterocolitis, sepsis, and intraventricular hemorrhage of the newborn on screen” Babies have higher blood volumes, increased levels of stem cells, and overall better neonatal outcomes.
So you could say there’s a lot of benefits!
A good rule of thumb is wait until it’s white!
Now, what about babies born by cesarean?
Delayed cord clamping used to be an option only available to women giving birth vaginally. With the science stacked so strongly in favor of delayed cord clamping, hospitals everywhere are beginning to offer this choice to all women.
So, if you know your baby will be born by cesarean, ask your doctor!
Studies show that full placental transfusion doesn’t happen in a cesarean birth but that a delay of between 20-40 seconds can help baby receive some of the benefits!