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All About Optimal Cord Clamping

It's no secret that babies are attached to an umbilical cord, which needs to be clamped and cut following birth. What seems to cause more confusion, however, is WHEN the right time to clamp this cord is! We know that the umbilical cord is what delivers nutrients and sustains life while the baby is in the womb, but why would we delay clamping after delivery? What are the benefits of this? Are there any risks? Let's dig into everything you need to know.


The Umbilical Cord After Birth


To understand why you might want to wait to clamp the umbilical cord, let's first talk about what it does in the minutes after birth. If you've ever seen an umbilical cord directly following birth, you'll see that it is still very functional - a dark purplish red color showing that it is still full of blood, and a thick, pulsating cord shows us that it is still delivering valuable goods to the baby. Within about 10 minutes the cord will stop pulsating.


Directly following birth, the umbilical cord still contains roughly 30% of the baby's blood supply. Clamping the cord immediately following delivery cuts off this blood supply, meaning baby does not benefit from this extra 30%.


Benefits of Delayed Cord Clamping


Perhaps due to the increase in blood volume available to the baby, delayed cord clamping has a number of benefits. Studies that reported clamping cords after at least 3 minutes showed:

  • Increased hemoglobin and iron in full-term babies, which can reduce risk for anemia (source)

  • Reduced need for blood transfusions

  • Improved circulation in premature babies (source)

  • Better establishment of blood volume in premature babies (source)

  • Lower risk of bleeding in the brain and necrotizing enterocolitis (an intestinal disease that affects almost 5-10% of premature infants) and intraventricular hemorrhage (source)

  • By age 4, slightly higher assessment scores of fine motor skills and social skills than children whose cords were clamped 10 seconds or less after birth. (source)

Due to the plethora of benefits that come from delaying cord clamping, the American College of Obstetrics and Gynecology (ACOG) recommends waiting at least 30-60 seconds after birth.


Are There Risks?


According to ACOG, there is a small increase in the incidence of jaundice that requires phototherapy in term infants undergoing delayed umbilical cord clamping. As a result, providers adopting delayed umbilical cord clamping in babies should ensure that mechanisms are in place to monitor and treat neonatal jaundice.


ACOG also states that there is no risk of increased hemorrhage in mothers who decide to delay cord clamping.


Conclusion


Due to the overwhelming benefits of cord clamping, it is being recommended to delay cord clamping for at least 30-60 seconds. The majority of hospitals now leave the umbilicial cord to empty of blood before clamping and cutting, but be sure to let your midwife/doctor know this is what you want! However you birth your placenta, optimal cord clamping is possible!


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