Optimal (Delayed) Cord Clamping

Back in 1913, we had a shift in postpartum procedures, one being the immediate clamping and cutting of the umbilical cord. Delayed cord clamping, also known as “optimal” cord clamping is a debatable topic among health care providers to this day. However, studies show that earlier cord clamping in not only unnecessary, but also can compromise the child’s health as it deprives him of essential nutrients and adequate blood supply. This is the reason why delayed cord clamping is encouraged by many midwives, pediatricians, and reputable organizations. Let’s look at some benefits and disadvantages of delaying when we clamp and cut the umbilical cord.

World Health Organization (WHO) reports that 29% of infant death is caused by a lack of oxygen at birth. As long as the cord is still pulsing, it is still giving the baby oxygen, allowing providers a leg up during the crucial minutes after birth when a baby may not be making proper respiratory efforts.

At the time of birth, approximately 1/3 of a baby’s blood volume is outside of their body. Think about that!! Research has shown that babies who undergo just a 90 second delayed clamping have sufficient amount of iron in the blood because they have 30% more blood volume than those who are clamped immediately after birth. Iron helps influence health as it reduces risk of anemia, but did you know it also affects gross motor skills, memory, and energy levels?

Mother should consider delayed chord clamping when they undergo premature labor. “In addition, a longer duration of placental transfusion after birth may be beneficial because this blood is enriched with immunoglobulins and stem cells, which provide the potential for improved organ repair and rebuilding after injury from disorders caused by preterm birth (39, 43). Although the magnitude of the benefits from enhanced placental stem cell transfusion has not been well studied, the other neonatal benefits have led investigators to consider revising umbilical cord clamping practice guidelines (4, 28, 40, 44–48).” ACOG – http://www.acog.org

Delayed cord clamping gives doctors an opportunity to determine if the baby needs extra care, for instance in a case of premature birth. According to recent studies, clamping the umbilical cord later on is healthy for newborns as it prevents intraventricular hemorrhage, as well as raising blood pressure and body temperature. It also allows the baby to have vital stem cells to help fight off infection.

Bilirubin is a byproduct of the normal breakdown of red blood cells. It usually passes through the liver and is excreted from the body. Newborns are not yet able to process bilirubin out of their system quickly, so an increase in blood supply can cause jaundice. Treatment for jaundice can be as simple as increased feeding and direct sunlight daily for a week or so, or as advanced as phototherapy treatments using a bili-light or a bili-blanket.

To properly allow blood transfer from placenta to baby, the baby should stay on or below the abdomen, making skin to skin difficult at times.

This condition is a large increase in packed red cell volume which can result blood clots or possibly stroke. There was one study (Prendiville et al., 1988) that showed Polycythemia as a result of delayed clamping in 2% of the newborns in the study. However, none of the babies affected had an actual adverse reaction.


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