WHAT IS DELAYED CORD CLAMPING?

Written by Lucy Hall

The practice of not clamping and cutting the umbilical cord as soon as the baby is born is called delayed cord clamping or DCC. Clamping the cord within the first 15 to 30 seconds of delivery has long been standard procedure, but there is now growing evidence that, in certain situations, postponing this procedure can have numerous health advantages for both the mother and the newborn.

How Does Delayed Cord Clamping Work?

Throughout pregnancy the placenta plays an important role in feeding the developing baby by supplying oxygen and nutrition via the umbilical cord. Once a baby is born, the placenta continues to function for a short period of time and can continue to transfer blood to a newborn. By delaying the clamping of the cord, more blood that is rich in iron, red blood cells and stem cells, can flow from the placenta into the baby. Delayed cord cutting can also increase the baby’s total blood volume by up to 30%.  This process is referred to as placental transfusion.

After birth, while the baby takes its first breaths, the body transitions from relying on placental oxygen to breathing air and the increased blood volume from delaying the cord cutting helps support that shift.

Delayed Cord Clamping Benefits for Babies

Improved Iron Levels

The most important advantage of delayed cord clamping relates to the rise in iron levels for the infant. Iron is an essential element for the development of the brain, for growth and for general health. Studies show that delayed cord clamping prevents deficiency of iron within the first 6 to 12 months of infancy. A baby born with a higher level of iron will have less risk of anaemia, delayed cord clamping may reduce the risk of developmental delays and cognitive problems related to low levels of iron.

Increased Blood Volume

Delaying clamping, allows babies to receive extra blood coming from the placenta which is rich in oxygen, stem cells and nutrition. This additional blood may help newborns better control their blood pressure and improve their blood circulation and organ performance. The volume of extra blood is quite beneficial for the preterm babies due to the fact that it decreases the demand for blood transfusion later in life.

Stem Cells and Immune Function 

Additional blood from the placenta in delayed clamping is rich in stem cells, an essential part of the immune function and also tissue repair. The importance of the stem cells is that they help in the development of the immune system of the baby. However, they may also help in the healing of tissues, and this is particularly useful in preterm babies.

Better Transition to Life Outside the Womb 

By providing a more seamless change in blood circulation, delaying the clamping of the cord can help facilitate this transition. Babies that experience delayed cord clamping may have a more stable heart rate and are less likely to require respiratory support after birth.

Delayed Cord Clamping for Preterm Babies

Preterm newborns are more prone to experience a variety of problems, including respiratory problems, infections as well as anaemia. Delayed cord clamping can give a preterm baby more blood volume, which may result in protecting them from some of these problems. It also lowers the risk of intraventricular haemorrhage and necrotising enterocolitis, a dangerous intestinal disease, in premature infants.

Is Delayed Cord Clamping Safe?

Delayed cord clamping has been proved safe for most infants, but immediate cord clamping is a necessity in instances where the baby suffers from distress and needs immediate medical attention or when there is excessive  maternal bleeding.

The priority is given to the health of the baby and mother and intervention may be needed immediately. On the other hand, many healthcare providers are quite skilled at balancing the benefits of delayed cord clamping with any medical concerns that arise, so they may adjust the timing according to the individual situation.

The Role of the Mother in Delayed Cord Clamping

Although the focus of delayed cord clamping is on the baby’s health, it’s important to recognise the mother’s role in this practice. Many women appreciate being part of the decision making process around their birth plan. In some birthing plans, delayed cord clamping is an intentional choice made to honour the natural rhythms of birth and allow time for the mother and baby to bond during those first few precious moments after delivery.

For mothers, particularly those who have had uncomplicated births, delayed cord clamping can also reduce the risk of postpartum haemorrhage. The placenta’s continued attachment during those extra minutes may allow for a more gradual detachment, leading to a smoother third stage of labor.

How Long Should the Delay Be?

There is no one size fits all answer to how long the delay should be. A delay of 1 to 3 minutes is sufficient to allow for optimal placental transfusion. However, some parents and healthcare providers choose to wait until the umbilical cord stops pulsing naturally, which can take up to 5 minutes or longer.

Many hospitals and birth centres have established protocols for delayed cord clamping, but it’s always a good idea for parents to discuss their preferences with their healthcare provider beforehand. Every birth is unique and the timing of cord clamping can be adjusted based on the baby’s health and the circumstances of the birth.

Delayed Cord Clamping and Cord Blood Banking

Some parents may want to collect and store their baby’s cord blood, which is rich in stem cells that can be used for medical treatments later in life. While delayed cord clamping and cord blood banking are sometimes viewed as competing practices, they can be compatible. It’s possible to allow for a brief delay in clamping while still collecting enough cord blood for storage. Parents should discuss their priorities with their healthcare provider to strike the right balance.

Delayed cord clamping is a relatively simple practice that can have profound benefits for newborns, particularly in terms of improving iron levels, increasing blood volume and supporting a smoother transition to life outside the womb. In most cases, delayed cord clamping is a safe, effective and an evidence based approach that supports the health of both mother and baby.

For expecting parents, understanding the benefits and discussing their preferences with healthcare providers can help ensure that they make informed choices.