The Benefits of Delayed Cord Clamping for Newborn Health

Delayed cord clamping, also known as optimal cord clamping, is the practice of waiting to clamp and cut a newborn's umbilical cord until after it stops pulsating or 1-3 minutes after birth. This simple change in birthing practice can provide significant health benefits to babies. Recent research shows that delaying clamping of the umbilical cord improves outcomes for both full-term and premature infants.

What is Delayed Cord Clamping?

The umbilical cord connects the fetus to the placenta during pregnancy, supplying the baby with oxygenated blood and nutrients. After birth, the cord continues to pulsate, pushing more blood from the placenta to the newborn. Traditionally, the umbilical cord was clamped and cut immediately after delivery. However, waiting to clamp the cord allows more time for placental transfusion, the transfer of blood from the placenta to the baby.1

Delayed cord clamping is defined as waiting until the cord stops pulsating (usually around 1-3 minutes) or at least 60 seconds after birth to clamp the umbilical cord.2 The World Health Organization recommends waiting at least one minute before clamping the cord for all births, with the infant held below the level of the placenta.7 For preterm infants, it's recommended to wait 30-60 seconds with the baby held below the placenta if they don't require immediate resuscitation.2

Benefits for Full-Term Infants

For healthy, full-term babies, the main benefit of delayed cord clamping is improved iron stores and decreased risk of iron-deficiency anemia in infancy. The extra blood received from the placenta can increase an infant's blood volume by up to 30%.1 This provides a substantial amount of iron, an essential nutrient for brain development. Infants whose cords are clamped later have higher hemoglobin levels and better iron status for up to 6 months after birth compared to those with early clamping.47

In addition to boosting iron stores, delayed clamping allows more time for the transfer of stem cells from the placenta to the newborn. Stem cells play an important role in the development of the immune, respiratory, cardiovascular, and central nervous systems.1 The higher blood volume also helps stabilize the baby's blood pressure and circulation during the transition to life outside the womb.3

Benefits for Preterm Infants

The advantages of delayed cord clamping are even more significant for babies born prematurely. Preterm infants have less blood volume than full-term babies and are at higher risk for anemia, bleeding in the brain, necrotizing enterocolitis, and other complications related to prematurity.2

Delaying clamping for just 30-60 seconds has been shown to reduce the incidence of intraventricular hemorrhage (bleeding in the brain), late-onset sepsis, and necrotizing enterocolitis (a serious intestinal disorder) in preterm infants.24 It also decreases the need for blood transfusions and improves circulation and blood pressure in these vulnerable babies.2

Implementing Delayed Cord Clamping

Despite the growing evidence supporting delayed cord clamping, surveys show that many practitioners still clamp the cord immediately after birth.5 Reasons for this include lack of knowledge, difficulty overcoming ingrained habits, and concerns about maternal hemorrhage or the need for infant resuscitation.

However, studies have found that delayed clamping does not increase the risk of excessive maternal bleeding or interfere with active management of the third stage of labor.13 In cases where the baby requires immediate medical attention, the cord can be clamped promptly and the infant handed off to the neonatal team. The benefits of delayed clamping outweigh the need for immediate resuscitation in most situations.2

To implement delayed cord clamping, hospitals should develop clear protocols and educate staff on the proper technique. The baby can be placed skin-to-skin on the mother's abdomen or held below the level of the placenta while the cord continues to pulsate. The cord is then clamped and cut after at least 60 seconds or when pulsation has ceased.1

Delayed clamping can be performed after both vaginal and cesarean deliveries. For C-section births, the surgeon may need to hold the baby slightly below the incision to allow the cord to continue pulsating. With proper planning and communication, delayed clamping should not significantly prolong the duration of a cesarean delivery.4

Cord Blood Banking and Delayed Clamping

One potential barrier to delayed cord clamping is the desire to collect cord blood for banking. Cord blood contains valuable stem cells that can be used to treat certain diseases. Some parents choose to privately bank their baby's cord blood for future use, while others donate it to a public bank to help others in need.

Collecting cord blood requires clamping and cutting the cord soon after birth, which may not allow enough time for optimal placental transfusion. However, it is possible to delay clamping for 60-90 seconds and still collect a sufficient volume of cord blood for banking.15 Parents who are considering cord blood banking should discuss their options with their healthcare provider to determine the best approach.

Conclusion

Delayed umbilical cord clamping is a simple, safe, and effective way to improve health outcomes for newborns. By allowing time for placental transfusion, this practice provides infants with added iron stores, stem cells, and blood volume that can have lasting benefits. The evidence is especially compelling for preterm babies, who face higher risks of anemia, brain bleeding, and other serious complications.

While more research is needed on the long-term effects of delayed cord clamping, the available data strongly supports its use in clinical practice. Healthcare providers should be educated on the proper technique and equipped to perform delayed clamping in most birth settings. With wider implementation, this evidence-based change in cord management has the potential to give millions of babies a healthier start in life.

Sources:

1 2 3 4 5 6 7 8 9 10

Stay updated with the latest discoveries and recommendations in the health domain! Subscribe to our Instagram, TikTok, and YouTube channels, and join us on Facebook to get the latest updates on health trends and breakthroughs.