Delayed Cord Clamping
Hello and welcome to my first blog post! Here is where I explain medical studies or journal articles in layman’s terms.
Our first topic is:
Delayed Cord Clamping
What is it?
Per American College of Obstetricians & Gynecologists (ACOG), delayed cord clamping is waiting for at least 30-60 seconds in vigorous term and preterm infants after birth to clamp the cord. Other professional organizations such as the Royal College of Obstetricians and Gynaecologists recommends deferring cord clamping until 2 minutes after birth and American College of Nurse-Midwifes recommends delayed cord clamping for 2-5 minutes after birth.
Note that this is only for vigorous newborns; as delayed cord clamping can delay resuscitation efforts in a compromised newborn.
Are there any benefits?
For term newborns, the benefits of delayed cord clamping include an extra 80-100 mL of blood after 1 minute of birth, increased physiologic quantities of iron, about 40-50 mg/kg of body weight and larger amounts of immunoglobulin and stem cells (vital for organ and tissue repair, which is also very important for preterm babies).
For preterm newborns, delayed cord clamping between 30-180 seconds was associated with fewer neonates needing blood transfusions for anemia (low blood levels), lower incidence of (bleeding in the brain) and necrotizing enterocolitis (inflamed or damaged intestinal tissue that can cause intestines to die or create a hole). One study of delayed cord clamping prior to 32 weeks also showed improved motor function in children at 18-22 corrected months of age.
Any risks?
One theoretical disadvantage is the additional blood volume could potentially be too excessive, causing high blood levels or jaundice (high levels of bilirubin in the blood, causing yellowing of the skin). To date, the literature does not support this theory, although there are some babies that meet the criteria for jaundice following excessive delayed cord clamping.
Many clinical trials did not include multiple gestations (twins, triplets, etc.) so there is little known about its safety. At this time, there is not sufficient evidence to recommend for or against delayed umbilical cord clamping for multiples.
If you think you are interested in delayed cord clamping for your delivery, speak to your provider. Ask about their preferences and guidance. It is also good to inquire would their preferences change in the case of an emergency.
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