Benefits and Risks of Delayed Cord Clamping

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The umbilical cord is the connecting link between the mother’s placenta and the baby in the womb. The cord is seen to pulsate and transfer blood, oxygen and stem cells to the baby. A better transition from life in the womb, to the outside world, is possible from the extra blood for the baby, therefore delayed cord clamping is the best option for newly born babies.

In this article:

What is Cord Clamping?
Is Delayed Cord Clamping Common?
How Long Can You Delay Cord Clamping?
Benefits of Delayed Cord Clamping
Risks of Delayed Cord Clamping
Should I add it to My Birth Plan?
Can You Have Delayed Cord Clamping with C Section?

Delayed Cord Clamping: Benefits and Risks

What is Cord Clamping?

Delayed cord clamping is defined as the elongation of the time between the delivery of the newborn and the clamping of the umbilical cord. However, some suggest that it is not good for the baby as it missed out a large amount of blood and also other benefits. According to World Health Organisation, it suggests that DCC is safe for the full term as well as premature babies, as long as they do not require breathing assistance, the cord is attached to the baby and the mother can significantly hamper resuscitation efforts.

benefits of delayed cord clamping

Is Delayed Cord Clamping Common?

In the past few years, the potential benefits of the delayed cord clamping have gained more attention towards it. Despite no risk for infants and mothers, it should be practiced on healthy infants and mothers without any complications.

How Long Can You Delay Cord Clamping?

The circumstances of mother and baby influence the timing of the clamping of the umbilical cord. An infant receives 30% more fetal-placental blood volume in delaying cord separation than immediate cord clamping. According to the WHO, it states that “optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased and the cord is pulseless and flat”.

Benefits of Delayed Cord Clamping

Before birth, the circulating blood supply is shared both by the baby and the placenta. The baby is provided with oxygen and nutrients through the placenta and the umbilical cord. The functions of the lungs, liver, gut, and kidneys of the baby are performed by the placenta and so the baby organs require a small flow of blood. Hence at the time, the placenta carries a significant portion of the body’s blood volume. The blood in the placenta belongs to the baby. After birth, the placenta provides essential oxygen and nutrients and delivers the blood back to the baby. This imperative part of the birth process is known as “Placental Transfusion”. Placental transfusion provides the baby with red blood cells, stem cells, immune cells, and blood volume. The benefits are as follows –

Neurodevelopmental Benefits

Extra minutes attached to the umbilical cord at birth may translate into a small boost in the neurodevelopment of the child several years later. Children with DCC have slightly higher social skills and fine motor skills than the ICC children.

Decreased Risk of Anemia

Breastfeed children need to be supplemented with iron since breast milk is low in iron to prevent anemia. Infants require iron for rapid brain growth and development. A study found that DCC increases the iron endowment at birth and haemoglobin concentration at 2 months of age. Delay in cord clamping at 2 minutes could help prevent iron deficiency from developing before six months of age.

Increased Blood Volume or Smoother Cardiopulmonary Transition

Almost one-third of the blood volume resides in the placenta for both premature and full-term babies. This volume of blood us required to suffuse the fetal lungs, kidneys, and liver at birth. Babies whose cords are clamped with 2-3 min delay have adequate iron stores and also smoother cardiopulmonary transition. Another potential benefit of this increased blood volume is increased blood platelets required for normal blood clotting.

Increased Levels of Stem Cells

stem cells play an imperative role in the development of immune, respiratory, cardiovascular and central nervous systems amid many other functions and also repairs the brain damage to the baby during a difficult birth. Therefore, DCC results in an infusion of stem cells.

Better Outcomes for Preterm Infants

Premature babies who have DCC tend to have better blood pressure immediately after birth and need fewer drugs to maintain blood pressure. They also need few blood transfusions and less bleeding into the brain. It reduces the risk of critical bowel injury – necrotizing enterocolitis.

Risks of Delayed Cord Clamping

Polycythemia

Circulation of an excess of blood flow to the newborn may develop blood hyperviscosity leading to polycythemia.

Hyperbilirubinemia

Due to increased iron stores, DCC babies will have a greater incidence of hyperbilirubinemia is because of the high level of bilirubin in the blood. In the womb, the placenta takes care of the excess bilirubin, but at birth, baby’s liver must process the bilirubin which leads to jaundice and often requires phototherapy.

Respiratory Distress

Respiratory distress occurs when there is not enough of a liquid coating the lungs after birth to keep the airways and tiny alveoli of the lungs open. This can cause cell damage near the lungs and a build-up of carbon dioxide in the blood. Due to this babies need to be placed on a ventilator.

Maternal Risks of Delayed Cord Clamping

Concerns about DCC also surround the mother and has been implied that DCC may lead to an increase in postpartum hemorrhage. However, there is no statistical evidence proving that DCC results in an increase in blood loss and also no significant difference regarding blood loss between early and delayed cord clamping.

Should I add it to My Birth Plan?

Ultimately, the benefits of DCC do outweigh the hypothesized risks. There is no evidence to suggest that full-term infants cannot gain the same benefits from DCC as preterm babies.

Can You Have Delayed Cord Clamping with C Section?

Delayed cord clamping might not be beneficial or even safe for the baby in certain situations, these include c-sections that are being performed because the baby has a slow heart rate, severe fetal distress, placental abruption and placenta previa. In these situations, if the baby is delivered and immediately shows signs of being well, it might be possible for the doctor to milk the cord blood toward the baby, before clamping.

Conclusion

Research suggests and it is clear that delayed cord clamping is safe and beneficial for the mother and the baby.

Refrences

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Delayed-Umbilical-Cord-Clamping-After-Birth?IsMobileSet=false

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