Delayed Cord Clamping: A Guide to Research, Benefits and Options

A photo of the hands of a clock symbolizing the the time for delayed cord clamping.

Everything You Need to Know: A Parent’s Guide to Delayed Cord Clamping

There has been a lot of buzz going around the parenting world lately about the practice of delayed cord clamping, with expecting mothers asking questions like what is it, what are the benefits, and how it will affect my child down the road.

Though the conversation has been happening for many years, a study published by JAMA Pediatrics sparked even more interest in the subject after reporting that the fine motor and social skills of 4-year-olds improved in children who underwent delayed cord clamping during childbirth.

Enhanced neurodevelopment? Potential health benefits? A smarter baby? Mommies-to-be everywhere are saying sign me up!

While it seems like a simple answer, it is important to fully understand what it is exactly you are signing up for. That’s why we wanted to give you everything you need to know about delayed cord clamping in one place: the what, the how, and most importantly, the why.

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The What

Delayed cord clamping is the practice of waiting to clamp and cut a newborn baby’s umbilical cord until after the placenta is delivered.

The How

Studies show that only 80 ml of blood is transferred from the placenta in the first minute following birth, while 115 ml are supplied after three minutes. Halting blood flow too early reduces the total supply of blood to a newborn and decreases the amount of iron intake, while waiting longer than 3 minutes offers no additional benefit to the baby.

Instead of cutting the cord directly after birth, you can ask your doctor to wait until your baby has received the maximum amount of stem cells and oxygenated blood from the placenta.

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The Why

“There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth. The extra blood at birth helps the baby to cope better with the transition from life in the womb.”

— Dr. Heike Rabe

While the evidence in support of delayed cord clamping increases, so does the evidence against immediate cord clamping, which can actually be detrimental to the baby. Research shows that clamping too soon disrupts the natural birth process and prematurely disconnects the baby from the placenta, which is still circulating blood to the newborn.

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Benefits of Delayed Clamping

The benefits of delayed cord clamping to your baby include:

  • lower frequency of iron deficiency anemia
  • reduced need for blood transfusion
  • higher blood volume
  • neurodevelopment may be enhanced (JAMA Pediatrics)

Delayed Cord Clamping has many potential benefits for newborns. You should discuss if delayed cord clamping is right for you and your baby with your midwife or doctor. 

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WHO Guidelines for Delayed Cord Clamping 

The World Health Organization recommends delayed cord clamping to improve “maternal and infant health and nutrition outcomes. Delayed cord clamping is when the cord is clamped not earlier than a minute after birth.

Here’s a summary of the WHO guidelines on delayed cord clamping:

  • For full term or preterm babies who do not require positive pressure ventilation, the cord should be left for at least a minute before it is clamped.
  • If a new born baby does not breathe by itself after being thoroughly dried, it should be stimulated by rubbing its back 2-3 times before the cord is clamped and positive pressure ventilation is commenced.

  • Essential neonatal care should be initiated simultaneously with delayed cord clamping.

  • The optimal timing of cord clamping applies equally to both full term and preterm babies.

  • Delayed cord clamping is NOT  recommended if  the baby is asphyxiated/being deprived of air and needs to be instantly moved for resuscitation.Although if the doctor has experience in administering effective positive pressure ventilation without cutting the cord, he can start the ventilation before the cord is cut.

  • It’s important to note that clamping not earlier than one minute is regarded as the lower limit. Ideally, the cord shouldn’t be clamped earlier “than is necessary for applying cord traction to reduce postpartum hemorrhage and speed the expulsion of the placenta”. It is agreed that all this would usually take about 3 minutes.

Cord Clamping and Cord Blood Banking

Many delayed cord clamping supporters will say that you can not do both delayed cord clamping and cord blood banking.  However, there is approximately 200 milliliters (mL) of blood in the placenta and umbilical cord.  A minimum  of 50 mL that is needed for cord blood storage.  Delayed cord clamping is recommended to last between one and three minutes, according to the World Health Organization. This  transfers  about 80-100 mL of blood into the baby. This leaves an ample amount of blood left to allow for cord blood collection.

Delayed cord clamping is recommended to last between one and three minutes, according to the World Health Organization. This transfers about 80-100 mL of blood into the baby. This leaves an ample amount of blood left to allow for cord blood collection.

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“Delayed Umbilical Cord Clamping May Benefit Children Years Later”, Shots (Health New from NPR), May 26 2015

“Timing of Umbilical Cord Clamping After Birth”, The American College of Obstetricians and Gynecologists (ACOG), Reaffirmed 2014

“Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age”, JAMA Pediatrics, May 26 2015

“Kids’ motor and social skills improve when cord clamping delayed at birth” CBC News, May 26 2015

“Delaying umbilical cord clamping may improve child’s development”, Medical News Today, May 29 2015

“Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes”, World Health Organization, September 28 2016