Its a bit of a buzz-phrase during antenatal classes. Whilst you may have heard of delayed cord clamping I thought it would be helpful to go into a bit more detail about what it actually is!
The information in this post is taken from the RCOG Scientific Impact Paper and statement.
What happens in the cord?
*After birth, blood flow in the umbilical arteries and veins usually continues for a few minutes.
*The additional blood volume transferred to the baby during this time is known as placental transfusion.
*Immediate clamping of the umbilical cord used to be recommended routinely. It was mainly to reduce haemorrhage during childbirth by delivering the placenta quicker
*However, immediate cord clamping means up to a third of the baby’s blood volume in the cord at birth, does not get transferred back to the baby.
*This means baby doesnt recieve an extra 20–30 mg/kg of iron. This extra iron is sufficient for the needs of a newborn baby for around 3 months.
Why do they need the extra iron?
*Term babies who have immediate cord clamping have lower iron stores for up to 3–6 months after birth.
*Most healthy babies at term will adapt without major consequences
*However, this may be more important if born preterm or with health concerns
*A brief delay in cord clamping will increase the baby’s blood volume.
*With a longer delay there may be other advantages, such as transitioning their circulation and more stable blood pressure.
*Iron definiciency in newborns, can impact on their development. The links are not clear, and it is not known whether delayed cord clamping alone would improve development, but this basic intervention is likely to have some benefits, and minimal risks.
Disadvantages of delayed cord clamping?
*Jaundice may be more common after deferred cord clamping. However the benefits should outweigh this risk as long as phototherapy for jaundice is available.
*It makes early skin-to-skin difficult because of gravity – its best to keep baby lower on the abdomen or chest. If the cord is particularly short, baby should be kept closer to the perineum until the time for the cord to be clamped.
*In emergency situations or caesarean sections, it may be risky to mother or baby to delay the separation of baby from mother. If baby is born in poor condition, they may need early assessment and intervention by paediatric teams. Then the cord should be clamped and cut immediately. If mother is bleeding heavily, delaying cord clamping may increase the uterine blood loss.
What do the guidelines say?
*The International Federation of Gynecology and Obstetrics (FIGO) and the World Health Organization (WHO) no longer recommend immediate cord clamping.
*@NICE in the UK recommends that for healthy women where the baby is born at term (end of pregnancy) you should wait 60 seconds- 5minutes before clamping the cord.
Wanting to know more about having a positive birth experience? Check out my posts on induction, instrumental birth and our full online antenatal course at www.thebirthcollective.org