Delayed cord clamping, or DCC, following labor and delivery is a practice that has become standard of care at many hospitals, including Women & Babies Hospital. Endorsed by the American College of Obstetrics and Gynecology, delayed cord clamping can be very beneficial to both premature and full-term babies alike.
Recent Neonatal Resuscitation Program guidelines from the American Academy of Pediatrics recommend delayed umbilical cord clamping for at least 30–60 seconds for most vigorous term and preterm infants.
There are very few risks associated with delayed cord clamping for healthy mothers and babies. “The main risk to delayed cord clamping is that the increased blood volume may result in jaundice,” Barnes says. “Because all babies are monitored for jaundice, this is a complication that we would be able to detect.”
Doctors traditionally cut the cord so quickly because of long-held beliefs that placental blood flow could increase birth complications such as neonatal respiratory distress, a type of blood cancer called polycythemia and jaundice from rapid transfusion of a large volume of blood.
When the umbilical cord is not clamped and cut right after the baby is born, the baby gets more of their own blood back into their body. Getting extra blood may lower the chance of your baby having low iron levels at 4 to 6 months of life and may help your baby's health in other ways.
The World Health Organization recommends that the umbilical cord not be clamped earlier than 1 minute after birth in term or preterm newborns. The Royal College of Obstetricians and Gynecologists also recommends deferring umbilical cord clamping for healthy term and preterm infants for at least 2 minutes after birth.
There is another possible downside to delayed cord clamping. The extra red blood cells that the baby receives from delayed cord clamping get broken down in the circulation and bilirubin is released. High bilirubin levels are not good for infants – but treatment is pretty straightforward.
You can safely delay cord clamping by 30 to 60 seconds in both vaginal and cesarean deliveries. The baby should be: Full term. Vigorous (moving, crying and pinking up with blood flow after delivery).
What is the Golden Hour After Birth? The Golden Hour is the time right after delivery where mom and baby have uninterrupted skin-to-skin contact for at least the first one to two hours. As long as mom and baby are well, immediate and continuous skin-to-skin contact is recommended.
The first hour after birth when a mother has uninterrupted skin-to-skin contact with her newborn is referred to as the “golden hour.” This period of time is critical for a newborn baby who spent the past nine months in a controlled environment.
The WHO recommends delayed cord clamping unless the infant needs immediate medical attention. The American College of Obstetrics and Gynecologists (ACOG) recommends delayed cord clamping for all healthy infants for at least 30-60 seconds after birth given the numerous benefits to most newborns.
Yet, early umbilical cord clamping can be detrimental to the newborn, leading to an increased risk of anaemia and, in the premature infant, an increased risk of intraventricular haemorrhage and respiratory complications.
Now guidelines say that delayed (or optimal) cord clamping is better for your baby. This means waiting until the cord has stopped pulsating and has become white before cutting the cord. The midwife should be able to feel when this happens by just touching the cord.
In term infants, one-minute delay in cord clamping after birth leads to an additional 80 mL of blood from the placenta to the infant's circulation, which increases to about 100 mL by 3 minutes after birth.
Hospitals treat placentas as medical waste or biohazard material. The newborn placenta is placed in a biohazard bag for storage. Some hospitals keep the placenta for a period of time in case the need arises to send it to pathology for further analysis.
A lotus birth is the decision to leave your baby's umbilical cord attached after they are born. The umbilical cord remains attached to the placenta until it dries and falls off by itself. What are the risks of lotus birth? There are no research studies available on this topic.
"Generally speaking, most obstetricians and providers have recognized that delayed cord clamping is beneficial to your newborn baby," Furr says. "Also, it is entirely within your right to request delayed cord cutting.
'6 For healthy women with term births, the National Institute for Health and Care Excellence (NICE) recommends that the cord is not clamped in the first 60 seconds, except where there are concerns about the cord's integrity or the baby's heart rate.
Immediate (or early cord clamping) lasts approximately 1-60 seconds. Delayed cord clamping lasts approximately 60 seconds - 5 minutes' Optimal cord clamping lasts more than 5 minutes or until the cord stops pulsating.
Most babies will start breathing or crying (or both) before the cord is clamped. However, some babies do not establish regular breathing during this time.
Cutting the cord too soon after birth might stress the baby's heart, increase the risk for bleeding inside the brain, and increase the risk for anemia and iron deficiency. Waiting too long may result in the infant having too many red blood cells.
In the United States, it's a common tradition for the father or non-birthing parent to help the doctor clamp and cut the umbilical cord. This practice can be a great way for the non-pregnant partner to jump-start their emotional connection to their child and be directly involved in the delivery process.
When cord clamping is delayed, there is a slightly higher risk the baby will develop jaundice. This can happen because the overall amount of blood products are increased through the placenta supply, elevating bilirubin, and could potentially overwhelm the liver.
“Early” cord clamping is generally carried out in the first 60 seconds after birth (generally within the first 15–30 seconds), whereas “delayed” umbilical cord clamping is carried out more than 1 min after the birth or when cord pulsation has ceased (5).