In this article we will look at the topical issue of delayed cord clamping. It has been routine practice to cut and clamp the umbilical cord immediately after birth, within the first few seconds of life, for the last 50 years. It was thought this was the safest way to lessen the risk to the mother of severe blood loss. However, numerous studies carried out over many years, have concluded that the risk is the same regardless of when the cord is clamped. This subject has been in the headlines recently with several midwives and medical professionals calling for a change to this standard protocol within the NHS.
The World Health Organisation (WHO) defines delayed cord clamping as taking place more than 60 seconds after the birth, or when the cord has stopped pulsating. It is thought that up to one third of the baby’s total blood volume is contained within the umbilical cord and placenta. The central argument in support of delayed umbilical cord clamping is that it allows the blood and iron levels in the baby to reach their optimum point, with no detrimental effect on the mother. The amount of iron available to the baby at birth is critically important to support them through the first six months, until they are weaned and introduced to iron in their diet.
Delayed Cord Clamping Video
NICE (National Institute for Health and Care Excellence) is the body that sets the guidelines for practice within the NHS. They are currently reconsidering their procedures regarding delayed cord clamping but these are not due to be available until Autumn 2014.
One argument that has been presented against delayed cord clamping is that it can make babies slightly more susceptible to developing jaundice. If delayed cord clamping were to become the norm across all maternity units then there would need to be access to provision of phototherapy for those babies affected by jaundice. There are obviously some situations in which delayed cord clamping is not advised such as baby needing resuscitation or mother losing a large volume of blood.
The WHO has analysed the results of numerous studies around the world looking at the effect of delayed cord clamping and whether there is an optimum point to cut the cord. It found that the best time to cut the cord is 1-3 minutes after birth. The increased iron levels to the baby are extremely beneficial as they boost the natural supply that all babies are born with. Interestingly, there appeared to be a greater incidence of jaundice among babies where the cord was not cut for at least 5 minutes after birth. This result suggests that there is a fine balance to be had between increasing blood & iron levels in baby and increasing the risk of newborn jaundice.
Delayed Cord Clamping Conclusion
Overall, the evidence seems to be overwhelming that delayed cord clamping for between 1-3 minutes after birth is extremely beneficial for both Mother and baby. It is highly likely that the updated NICE guidance will reflect this. Many maternity units have adopted this as standard practice, recognising that delayed cord clamping is in the best interests of mothers and their babies.
What do you think? Please comment, like or share this post. You might also want to read our post on placenta encapsulation.