Parents across the world are increasingly asking their gynecologists or obstetricians to delay the clamping of umbilical cord. Although the concept is still new in India, this is as good a time as any to educate yourself about delayed cord clamping and its benefits. So here is everything you need to know about cord clamping.
Delayed cord clamping

What Is Meant By Delayed Cord Clamping?

The definition of delayed cord clamping has been changed with time. While before the mid 1950s , delayed cord clamping referred to the ‘cutting off the umbilical cord’ after 5 minutes post delivery, the World Health Organization now states that delayed clamping is when the cord is cut 1-3 minutes after birth, which is now a standard practice. Because there has not been a specific recommendation for clamping the cord, many practitioners choose to clamp the cord as early as 30-60 seconds after birth , while maintaining the baby at or below the level of the placenta. There is another recommendation that expressed by the International Childbirth Education Association, which is that “Delayed cord clamping (DCC) is a practice by which the umbilical cord is not clamped or cut until after it stops pulsating. It may also include not clamping or cutting the umbilical cord until after the placenta is delivered.” Source
Limited findings regarding the optimal time when the cord should be cut has led a controversial status to the debate and experts worldwide weigh the pros and cons of delayed cord clamping. Lets now understand the role of the umbilical cord.

What Does The Umbilical Cord Do Anyway?

To understand more about cord clamping, you need to first familiarize yourself with how a fetus gets blood and nutrition. When the baby is inside the mother, then the baby and the placenta together has a blood circulation system which is separate from that of the mother. At any given point of time, about 1/3rd of the baby’s blood will be inside the placenta and only 2/3rd of it inside the baby. So how does the baby’s body connect with the placenta? Through the cord of course. The umbilical cord, which connects the baby and the placenta to the mother’s body, has one vein and two arteries. The vein takes oxygen and nutrients from placenta to the fetus and the arteries take waste from baby’s body to the placenta. So placenta can be considered as your baby’s “external blood circulation system”.

What Happens To The Cord During Delivery?

When your baby is born, remember that 1/3rd of the blood is still inside placenta. Right after birth, the cord starts pulsating and this is a sign for the placenta to send back all the blood to the baby. This process is called placental transfusion. It is this transfusion of blood that ensures that the baby has enough blood volume and all the necessary blood cells like WBC and RBC in the right amount.
The whole argument for delayed cord clamping is based on the fact that if the cord is clamped early, the placental transfusion is interrupted and the baby is left with lower volume of blood. This seems logical. Then,

Why Are Cords Clamped Early?

Clamps have been traditionally clamped early because it was earlier believed that delay in cord clamping increased the risk of hemorrhaging in mothers, a belief that was later refuted by research. The practice of clamping cord early however continued mainly because no one wanted to change it. Some experts also vouched that more blood, or more RBC’s in the baby could put the baby at a risk of neonatal jaundice. But as a practice, because delaying cord clamping would need more time, no doctor really takes the pain owing to their busy practices.

Should I Go For Delayed Cord Clamping? What Are The Benefits Of Delayed Cord Clamping?

The placental transfusion is expected to continue for the first five or six minutes after delivery. In delayed cord clamping, the obstetrician wait for 5-6 minutes before clamping the cord, thereby letting the placenta transfer full blood volume back to baby, making him/her better prepared for the transition from inside the womb to outside. Some doctors say that even one minute of delay can help the child much better than early clamping. Not convinced? Here are five benefits of delayed cord clamping:

Top Benefits Of Delayed Cord Clamping

  1. Better blood volume: The primary advantage is that the 1/3rd volume of blood present in placenta will be transferred to the baby if cord clamping is delayed. Increased blood volume will result in increased blood platelets which in turn helps in better clotting of blood
  2. More stem cells: Stem cells are absolutely important for all bodily functions. Fetal blood has a higher concentration of stem cells than normal adult blood. This is why this blood is used in stem cell banking. Delayed cord clamping would ensure that the baby’s body is infused with all the stem cells present in placenta as well
  3. No risk of anemia: Placental transfusion ensures that the baby’s body has enough amount of iron at birth. This is because breast milk is naturally low in iron. However, placental transfusion will be interrupted if the cord is clamped within 10 seconds of birth as is the practice. This leads to a risk of anemia, due to which many pediatricians prescribe iron drop supplements to babies. However, in delayed cord clamping the risk of anemia is reduced substantially
  4. Better blood pressure for preemies: Research has shown that pre-term babies whose cord was clamped late generally had better health and needed fewer drugs or blood transfusions than the ones who had early cord clamping
  5. Overall long term health: Research shows that delayed cord clamping impacts the child’s health in a positive way even when the child is four or five years old. The research further showed better neuro-development, better fine motor skills and even higher social skills in kids who had delayed cord clamping

Delayed cord clamping is a part o having an undisrupted normal birth process and offers many health benefits to newborn babies. In babies who are born prematurely, delaying the clamping would mean a life support system, albeit for a few minutes. It is recommended that you ask your doctor about this, and include the same in your birth plan. Also, because the usual practice involves cutting the cord immediately after birth, it would be wise to ask the spouse or other attendant to remind the doctor, if necessary.