“Cutting the cord” is the last step in separating infant from mother. Traditionally, the umbilical cord is cut within seconds of Baby’s appearance, but the past few decades have seen a return to earlier practices of delaying cord clamping for just a few extra minutes. Here’s a look at the benefits and risks of delaying cord clamping.
What is the Umbilical Cord?
The umbilical cord is Baby’s source of nutrition in the womb. Vital nutrients, oxygen, and antibodies are passed to the growing fetus, while waste products like carbon dioxide are sent back to the placenta. It is a thick cord made of tissue and blood vessels, rich in undifferentiated stem cells. The umbilical cord is attached to the placenta and the spot on Baby’s abdomen where the belly button will develop.
As Baby’s grand appearance draws closer, the mother’s body will also pass on many antibodies she has developed. These antibodies will help the newborn fight off infection until he is about three months old, at which point they begin to fade (thus, the need for vaccinations). The vessels are wrapped in Wharton’s jelly, which is in turn wrapped in a membrane called the “amnion” (think amniotic fluid). The umbilical cord is about 20 inches long and thinner than your pinky.
When Should the Cord Be Clamped?
Not enough research exists to clearly state how long after birth is best to cut the cord. Some organizations say under a minute, and most seem to happen in less than 20 seconds. But 75 years ago when babies were born to midwives instead of doctors, the cord wasn’t clamped until blood flow stopped -- closer to five minutes. The World Health Organization (WHO) recommends obstetrical teams wait at least one if not three minutes to clamp the cord, and other experts suggest waiting until the umbilical cord has finished pulsing, suggesting the natural transfusion process is complete. WHO suggests that even babies born to mothers with HIV are more likely to benefit from the practice; “the evidence shows that the benefits of delaying cord clamping for 1-3 minute outweighs the risks of transmission of HIV.” The exception to this rule, of course, is infants with the cord wrapped around them.
What are the Benefits of Delayed Cord Clamping?
The point of delaying the clamping is to allow more blood to make its way from the placenta into the baby. It may increase both iron and general blood volume by about a third. Extra iron decreases the risk of anemia and is important for neurological development. One study found delayed clamping gave baby boys improved social and fine motor skills well into childhood. Some parents are choosing to bank their cord blood, because the profusion of stem cells can offer protection against leukemia and dozens of other diseases in later life. However, the extra influx of stem cells that comes with delayed cord clamping may actually provide an extra third of stem cells that are left behind with immediate cord clamping. In an National Public Radio interview, Dr. Heike Rabe suggests stem cells could help repair any brain damage that might follow a tough birth. These benefits appear to be most beneficial for preterm infants.
What Are the Risks of Delayed Cord Clamping?
Not every medical body recommends delaying the clamping. Some babies can receive too many red blood cells (polycythemia), which can lead to clotting, respiratory concerns, and even strokes. Other research has found increased incidences of jaundice, although infantile jaundice does not usually carry continued issues. Ultimately, the choice should be yours, but it is important you talk to your doctor about what is best for you and your baby.
