Baby Image Credit: Unsplash

Cutting the cord – the umbilical link between a mother and a child – is a big part of birth, but say the experts, it’s probably best to wait a while before doing it.

Why? US-based Cleveland Clinic explains: “Studies have shown that waiting to clamp the umbilical cord for 30 to 60 seconds allows beneficial blood cells to get through the cord to the baby. That extra boost of iron helps babies transition to this new haemoglobin in the first weeks of life. Red blood cells can go from the placenta through the umbilical cord to the baby even up to five minutes after birth.”

When does the delayed cord clamping occur?

According to Cleveland Clinic, “Delayed cord clamping happens after the delivery of your baby, but before delivery of the placenta — when the baby is still attached to the umbilical cord.”

What does the placenta possess?

“The residual placenta blood is body temperature and oxygenated with about 15 to 20 mL/kg of red blood cells, several million to a billion stem cells, and 10 to 15 mL/kg of plasma. The amount of iron provided by the placental transfusions is enough for a three to eight months’ supply for a term infant,” explains a paper titled ‘Cord management of the Term Newborn’, published in 2021 in the journal ‘Clinics in Perinatology’.

What are the benefits of such a move?

Clamping the umbilical cord at least 60 seconds after birth reduced the risk of death or major disability at two years by 17 per cent, reflecting a 30 per cent reduction in relative mortality with no difference in major disability, states the paper.

Dr Ramneek Kaur, Specialist - Obstetrics and Gynaecology at Bareen International Hospital, says: “Delayed cutting of umbilical cord increases the level of haemoglobin at birth and improves the level of iron during the first months of the baby. Delay in cutting the umbilical cord is associated with significant health benefits in preterm infants too. This includes:

  • Improved circulation during transition,
  • Better red blood cell count,
  • Lesser need for blood transfusions,
  • lower incidence of necrotizing enterocolitis and intraventricular haemorrhage.

If it’s beneficial, why is it usually cut as soon as the child is delivered?

“According to a few medical studies, when infants undergo delayed umbilical cord clamping, there is a small incidence of jaundice. But this can be managed with phototherapy,” says Dr Kaur.

Why would a delay in cord cutting cause jaundice?

“When foetal haemoglobin’s red blood cells break down, they form bilirubin. Bilirubin can be harmful for the developing brain.

“The extra blood provided by delayed cord clamping can increase jaundice levels in babies because some develop problems with bilirubin. So delayed cord clamping may slightly increase the number of babies that need phototherapy treatment. With phototherapy, we put babies under an ultraviolet lamp to help break down bilirubin more quickly,” explains Cleveland Clinic.

When should you not delay cord clamping?

According to Cleveland Clinic, you should not delay it if the baby:

  • Comes out depressed (limp or grey or blue in colour).
  • Has heart rate abnormalities.
  • Needs to be resuscitated by the staff in the neonatal intensive care unit (NICU).

If babies are preterm or not vigorous, the healthcare professionals may have to clamp the cord immediately after birth so they can go to the NICU team for evaluation.

You should also avoid delayed cord clamping if the preterm infant:

  • Is depressed.
  • Has an infection.
  • Has trouble breathing.
  • If the neonatologist or NICU team has concerns about the health of the baby.

Can you delay cord cutting if the baby is born via a C-section?

Dr Kaur says, “In case of a C-section, delayed cutting of umbilical cord is still debatable and still being studied. The benefits of delayed cord clamping should be weighed against the risk of postpartum haemorrhage.”

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