Having the umbilical cord – the tether that’s linked you and your baby for nine months – cut is an iconic part of the labor and delivery process. The debate about when to cut heated up a few years ago when delayed cord clamping (DCC) became a hot topic. It was a 2014 World Health Organization (WHO) report that generated the buzz.
“Delayed” here is a relative term. We’re not talking about an hours’ long delay. According to the WHO report: “‘Early’ cord clamping is generally carried out in the first 60 seconds after birth (most commonly in the first 15 to 30 seconds), whereas ‘delayed’ … cord clamping is generally carried out more than 1 min after the birth or when the umbilical cord pulsation has ceased.”
Choose a pediatrician your baby deserves.
Experts weigh in. The American Congress of Obstetricians and Gynecologists (ACOG) endorsed DCC in preterm infants before recommending delayed umbilical cord clamping in full-term babies in 2016.
“In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes,” their report read.
Preterm “infants are likely to benefit the most from the additional blood volume gained from the placenta,” ACOG reported in a news release. “Term infants can also benefit, and these benefits may have a favorable effect on developmental outcomes.”
“Given the benefits to most newborns … (ACOG) now recommends a delay in umbilical cord clamping in vigorous term and preterm infants for at least 30 to 60 seconds after birth,” the report reads.
The American College of Nurse-Midwives agrees that “a brief pause after birth could benefit most newborns by delivering them a surge of oxygen-rich blood.”
The pause doesn’t need to – and shouldn’t – delay skin-to-skin contact between mother and baby.
Benefits. Delayed cord clamping allows more blood to pass from the placenta to the baby, which may increase baby’s blood volume by as much as a third.
Further, the iron in the blood increases the newborn’s iron storage – an important component of healthy brain development. There’s also a lessened risk of iron deficiency, which can cause severe side effects.
When red blood cells don’t carry enough oxygen, people can become anemic. Our bodies need iron to make hemoglobin, the red pigment in blood responsible for carrying oxygen. Children are particularly susceptible to anemia, and the most common cause is not getting adequate iron.
Risks? Any risks posed by DCC seem to be minimal, but experts say newborns should be monitored for signs of jaundice – a risk faced by every newborn but one that may be slightly elevated with DCC.
Delayed bathing. Experts – WHO, National Institutes of Health and others – have weighed in on the benefits of delaying baby’s first bath for 12 or more hours. Just as it was longtime standard practice to cut the umbilical cord right away, newborns have long gotten their first baths within a couple of hours of arrival. But new research suggests that delaying that birth soak could make breastfeeding easier.
At first blush, the two don’t seem to be related. So, what’s going on here?
Delaying the first bath allows more skin-to-skin time between mother and baby and – importantly – preserves smell. The similarity in how the amniotic fluid and mom’s breast smell to a newborn could actually encourage babies to latch on.
Studies showed that newborns whose first bath was delayed were also more likely to have stable body temperatures after that first bath. And a baby who’s cold may be too tired to nurse.
Talk to your birthing team about your wishes on cord cutting and bathing. Your doctor, midwife or doula will likely have recommendations, but the decision is ultimately up to Mom.
