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Obstetrics & Gynecology
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Emergency Care: No
Delayed Umbilical Cord Clamping
Provided by: 
By Roy Steinbock
Is it true that waiting to clamp the umbilical cord after delivery is more natural and better for the baby? If so, how long would you recommend waiting?
Currently no one standard exists for when to clamp the umbilical cord. In most labor and delivery rooms, once the baby is born, the doctor immediately clamps the cord, stopping the blood supply from the placenta to the baby, and then cuts it, separating the baby from the mother. This usually happens quickly, allowing immediate bonding between baby and mother or necessary medical intervention. Delayed cord clamping, an alternative to this procedure, means the delivering caregiver waits more than 30 seconds before clamping and cutting. This way, the baby remains connected to the placenta for longer, and more blood can flow towards the baby, increasing its reserve. The suggested time for delayed cord clamping is between one to three minutes, but up to 10 minutes has been shown to be safe.
Current literature about delayed umbilical cord clamping suggests that it is safe and beneficial for some births. For example, it may prevent anemia (low red blood cell count) in the first six months of life, and it could possibly reduce the rates of two common complications of prematurity—intraventricular hemorrhages (brain bleeds) and severe life-threatening infections.
Alas, it may not work for all newborns. Some researchers believe that the babies could develop polycythemia, a condition where the blood is too thick and can clot inappropriately, causing breathing difficulties and even stroke in newborns. Additionally, delayed cord clamping is not suggested in cases where there’s been maternal bleeding or fetal distress, including slow heart rate, meconium staining, or breathing difficulties. In addition, if you are thinking of banking your cord blood for stem cells, early clamping can increase the yield for a better sample.
At this point, we don’t know enough to suggest delayed cord clamping works for all births. If you do decide to delay clamping, here are a couple of suggestions. Ask the delivering caregiver to keep the baby at the level of your belly prior to clamping the umbilical cord. This will allow blood to flow from the placenta to the baby naturally. Don’t delay clamping for more than 10 minutes.
Roy Steinbock, MD, runs the Mindful Pediatrics practice in Boulder, Colorado.
Author: Roy Steinbock
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