4:06 min| 53,331 views
Learn about the technique of waiting to clamp the umbilical cord and why you might want to talk to your caregiver about this option.
Mark Sloan M.D. teaches pediatrics and reflective writing at the Santa Rosa Family Medicine Residency program. He is the author of Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth.
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Mark Sloan: Delayed cord clamping refers to the timing of the clamping of the umbilical cord, and current practice amongst many physicians is to do early cord clamping, clamping as soon as the baby's born, cutting the cord. Delayed cord clamping usually involves waiting at least a minute and optimally more like 2 to 3 minutes before clamping the cord.
There are many benefits to delayed cord clamping. The first benefit is that it helps the baby make the transition from the all-liquid world of the womb to the air-filled environment we all live in after birth. The second main advantage of delayed cord clamping involves iron, because iron is necessary for brain growth, and there's about a 3 to 6-month supply of iron in the blood that's in the placenta at birth that needs to be transfused to the baby in order to help them with their brain development.
The process of delayed cord clamping is really not very different from what you'd have with early cord clamping. Generally, with delayed cord clamping, if it's a vaginal birth, the baby will be placed on your tummy with a warm blanket over her and basically wait 2 or 3 minutes for the transfusion to occur from the placenta into the baby, and then the cord is clamped and cut, and that's the end of it, so it's really not a whole lot different than if you had early cord clamping in that regard.
If you deliver by c-section, it's a little more complicated. It's not complicated in terms of what happens with the baby, but you'd want to make sure that the staff knows that you want the delayed cord clamping to happen so they can be prepared with the right drapes and blankets to keep the baby warm while the transfusion occurs. In almost all uncomplicated vaginal births and certainly in many c-sections, delayed cord clamping is possible, but it's good to let your obstetrician or your midwife and particularly the nurses you're working with when you're in the labor and delivery unit know that that's what you'd like to see happen.
Even in cases of emergency, delayed cord clamping is possible many times, but there will be situations where the baby has to be removed quickly, and in those situations, early cord clamping is probably the best thing to do.
As far as risks from delayed cord clamping, for mothers there really are no risks. It has been studied extensively, and they've found that there's no differences in outcomes in terms of infection or hemorrhage in mothers who have early cord clamping or delayed cord clamping, so really no difference at all. In babies, the only difference they have discovered is that there's a slight increase in jaundice in babies who have delayed cord clamping, which makes sense, because jaundice comes from broken-down red blood cells, and the babies who have delayed cord clamping have more blood in their system, so it makes sense that they would be a little more at risk to get jaundice. The studies also showed, though, that jaundice was completely harmless for the kids, so it's my opinion—I think the benefits of delayed cord clamping certainly outweigh the risk of a mild increase in jaundice.
Umbilical cord milking is a procedure that involves the obstetrician holding the cord as close to the placenta as possible and with the other hand just milking the cord, just pressing on the cord and milking the blood from the cord into the baby, allowing it to refill from the placenta and then doing that again. It's a very valuable procedure in premature babies when you have to move kind of quickly, because you can get more blood in quicker than you can by waiting for the transfusion to occur. It can also be useful in c-sections in that you're trying to get the baby from the operating table to a warm bed as quickly as possible, and by milking the cord, sometimes you can get that procedure done quicker. But there's really not much need for umbilical cord milking in an uncomplicated birth, because you have time, there's no rush, and you can just allow the transfusion to occur normally.
It is possible to do both delayed cord clamping and cord blood banking, and the cord blood banks tend to recommend that the cord be clamped at around 2 minutes of age, which allows enough blood to still be in the placenta for them to harvest.