Delayed cord clamping – pros and cons

There is this constant debate between the proponents and opponents on the decision of delayed cord clamping. Though this should be a personal choice, here all you need to know about it.

By: Debjani Arora | | Updated: October 9, 2014 5:12 pm

The umbilical cord keeps the baby attached to the mother while inside the womb. But post birth that link is detached to separate the baby from the mother, which is a natural process post birthing. Though this is considered just a medical process to be followed right after the birth, there are a host of benefits that your baby can enjoy if the process is delayed a bit longer.

Clamping the cord denotes the moment just after the baby’s birth, when it is finally recognized as a different being than that of the mother, after nine long months of nourishing and nurturing inside the womb. In the general process the clamping is done once the mother has delivered the placenta and expelled it out of her system after birth. Once the placenta is delivered the cord is clamped at both the ends and then cut through the middle. ‘Ideally the clamping and cutting of the cord has to happen once the cord stops pulsating,’ says Sonali Shivlani, an Internationally Certified Pregnancy, Lactation and Child Nutrition Counsellor. Whether it’s a vaginal birth or a cesarean section in either case it is ideal to cut the cord once it stops to pulse.

In case of a vaginal birth if the delivery of the placenta takes time, a breast crawl by the baby and early suckling can help birth the placenta soon. Yes, the cord is big enough for your baby to reach to your chest. Sometimes the clamping is also done before the placenta is birthed depending on what decision your doctor takes regarding your labour and birth. Also know about the amazing benefits of a breast crawl.

‘Once the delivery is done the father can seek permission from the doctor to cut the baby’s cord,’ says Sonali. This can also initiate the bonding between the father and the baby establishing the first physical connection between them. Also read why should dads practise kangaroo care.

What is delayed cord clamping?

Ideally in a medical set up the cord is clamped and cut within the first few seconds after the birth while the cord is still rich with life. A wait period of two minutes is suggested by experts and practitioners who support the theory of delayed cord clamping and believes in the benefits that the baby can earn from it.

What are the benefits of delayed cord clamping?

Researchers at the University of South Florida’s Center of Excellence for Aging and Brain Repair has a study published in the Journal of Cellular and Molecular Medicine suggesting, stating that at birth, the placenta and umbilical cord starts contracting and pumping blood toward the newborn. After the birth the cord stands to be a rich source of stem cells that are transferred from the mother to the baby and are considered highly beneficial. Hence a delayed cord clamping was suggested.
Delayed clamping can be beneficial for babies who have low birth weights, are premature or born to mothers who are anemic. As an increased blood supply right after the birth makes it easier for the baby’s system to cope well.
It is estimated that a two minute delay in clamping of the cord can provide the baby with an increase in the iron reserve by 27 to 47mg. ‘This results in lower incidences of anemia in the baby during the first few months of life,’ says Sonali.
The cord and the placenta, even after the birth, while pulsating provides the baby with rich sources of nourishment, oxygen and abundance of placental blood supply. This increases the blood volume in the baby that helps to boost the newborn’s health. After the blood equilibrates and the cord’s pulse ceases only then does the blood flow from mother to newborn stops and that’s the ideal time to clamp the cord and separate the physical connection present between them.
Delayed clamping can also reduce the chances of intraventicular hemorrhage, a condition wherein bleeding happens into the fluid filled areas of the brain, especially if the baby is born prior to the expected due date or is premature by birth.

What are the flip sides of performing a delayed cord clamping?

If you have planned for stem cell banking then a delayed cord clamping might not be possible as the cord cells has to be collected right after the birth. So here is a personal choice that you need to make, though many stem cell banking companies might allow a few seconds more of the cord to pulse before clamping, but that definitely won’t be as beneficial as it would if you wait for it to stop pulsating. So here you need to take a decision for your baby.

Some opponents of delayed cord clamping believe that excess flow of blood to the baby after birth can increase the chances of neonatal jaundice.

Now neonatal jaundice happens to most of the newborns and infants during the initial days of their life. Bilirubin is a substance that the body produces due to the breakdown of hemoglobin in the blood, when the body replaces the old red blood cells. This is a basic physiological phenomenon that takes place in the human body.

The bilirubin produced in the process is then expelled out of the body by the liver. The liver enzymes break down bilirubin so that it can be removed from the body through stool and urine. But in case of a newborn whose liver isn’t matured enough, the bilirubin isn’t tactfully expelled out of the body and makes its presence felt by making the baby look yellow under the skin and in the eyes.

One should note that even early clamping can lead to neonatal jaundice and in most cases it is effectively managed and gets over within days. Also read neonatal jaundice — all that you need to know.

What is the right way of taking care of cord after clamping?

After the clamping is done and the cord is cut, a part of the cord would still remain attached to the baby’s navel area. ‘Make no attempt to pull it or twist it in any way. The cord will dry up and fall on its own within the next few days,’ informs Sonali. In case if you notice any inflammation or discharge from the naval area contact your doctor immediately as it could signify an infection on its onset. Else refrain from using any powder or ointment in the area.
Also make sure you don’t hurt the sensitive area by covering it with a nappy or a diaper.
Once the cord dries and falls keep the area clean by following your doctor’s advice. Do not use any over-the-counter products on the navel.
‘The navel area might appear to be a bit protruding, avoid any massages or navel binders. It would heal and settle on its own,’ informs Sonali.

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Published : May 20, 2014 1:54 pm | Updated:October 9, 2014 5:12 pm

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