Cord Clamping: Worth the Wait

Did you know that when your baby is born, 30% of his or her blood will still be in the placenta? Waiting to clamp and cut the cord will allow your baby to receive this vital blood. Babies who get delayed cord clamping, or as it is now being called, appropriately timed cord clamping, have higher iron levels even a year later. And they are less likely to lose significant weight in the first week of life, because they don’t have to burn calories trying to restore their proper blood volume. Waiting to clamp the cord can protect babies against unnecessary formula since early weight loss and low iron are common reasons pediatricians encourage supplementation.

At birth, a new baby transitions from fetus to newborn, and begins to breathe because of the change of temperature. So your baby can begin breathing with the cord intact. This is a gentler beginning, because he or she will still be receiving oxygen from you, via the cord. After breathing, the next newborn job is to begin regulating body temperature. The best place to do this is on your bare chest, and most cords are long enough that babies can comfortably rest there. This is the perfect place to transition; your baby wants to hear your heart beat, smell you, and gaze at your face. Ninety-six degree cord blood flowing in will also help to keep him or her warm. Some obstetricians are still citing a concern about allowing the baby to go skin to skin with the cord intact, but this concern has been debunked.

Sometimes parents worry that their babies will be taken away from them at birth. With the cord intact this is impossible. Many expectant parents have heard to wait until the cord has stopped pulsing. But handling the cord to see if it’s still pulsing will encourage it to stop pulsing. A hands-off approach will allow more of the baby’s own blood to flow into his or her body.

How long should you wait to clamp and cut the cord? Any wait has benefits. The early studies on delayed cord clamping looked at waiting thirty or sixty seconds. There’s a doctor doing a Ted Talk saying we’d save millions of health care dollars worldwide if we waited ninety seconds. But waiting two minutes benefits babies more. And five or ten minutes confers even more benefits. The studies started with the premise of immediate cord clamping, and looked at slight delays. But the biological norm is waiting much longer. If you wait, you’ll notice that the cord goes from thick and dark, to pale or white and stringy. The blood has gone into your baby at that point. There is no too late, the cord can be clamped and cut after you birth the placenta.

Parents sometimes ask me about delayed cord clamping and cord blood banking. It is possible to wait a moment or two prior to clamping, and still have enough cord blood to bank. However, when most or all of the baby’s blood is allowed to enter his or her body at birth, there isn’t enough left to save. Some delay is even possible with a cesarean birth.

In my childbirth classes, I encourage students to ask that the cord not be cut until they request it. Birth is the first transition, and cutting the cord is the next one. They do not need to be done one on top of the other. Immediately after birth parents are usually processing what has happened, smelling their baby, checking the gender, counting fingers and toes. There is no rush, the cord can be cut after they have had a chance to meet their little one. Interested? Read more.