Do you ever wonder what babies experience as they make their entrances into the world outside the uterus? Whether they deliver vaginally or by cesarean, this is a profound change for them.
Just think about it for a minute: babies go from a warm, dark, cozy space into noise, light, and cold!
Not only that, but physiologic changes happen, too. Now they will not be receiving oxygen from the umbilical cord; they must breathe air for the first time. So how do we help make this life-changing transition easier and less traumatic for them?
One important concept that has gained traction is delayed cord clamping.
Delayed Cord Clamping
Between the time that a baby is born and the time that the placenta separates from the wall of the uterus, the umbilical cord is still pulsing, bringing blood flow with oxygen, iron, and all manner of good things to the baby.
So why clamp and detach that lifeline immediately?
When we delay clamping the umbilical cord of a healthy vigorous baby for 30-60 seconds, some good things may happen:
- The baby’s blood count is higher. Studies have shown that babies’ iron levels were higher at age 6 months if cord clamping had been delayed. If you will be breast feeding and not supplementing with iron, this could be a benefit for your baby.
- A large review just published in the American Journal of Obstetrics and Gynecology reports that delayed cord clamping reduces the risk of hospital death in preterm infants. And their blood counts tend to be higher, so the need for blood transfusion is lower.
- There may be a lower risk of bleeding in the head, bowel infections, and low blood pressure for babies who have had delayed cord clamping.
- Cord “milking” is an alternative to delayed cord clamping. The cord is simply milked toward the baby a few times, and this practice seems to give babies the same benefits of increased blood counts, just in less time.
Is It For Every Baby?
Not every baby is a good candidate for delayed cord clamping or cord milking.
- If there is a placental abruption (early separation from the wall of the uterus), or a placenta previa, or a tear in the umbilical cord, then the cord needs to be clamped right away to keep the baby from losing blood.
- If there has been concern about poor fetal growth during the pregnancy due to inadequate placental blood flow, the baby may not benefit from delayed cord clamping.
- If a baby has trouble breathing, or has a birth defect that needs immediate support and attention, cord clamping should not be delayed.
- If you plan to collect blood for cord blood banking, there may not be enough blood to be useful for stem cell therapy later on.
- A potential problem with delayed cord clamping is that the newborn’s bilirubin level tends to be a little higher, so babies who have had delayed cord clamping are more likely to be jaundiced and require phototherapy.
Talk with your OB provider. Delayed cord clamping is one of many topics that are good to discuss prior to your baby’s birth.
Find out your provider’s routine, and let him/her know if you have a special request. Do you want the room quiet for the birth? The lights dimmer? Do you want the baby to be placed on your tummy while waiting to clamp the cord?
Your OB provider is the captain of the delivery room and can make these things happen in an uncomplicated birth. Make a plan and talk about it with your provider, but be flexible.
Births don’t always go as planned, and your baby won’t be scarred for life if the right music isn’t playing or the cord is clamped right away!