Delayed Cord Clamping: A Guide to Research and Options

Here’s what parents need to know about the new studies on delayed cord clamping: the research, the benefits, and the options

Delayed cord blood clamping has been receiving noticeable attention during the past year, largely due to the published findings by JAMA Pediatrics. The practice of delayed cord clamping involves putting off umbilical cord clamping after delivery between 90 seconds and three minutes, enabling the stem cell rich blood flow between mother and baby to continue. The possible neonatal advantages following delayed clamping involve a lower frequency of iron deficiency anaemia, reduced need for blood transfusion and a higher blood volume. Neurodevelopment is also a recent point of study around delayed clamping. The evidence supporting these hypotheses has progressed in recent years but surged in 2015 after the largest study on delayed cord clamping published results.

Amidst many clinical institutions, delaying clamping is frowned upon and viewed cautiously, due to popular belief of its negative impact on a child’s future. Essentially, the most commonly perceived issues are: Firstly, delayed clamping may cause an excess in placental transfusion, leading to neonatal polycythemia. This disease involves an increase in red blood cell proportion in the blood, possibly causing fatigue, headache, respiratory difficulty and even strokes. Moreover, post-birth resuscitation may be more difficult following delayed clamping, especially in preterm babies. Finally, some professionals and parents fear that stalling clamping may render cord blood collection, for stem cells, more difficult or inaccessible. Overall, preterm infants seem to benefit most from delayed clamping due to the necessity of the extra minerals found within the blood to deal with possible issues correlated with pre-natality.

Nevertheless, the potential benefits of this delayed cord clamping are evident. Along with an increase in iron supply and higher blood volume which can be helpful to children living in areas where iron deficiency is common, the chance of a child suffering from intra-ventricular hemorrhage is also significantly reduced, by around 50%. “There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth”said Dr. Heike Rabe, “The extra blood at birth helps the baby to cope better with the transition from life in the womb.”

Parents considering delayed cord clamping during their delivery are often faced with the question of whether or not they can bank their baby’s cord blood also. Studies show that around 80 ml of blood is transferred from the placenta in the first minute following birth and 115 ml are supplied after three minutes. Halting blood flow reduced the total supply of blood to a newborn, and decreases the amount of iron income. The The American College of Obstetricians and Gynecologists (ACOG) reaffirmed in 2014 that delaying cord clamping for a minimum of 90 seconds ensures that the child receives the benefits of the additional blood flow. Delaying cord clamping and cord blood banking do not have to be mutually exclusive however. The ACOG also confirmed that delaying clamping for longer than three minutes is unnecessary, given that after that time, the benefits of continuing the delay begin to diminish.

A Swedish study, published by JAMA Pediatrics, was conducted to enlighten the public on the possible effects of delayed umbilical cord clamping. Doctors gathered 263 healthy children; half were to undergo delayed clamping while the other portion received immediate clamping. Four years later, the doctors examined the children, mainly verifying the differences between their social and motor abilities, intelligence quotient, communication skills, and general behavior. The results indicated that the children who received delayed clamping had higher social and fine motor capacities. In addition, doctors noticed that only boys generally displayed better competence to their tests. Therefore, researchers concluded that children born in high-income , low-risk populations, such as Sweden, neurodevelopment may be enhanced by delayed clamping.

Future research in delayed cord blood clamping is an increasing demand among families, and clinics around the world are funding the necessary investigation. Studies such as the one performed by JAMA Pediatrics help to uncover possible benefits of cord clamping, including a child’s motor skills, social skills and neurodevelopment. In addition, with the endorsement by the ACOG, delayed cord clamping and cord blood banking do not need to be at odds. Delaying cord clamping for three minutes or less ensure that the child receives both the immediate health benefits of increased blood flow at a crucial moment and the long term benefits of preserved stem cells that are a 100% genetic match.