About Cord Blood

What is delayed cord clamping (DCC)?

After your baby has been born the umbilical cord, which links your placenta to the baby, continues to pulsate and transfer blood and oxygen and stem cells to your baby until baby has transitioned to life outside the uterus and becomes stable.

 

Cutting the cord immediately after the birth has been routine practice for 50-60 years but more recently research is showing that it is not good for the baby as it means the baby misses out on a large amount of blood (214g). This has led to more recent changes in guidelines and practice towards delaying clamping. Waiting until the cord has stopped pulsating and becomes white is becoming increasingly normal practice in births where there is no medical reason to speed things up.

 

Normally the doctor/midwife should be able to feel when this happens by just touching the cord. If there is a reason why time cannot be allowed for this, then the midwife or doctor waits 1-3 minutes following the birth of the baby before clamping and cutting the cord.

SOGC guidance recommends that cord clamping is delayed in all maternity units for at least 1 minutes in all babies unless the fetal heart is less than 60 bpm and not getting faster, at this point, for practical reasons, the baby may need to be taken away to get breathing support.

 

Why is delayed cord clamping recommended by WHO and SOGC?

Delayed cord clamping allows the blood from the placenta to continue being transferred to the baby even after they are born. This means that the baby could receive up to 214g of cord blood, which is about 30% more blood than they would have without it.

 

The benefits of this include:

• increased iron levels in the baby even up until they are six months old which helps with growth and both physical and emotional development.

• increased amount of stem cells, which helps with your baby’s growth and helps with their immune system.

 

Babies who have immediate cord clamping (particularly boys) have also been shown to be more likely to:

• be anaemic at four months of age

• have decreased fine motor skills (coordinating small muscles, such as hands and fingers) at the age of four years

• have decreased social skills at the age of four years.

 

When would DCC not be practised?

In most situations DCC is extremely beneficial. However there are a few circumstances in which it may not be suitable, such as:

• if the mother is bleeding heavily

• there is an issue with the placenta, such as placental abruption, placenta praevia, vasa praevia or the cord is bleeding so the blood is not getting to the baby.

If the baby needs help with breathing (resuscitation) the cord may need to be clamped early if there are no facilities in the hospital to do this beside the mother, however it should be possible to delay cord clamping while the baby is assessed and the breathing support starts.

 

What is the difference between DCC and milking the cord?

DCC is a natural and physiological process where the cord blood is transferred to the baby with no assistance from health professionals. ‘Milking’ the cord occurs when the midwife or doctor push the blood through the cord so it is transferred more quickly. It is a safe technique but it usually only happens if there is a need to speed this process up, most commonly if the baby needs help with their breathing.

 

Should I have DCC on my birth plan?

Yes, you can add DCC to your birth plan, particularly if you know you are at risk of having a premature baby or if you are having a planned caesarean section. Although most units should be practising it, it is taking longer for it to become ingrained in usual practise and the more women who open up the conversation about it, the more usual it becomes.