Risks and Benefits of Delayed Cord Clamping

The Benefits of Delayed Cord Clamping

There are so many benefits to delayed cord clamping. Here is a list of benefits from numerous sources. 

From “Midwife Thinking: The Placenta Essential Resuscitation Equipment” by Dr. Rachel Reed

• Allows fetal blood that was previously in the placenta to transfer back into baby
• As she stated from a Cochrane Review, “higher birth weights, early haemoglobin concentration and increased iron reserves 6 month after birth” in healthy term infants
• Increases baby’s circulating blood volume
• Provides the extra blood volume needed for the heart to direct 50% of it’s output to the lungs, fills capillaries in lungs, making them expand which allow baby to breathe effectively
• Aides lung fluid clearance of tiny air sacks in lungs (alveoli) which also allows baby to breathe effectively
• Increases the number of circulating red blood cells, which carry oxygen, which increases baby’s capacity to send oxygen around the body
• Even with a compromised baby, baby is still receiving some oxygen with placenta attached and circulating

From “Delayed Cord Clamping Should be Standard Practice” by Dr. Nicholas Fogelson

• There is increased tissue oxygenation
• Even a 30 second delay can result in 20-40 ml of blood transfused back into baby
• Decreased rates of intraventricular hemorrhage and necrotizing enterocolitis in preterm babies

From Dr. Nicholas Fogelson’s presentation “Delayed Cord Clamping Ground Rounds”

• Stored iron and body iron higher
• Decreased sepsis and IVH
• Theoretically stated through a research study performed by Tolosa, Park, Eve, KLasko, Borlongan, Sandberg: “increase stem cell therapy that can promote acute benefits in the case of neonatal disease, as well as long term benefits in age related diseases.”

From “Delayed Cord Clamping Podcast” with Dr. Nicholas Fogelson and Dr. Judith Mercer

• Preterm babies need less transfusions
• Higher iron levels in babies 7 months after birth

From “Midwifery Model of Care”

• Improved newborn hematocrit(volume of RBC to total volume of blood)
• Reduced risk of newborn anemia

Possible Concerns from Healthcare Providers

However, like all practices there are some concerns with delayed cord clamping that need to be mentioned.

From “Midwife Thinking: The Placenta Essential Resuscitation Equipment” by Dr. Rachel Reed

• The baby needs resuscitation in a clean, neat area away from concerned parents
• A compromised baby might need external support to make the transition(experienced a rough time during birth)
• The resuscitation area may be attached to the wall

From “Delayed Cord Clamping Should be Standard Practice” by Dr. Nicholas Fogelson

• It is not the norm
• The idea that if the baby is premature, it needs to be brought to the warmer right away

• Has been shown to cause polycythemia(benign per Midwifery Model of Care)
• Jaundice in infants
• High blood viscosity (inherent resistance of blood flow)

From “Delayed Cord Clamping Podcast” with Dr. Nicholas Fogelson and Dr. Judith Mercer

• Used to be believed that it would increase IVH