DELAYED CORD CLAMPING
Delayed cord clamping (DCC) is the increase in time between delivery of the baby and the clamping of the umbilical cord. This allows extra blood and stem cells from the placenta (60 – 120ml) to reach the baby.
There is much debate surrounding the optimal time to clamp the umbilical cord. The World Health Organisation findings suggest that late cord clamping (1 – 3 minutes after delivery or longer) is recommended for all births, vaginal and caesarean sections.
The benefits for term babies (those born after 37 weeks) include an increased blood count and reduced iron deficiency. It is also suggested by some studies that DCC can lead to a boost in neurological development. An article published in the American Journal of Obstetrics and Gynaecology in 2018 suggests that DCC in pre-term babies (born before 37 weeks’ gestation) benefit the most. DCC with these infants resulted in a significant reduction in the rate of neonatal deaths, a decreased need for neonatal blood transfusions and a better physiological transition from fetal to newborn life. According to the Royal Australian and New Zealand College of Obstetrician and Gynaecologists (RANZCOG) there is no clear evidence to guide practitioners regarding DCC in term infants, but that infants most likely to benefit are those whose mother is iron deficient during her pregnancy or infants who will be exclusively breast fed without iron supplements. Disadvantages of DCC include an increase in hyperbilirubinaemia which can result in jaundice during the newborn period leading to the need for phototherapy, as well as an increased risk of polycythaemia (increased number of red blood cells) in growth restricted infants. DCC may also reduce the volume of umbilical cord blood available for harvesting stem cells.
I routinely practise DCC for at least one to three minutes unless there is a safety concern for the newborn baby or the mother.
Dr Len Kliman is one of Melbourne’s most experienced and respected obstetricians and gynaecologists.
With over three decades of experience, Dr Kliman has delivered over 20,000 babies and cared for tens of thousands of gynaecological patients.
In 2017, Dr Kliman was awarded an Order of Australia (OAM) for his services to obstetrics and gynaecology.