Delayed Cord Clamping: New ACOG Recommendations

Swaddled Newborn Boy

Recently ACOG, The American College of Obstetricians and Gynecologists, updated their recommendations in regard to umbilical cord clamping after birth.  It is now suggested that clamping is done a full 30 to 60 seconds after birth for all healthy infants, due to multiple proven benefits.

Why do it?

 

It was previously known that preterm infants had a lot to gain from delayed cord clamping when possible, but we now know that it can benefit term babies as well.  For preterm infants, delayed cord clamping is associated with less need for blood transfusions due to higher red blood cell volume and better transitional circulation. Delayed cord clamping also lowers a preterm infant’s chances of contracting necrotizing enterocolitis, an intestinal disease, and lowers their chances of brain hemorrhage.

 

Though it has long been suspected and encouraged, we now can point to official confirmation that delayed cord clamping for term babies is also beneficial. When possible, delaying clamping the cord for your baby can boost their behavioral, cognitive, and motor development later on in life. These important developments are all linked to iron levels, which are improved for several months due to higher hemoglobin levels after birth. This makes iron deficiency less likely within the first year of life, and therefore lessens risk of delayed development.

 

Are there any risks?

 

In term infants, there is a small increase in jaundice occurrence with delayed cord clamping. This requires phototherapy, which ACOG recommends all doctors and providers have readily available in case it is needed.

 

Though some may wonder if delayed cord clamping could get in the way of managing the third stage of labor, there is no research that suggests that the practice increases the risk of postpartum hemorrhage.

 

Delayed cord clamping is not appropriate in the event of:

 

  • Need for resuscitation of the infant
  • Impaired infant placental circulation
  • Abnormal placentation
  • Maternal hemorrhage
  • Hemodynamic instability

 

If delayed cord clamping is not possible, you may have the option of milking the umbilical cord to attempt to push more blood toward the infant before having to clamp. There is currently more research being done on this practice, and not enough at the moment to claim benefit or harm.
Whatever your preferences for your birth, we always recommend that you start a conversation with your OB or midwife before you are in labor! Talking about your options and their common practices will give you more time to make sure that you have a mutual understanding, and will better prepare you both for the experience.