Delayed Umbilical Cord Clamping – What is it, and how much of an impact does it really have?
Written by Emily Stevens, Nutrition and Dietetics Student
Reviewed by Rachel Hilts, PDt
When we think about infant nutrition, we often think about the importance of maternal dietary intake during pregnancy, breastfeeding, and food sources for infants. While all of these factors are important to discuss, did you know that certain birthing practices can also affect your baby's nutritional status?
One of these critical birthing practices is delayed umbilical cord clamping.
What is delayed umbilical cord clamping?
After birth, circulation from the placenta to the infant occurs for several minutes through the umbilical cord (1). Delayed cord clamping can be defined as any delay in clamping the umbilical cord for longer than 1-minute. In contrast, early cord clamping occurs within the first 60 seconds after birth (1). Allowing the umbilical cord to remain intact during this time allows for the placental blood to be transferred to the infant (1).
By delaying cord clamping, babies have increased iron levels at 6 months of age, as well as increased levels of hemoglobin (an iron-rich protein in our blood that helps to transport oxygen) at birth (1). Delayed cord claming has been recommended by many different health organizations, including the WHO and the Society of Obstetricians and Gynaecologists of Canada, as it has been shown to help improve health and nutition outcomes for both mom and baby (1,2,3).
By waiting just 3 minutes after birth, rather than clamping the umbilical cord right away, an average of 80-100ml of blood can be transferred from the placenta to the baby – this can make a big difference in the total blood volume of a newborn (4)!
So why is delayed umbilical cord clamping important? How does it affect my baby's nutritional status?
The process of delayed umbilical cord clamping offers various benefits, but most notably, the increased iron status in infants. The additional blood that is passed through the umbilical cord with delayed cord clamping supplies a large quantity of iron, roughly 40-50 mg/kg of body weight, which can help prevent deficiency for the first year of life (4).
Iron is an essential micronutrient that plays a crucial role in developing hemoglobin, which transports oxygen in red blood cells across the body (5). Iron is also important for supporting brain development in infants and children (5). Human milk typically has low quantities of iron (6). Because many babies are exclusively breastfed for the first six months of life, the iron stores an infant obtains from its mother during pregnancy and birth must be sufficient for the first six months of life. Once a baby reaches six months of age, its iron stores have become depleted (6); this is why starting complementary feeding with iron-rich foods is essential at six months!
Delayed cord clamping has both short and long term benefits (7):
Immediate impact: Delayed umbilical cord clamping provides your baby with improved blood volume and birth iron stores.
Short-term outcomes: In preterm infants, delayed umbilical cord clamping improves blood status and decreases the risk of birth complications (such as intraventricular hemorrhage, late-onset sepsis, and the need for blood transfusions or mechanical ventilation).
Long-term outcomes: For infants born full term, delayed cord clamping improves iron status through six months of age. In preterm infants, it improves iron status through six months of age and improves hematological status through 10-weeks.
Long-term consequences: Improved iron status in infants may prevent the potentially harmful impacts iron deficiency can have on motor and cognitive development.
In short, keeping the umbilical cord attached for a few extra minutes at birth (1-3 minutes minimum is recommended) may provide a benefit to your babies neurological development years later, by both reducing birth complications, and improving iron status (3).
There are, of course, times when it may be medically necessary to to clamp the cord sooner, for example if there is a need for urgent medical care for mom or baby, so it’s important to talk to your healthcare provider before birth and come up with a birthing plan.
References
1. World Health Organization. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. 2014. [cited 2021 Oct 29] Available from: https://apps.who.int/iris/bitstream/handle/10665/148793/?sequence=1
2. World Health Organization. Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants. 2021. [cited 2021 Oct 29] Available from: https://www.who.int/elena/titles/full_recommendations/cord_clamping/en/
3. The Society of Obstetricians and Gynecologists of Canada. Delayed cord clamping. 2021. [cited 2021 Oct 29] Available from: https://www.pregnancyinfo.ca/birth/delivery/delayed-cord-clamping/
4. The American College of Obstetricians and Gynaecologists. Delayed Umbilical Cord Clamping After Birth. 2020. ACOG. [cited 2021 Oct 29] Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/12/delayed-umbilical-cord-clamping-after-birth
5. Centers for Disease Control and Prevention. Breastfeeding: Iron. 2021. [cited 2021 Oct 29] Available from: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/iron.html
6. Friel J, Qasem W, Cai C. Iron and the Breastfed Infant. 2018. Antioxidants 7(54):1-8
7. Chaparro CM, Lutter CK. Incorporating nutrition into delivery care: delivery care practices that affect child nutrition and maternal health. Mat and Child Nutr. 2009. 5:322-333
