When should the cord be clamped?
Clamping and cutting the umbilical cord after birth is an essential requirement of cord blood collection for stem cell storage. The timing of the cord being clamped is an important consideration for cord blood collection.
Generally when a baby’s cord is clamped within one minute of birth this is called early cord clamping. This method ensures the cord blood remains in the umbilical cord and placenta for collection. Research has shownone of the key factors to successful cord blood transplants is the volume of cord blood infused - the greater the cord blood volume, the better the clinical outcome of the treatment.
Delayed cord clamping is when the umbilical cord is left unclamped for more than one minute or up until the cord stops pulsating. If the umbilical cord is left unclamped, the blood in the placenta will travel back to the baby’s body increasing the baby’s blood volume. The time it takes for this is different for every baby. For many babies this is approximately 3 minutes however some can take up to 10 minutes30. Delayed cord clamping significantly reduces (or drains completely) the cord blood remaining in the umbilical cord after birth. This obviously impacts the ability to collect an adequate volume of cord blood for potential future treatments.
The medical discussion regarding the relative benefits of delayed cord clamping and cord blood collection is complex and controversial. Many considerations are often debated including bleeding after birth (postpartum haemorrhage), birth weight, early and late haemoglobin concentrations, increased iron reserves and jaundice. The Australian medical community does not have a definitive position on delayed cord clamping, though standard practice in most hospitals is early clamping.
The relative benefits with regards to stem cells are also controversial and poorly understood. Delayed clamping returns some stem cells to the baby, but studies have shown that these stem cells disappear from the circulation in a matter of hours. On the other hand, a number of preclinical studies have shown that collecting these and then giving them back later can have significant benefits, particularly when the birth is traumatic, and clinical studies are already underway to examine this more fully.
Cell Care, in collaboration with health care professionals at birth, tries to accommodate the best wishes of the parents. While we note that a delay in cord clamping can impact the volume of your baby’s cord blood collection, a compromise is often reached in the instances where a mother elects to have a delay in clamping of the umbilical cord and collect cord blood.
Cell Care believes the decision around umbilical cord clamping is up to the individuals to make in consultation with their health care professional, but we recommend to parents that they explore their options in the context of their likely birth situation prior to deciding.