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About Delayed Cord Clamping

Parents have the opportunity to delay cord clamping and store cord blood with Cell Care.

Introduction

Expectant parents often contact Cell Care to discuss both their child’s cord blood collection and delayed cord clamping options. We recognise the importance of individual birth plans and aim to ensure cord blood collection does not interfere with parents’ birth plans. Here we explore the topic of delayed cord clamping with respect to its impact on cord blood collection.

What is delayed cord clamping?

Delayed cord clamping is the process of allowing the blood from the placenta to flow to the baby for some period of time after the baby is born by delaying the process of clamping and cutting the umbilical cord. There is currently no set definition for delayed cord clamping, and cord clamping times may vary significantly between studies and in practice. Delayed cord clamping can be loosely defined as a delay of greater than 30 seconds to as long as 3 minutes before clamping35,29.

What is recommended?

It is routine practice in Australia (and many other countries) for the umbilical cord to be clamped and cut within 30 seconds of birth36. The Royal Australian College of Obstetricians and Gynaecologists (RANZCOG) recommend early cord clamping “to all pregnant women as this reduces the risk of post-partum haemorrhage and the need for blood transfusion”. “Heavy bleeding after a baby is born (postpartum haemorrhage) is a complication of pregnancy that has the potential to be very serious, even resulting in death in rare cases37."

What do clinical studies report regarding the impact of delayed cord clamping?

Studies show that approximately 80 mL of blood is transferred from the placenta in the first minute following birth, and this reaches approximately 100 mL at 3 minutes after birth38.

Benefits to pre-term infants (born at less than 37 weeks) after delayed cord clamping are reported to include higher blood pressure and haemoglobin, and a lower incidence of anaemia, interventricular haemorrhage and sepsis; the latter two being serious complications affecting babies born very prematurely35.

Delayed cord clamping in full term infants has demonstrated higher birth weight and haemoglobin reserves up to six months after birth. However, these results have not been associated with long term improved clinical outcomes. These results need to be balanced against the reported additional risk of jaundice in newborns that requires phototherapy29 and the additional risk of reducing the volume of a cord blood collection such that it cannot be banked for your children’s future medical use.

Can I choose to do delayed cord clamping and cord blood banking?

The answer is yes. Delayed cord clamping and cord blood banking can be achieved through planning and communication with your Obstetrician or Midwife and Cell Care. Given that up to 80% of blood volume is transferred from the placenta to the baby in the first minute after birth38, Cell Care recommends certainly no more than 1 minute of delayed cord clamping before attempting a cord blood collection. Research has shown one 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 treatment39. Therefore, extended delays in clamping – i.e., beyond 60 seconds – is likely to have a negative impact on the amount of cord blood that may be collected for storage; and if it can be used for future medical treatments.

Considerations for expectant parents:

  • The Royal Australian College of Obstetricians (RANZCOG) recommends early cord clamping to reduce the risk of postpartum haemorrhage (bleeding) and the need for blood transfusion37
  • Significant delays in cord clamping, beyond 60 seconds, could substantially reduce (or drain completely) the blood remaining in the umbilical cord after birth and so reduces the volume able to be collected and stored for potential future medical use for your family
  • Studies have shown the volume of cord blood is a key factor to successful cord blood transplants - the greater the cord blood volume, the better the clinical outcomes39
  • Cell Care’s experienced collectors can manage both delayed cord clamping (for a short period) and cord blood collections. We have successfully stored cord blood in instances where delayed cord clamping was requested
  • Cell Care’s own experience shows that in many cases, we are able to successfully collect above the international family bank average, even with 60 seconds of delayed cord clamping40

What should I do next?

The decision around umbilical cord clamping is up to you to make in consultation with your Obstetrician or Midwife. Cell Care recommends parents explore their options and decide what is right for them.

Please contact Cell Care on 1800 071 075 if you would like more information.