Dr Umm Maryam
For many years, it was common practice to clamp and cut the umbilical cord immediately after birth. Today, however, decades of research have changed our understanding of this important moment.
Current evidence shows that, for most healthy babies, waiting a short time before clamping the umbilical cord provides meaningful health benefits without increasing risks for the mother. This practice is known as delayed cord clamping (DCC) and is now recommended by major international health organisations.
What Is Delayed Cord Clamping?
Delayed cord clamping means waiting before clamping and cutting the umbilical cord after birth.
The World Health Organization (WHO) recommends delaying cord clamping for at least one minute after birth, while the American College of Obstetricians and Gynecologists (ACOG) recommends waiting 30-60 seconds in vigorous term and preterm infants.
During this short period, blood continues to flow naturally from the placenta to the baby. This process, known as placental transfusion, allows the baby to receive additional blood, iron, stem cells, and immune cells that support the transition to life outside the womb.
Why Does It Matter?
At birth, a significant amount of the baby’s blood is still within the placenta. Delaying cord clamping allows much of this blood to transfer naturally to the newborn.
Research has shown that this additional blood volume can improve iron stores for several months after birth, reducing the risk of iron deficiency during infancy. Iron plays a vital role in brain development, growth, and learning, making this seemingly simple intervention especially valuable.
Benefits for Full-Term Babies
For healthy term babies, delayed cord clamping has been associated with:
Higher haemoglobin levels at birthImproved iron stores during the first months of life
Reduced risk of iron deficiency in infancy
Potential benefits for early neurodevelopment
These benefits are particularly important in communities where iron deficiency is common.
Benefits for Preterm Babies
The evidence is even stronger for babies born prematurely.
Delayed cord clamping has been shown to:
▪︎ Improve blood circulation after birth
▪︎ Reduce the need for blood transfusions
▪︎ Lower the risk of intraventricular haemorrhage (bleeding into the brain)
▪︎ Reduce the risk of necrotising enterocolitis (a serious bowel condition)
▪︎ Improve cardiovascular stability during the newborn transition
These benefits have made delayed cord clamping a standard recommendation for many preterm births whenever clinically appropriate.
Are There Any Risks?
For most mothers, delayed cord clamping does not increase the risk of postpartum haemorrhage or excessive blood loss.
For babies, there is a small increase in the likelihood of jaundice requiring phototherapy, particularly among term infants.
However, this risk is generally outweighed by the long-term benefits, provided newborns are monitored appropriately after birth.
When Might Immediate Cord Clamping Be Necessary?
Delayed cord clamping is not appropriate in every situation.
Immediate clamping may be necessary if:
▪︎ The baby requires urgent resuscitation that cannot be performed with the cord intact.
▪︎ There is severe maternal bleeding or haemodynamic instability.
▪︎ Certain placental emergencies occur, such as placental abruption or cord avulsion.
▪︎ The clinical team determines that immediate intervention is required for the safety of the mother or baby.
In these situations, the priority is always the wellbeing of both mother and child.
Delayed Cord Clamping Is Not the Same as Lotus Birth
These two practices are often confused.
Delayed cord clamping involves waiting for a short period, typically 30 to 60 seconds or until the pulsation is ceased before clamping and cutting the cord.
Lotus birth, on the other hand, involves leaving the umbilical cord attached to the placenta until it separates naturally over several days.
The Bottom Line
Birth is filled with important decisions, and the timing of cord clamping is one of them.
For most healthy mothers and babies, delayed cord clamping is a simple, evidence-based practice that offers meaningful benefits, particularly by improving the baby’s blood volume and iron stores during early life.
At the same time, birth is unique. There are situations in which immediate cord clamping is medically necessary, and these decisions should always be guided by the clinical condition of the mother and baby.
The goal is not to follow one approach in every circumstance, but to provide care that is informed by the best available evidence while prioritising safety, compassion, and individualised decision-making.
References :
Click to read;
WHO guidelines On Delayed Cord Clamping
ACOG: What is delayed cord clamping?
