Your Baby's Umbilical Cord

 
All About Your Baby's Umbilical Cord - What you should know about the umbilical cord and delayed cord clamping
 

The decision about your baby's umbilical cord used to be simple: who is going to cut it?

More recently, our clients have also begun to have discussions with their providers about when the umbilical cord can and should be cut. 

Yesterday, the American College of Obstetricians & Gynecologists (ACOG) published a formal recommendation about when the umbilical cord should be clamped and cut, and we want everyone having a baby in Chicago to know all about it.

What is the umbilical cord?

The umbilical cord contains blood vessels that carry blood, nutrients, oxygen, and waste products to and from the placenta. Most cords consist of three vessels, two arteries and one vein, although some cords might only have two vessels which could mean you have additional testing during your pregnancy.

The cord is surrounded by a gelatinous substance called Wharton's Jelly which protects the blood vessels from being occluded.

What is the role of the umbilical cord after the baby is born?

As soon as your baby is born, he or she will begin to breathe and often, but not always, cry. A series of amazing physiological processes changes your baby's entire system involved in breathing and circulating blood. 

The umbilical cord, still attached to the baby and placenta (which is still attached to the uterus for anywhere from 5-30 minutes after birth) can be a source of oxygen for your baby as they make their transition to life on land. Likewise, blood may be trapped in the umbilical cord and placenta during the birth process and will continue to pulsate, or pump, into your baby after he or she is born for a few minutes.

What are the benefits of waiting to cut the umbilical cord?

ACOG states that at least 30-60 seconds of delayed cord clamping, the practice of waiting to clamp and cut the umbilical cord, can be beneficial for both term and preterm babies. Benefits include:

  • For preterm infants, improved circulation of blood during the time your baby is transitioning to being outside of the womb & decreased need for blood transfusion due to the additional blood obtained from the cord and placenta. That's right, the cord and placenta quite literally can serve as a source of transfusion for the most fragile babies.
  • For term infants, delayed cord clamping can improve iron stores and reduce the risk of anemia at during the first year of life.
  • Improved iron levels in both term and preterm babies produce significant cognitive, motor, and behavioral development benefits.

What are the risks of delayed cord clamping?

  • Previously, some believed that delayed cord clamping could increase the risk of the mother hemorrhaging, or bleeding too much, after delivery. However, studies have found that this isn't true.
  • Infants who have delayed cord clamping may have a small increase in jaundice, a yellowing of the skin caused by a variety of mechanisms. 

Where does the baby go during delayed cord clamping?

Your baby will likely be placed right on your abdomen for skin to skin. There is no need for the baby to be lower than the placenta as the placenta can pump blood in any direction.

While the cord continues to pulsate and give your baby additional blood and oxygen, your baby can be dried, assessed, and covered with a warm blanket.

When is delayed cord clamping contraindicated?

  • If delayed cord clamping is interfering with management of the woman's health immediately after birth, such as if the woman is actively hemorrhaging
  • If the attachment of the placenta to the uterus is abnormal
  • If the infant needs immediate resuscitation after birth

Can I bank cord blood and do delayed cord clamping?

Delayed cord clamping may decrease the amount of blood available for cord blood banking. ACOG states that the benefits of delayed cord clamping at this point in time exceed future benefit of cord blood.

ViaCord states that umbilical cord blood can always be collected regardless of when the cord is clamped and cut. It seems that individual circumstances may dictate how much blood remains in the cord after delayed cord clamping and there is no specific timeframe for how long delayed cord clamping could be done to leave enough blood for cord blood banking.

Photo credit: This Is Family Photo