Should you clamp the umbilical cord within a minute of birth or wait two or three minutes?
A Cochrane Systematic Review considered data from 11 trials that included a total of 2,989 mothers and their babies. The review sought to establish whether the timing of clamping of the umbilical cord was significant in reducing the risk of excessive postpartum bleeding in the mother (postpartum haemorrhage) or had any advantages or disadvantages for the health of the infant
It found that early or late clamping caused no differences for the mother in terms of greater risk of blood loss.
Delaying cord clamping for 2-3 minutes after the birth gives the infant increased amounts of haemoglobin in their first months of life, but may increase the risk of needing phototherapy to treat jaundice. Sometimes a newborn’s liver is slow to break down all of the red cells they had in the womb, particularly if they are left with more fetal blood from delayed cord clamping and phototherapy helps to speed the break down.
Although studies looking at the longer term health of infants are required, the current evidence suggests that there is no disadvantage to the amount of blood loss a mother experiences at the time of birth and there are advantages for babies.
“If there is access to phototherapy treatment, there would appear to be no additional risk in delaying clamping the cord in healthy term infants, particularly as this appears to boost the infant’s stores of iron. This may be of particular benefit for babies with poor nutrition,” says lead researcher Dr Susan McDonald Professor of Midwifery at La Trobe University who also works at Mercy Hospital for Women in Heidelberg, Victoria, Australia.
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