Cord clamping — The current recommendation by RANZCOG is to delay umbilical cord clamping for at least 30 to 60 seconds after birth in vigorous term and preterm infants. Studies of delayed cord clamping support a minimum delay of at least one minute in term births and 30 seconds in preterm births.
Approximately 75 percent of blood available for placenta-to-fetus transfusion is transfused in the first minute after birth.
In the well newborn baby, delaying cord clamping can
- increase in neonatal blood volume
- improve neonatal and infant iron stores
- decrease neonatal and infant anaemia
- assist the change from fetal to neonatal circulation
- reduce the chance of brain haemorrhage and ischaemic gut in preterm infants
Delaying cord clamping should not
- interfere with timely care of the newborn
- should never compromise the safety of the mother or newborn.
- be performed when the mother or newborn is clinically unstable
- may not be appropriate in cases of fetal growth restriction
Disadvantages of delayed cord clamping include
- an increase in rates of jaundice and phototherapy
- reduction in the volume of umbilical cord blood available for harvesting stem cells