Umbilical cord blood has been shown to have many health benefits to your newborn, your family, and to future patients in need of a stem cell transplant. Therefore it’s important to understand your options for taking advantage of this once-in-a-lifetime decision of what to do with your newborn’s cord blood.

As you begin think about your birth plan, delayed cord clamping will be something on your radar screen as part of your third stage of labor.  So will cord blood banking. Both take advantage of the health benefits of cord blood. Therefore, the questions many expectant mothers ask is “Can I delay cord clamping and still bank my child’s cord blood?

The answer is…it’s complicated. Research is still being conducted on the risks and benefits of delayed cord clamping and its impact on cord blood banking. As always, it’s best to talk to your physician about what’s right for you.  Here we share some background information that may be helpful in thinking about your choices.

Given the low volume of cord blood available, Cord for Life^® cannot accept donations from cord clamping delays in excess of 60 seconds.

What is delayed cord clamping?

Delayed cord clamping is a short wait between the delivery of your newborn and the clamping of their umbilical cord. As a result, more of the residual blood in the umbilical cord transfers to your newborn.

What are the benefits?

The World Health Organization (WHO) recommends delaying cord clamping to reduce the risk of postpartum hemorrhage. There is also evidence that delaying cord clamping in healthy newborns increases the iron available for healthy brain development later in life.

Delayed cord clamping may have significant benefits for premature and underweight babies.  For example, it can result in better blood pressure immediately after birth and less medication needed to maintain blood pressure. With delayed cord clamping, premature babies need fewer blood transfusions and are at a lower risk for serious health conditions, such as bleeding into the brain and necrotizing enterocolitis, a critical bowel injury.

Are there any risks?

With delayed cord clamping, there is a small increase in the incidence of jaundice, a potentially serious condition resulting from the breakdown of extra blood cells. Another concern is that delayed clamping could result in an excess of red blood cells, which might slow circulation.

In addition, the World Health Organization does not endorse delaying cord clamping for newborns and premature infants who require assistance with breathing using positive-pressure ventilation.

How long to delay cord clamping?

For healthy newborns, the American College of Obstetricians and Gynecologists recommends a delay of at least 30–60 seconds after birth.  The World Health Organization recommends a delay in cord clamping of at least one minute.  These times could be significantly longer for preterm infants with low to very low birth weight. Depending on the circumstances, recommended delays can be as much as five minutes.

Can I store my child’s cord blood if I delay cord clamping?

There is definitely a trade-off between delaying cord clamping and storing your child’s cord blood.  Here’s why.  As more cord blood transfers to your newborn during childbirth, less is available to store or donate for future use.

Successful cord blood collections rely on having enough blood volume to extract an adequate number of stem cells (known as total nucleated cells or TNCs) for a successful future transfusion.  In fact, studies indicate that a delay in cord clamping of 30 to 60 seconds has a small negative impact on collection of high-TNC-count cord blood units.  Importantly, delaying cord clamping beyond 60 seconds drastically reduces the chances of obtaining clinically useful cord blood units.

For a cord blood unit to have an effective potential use as a transplant product, the collected number of nucleated cells must be very high, typically over 1 billion cells.  The higher the collection volume of cord blood, the more cells are available for banking for future use.  The longer the delay before clamping the cord, the less cord blood volume available for collection (and therefore banking).  Importantly, once you decide to delay cord clamping, you should also consider how to maximize the cord blood collection volume.  With proper training and planning, a short delay in clamping can yield an adequate collection volume with sufficient cells for banking.

Should you wish to delay cord clamping, Cord for Life^® is available to discuss your best options for private banking and public donation.  Our goal is to support the best outcomes for your family and other in need of a cord blood transplant.

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Sources

1. NIH Impact of delayed umbilical cord clamping on public cord blood donations: can we help future patients and benefit infant donors?
2. NIH: Science Update: Delayed Cord clamping may benefit infant brain development, NIH-funded study finds.
3. NCBI: Delayed Cord Clamping in Very Preterm Infants Reduces the Incidence of Intraventricular Hemorrhage and Late-Onset Sepsis: A Randomized, Controlled Trial.
4. NCBI: Transfusion. 2018 Jun;58(6):1427-1433. doi: 10.1111/trf.14574. Epub 2018 Mar 25.
5. American College of Obstetricians and Gynecologists. Delayed Umbilical Cord Clamping After Birth.
6. American Pregnancy Association. Delayed Cord Clamping: The Benefits and Risks.
7. WHO Optimal timing of cord clamping for the prevention of iron deficiency anemia in infants
8. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva, World Health Organization; 2014.
9. Guidelines on basic newborn resuscitation. Geneva, World Health Organization; 2012.
10. WHO recommendations for the prevention and treatment of postpartum hemorrhage; 2012.