Should You Delay Cutting Your Baby’s Umbilical Cord?

Cutting your new baby’s umbilical cord is a momentous part of birth. It’s the last step in your infant’s transition from cozy womb life to his new one out in the world.

But whether this quick clip is done behind the scenes by your OB/GYN or your husband or partner steps in to do the honors, one thing is becoming more apparent. You’re better off waiting to cut the cord, at least for a few moments. 

The reason? There’s growing evidence that a delay in cord clamping — by just a couple of minutes — can potentially give babies, particularly those born preterm, the best start in life.

Read on to learn more about delaying cutting the umbilical cord and why it can be so beneficial.

What is an umbilical cord?

Forming around the 5-week mark of pregnancy and eventually measuring up to 2 feet long, the umbilical cord is a narrow tube that serves as a literal lifeline. Via this vital conduit, your baby receives nutrient- and oxygen-rich blood from you and sends carbon dioxide and waste products back to your body to get rid of. 

The umbilical cord runs from a central spot in your baby’s belly to the placenta, which manages the flow of molecules and blood cells in both directions. As long as the umbilical cord is attached to your baby, and your placenta is still intact inside you, this important exchange continues.

How long should you wait before cutting the umbilical cord?

Cutting the umbilical cord used to be one of the first things most health care practitioners did when a baby was born — whether vaginally or by C-section — and it was performed quickly. Within 15 to 20 seconds of a baby’s arrival, practitioners used a clamp to stop the blood flow, and the cord would be snipped with scissors (the rest of the cord comes out later on when the placenta is delivered).

But now, medical groups including the World Health Organization (WHO), have recommended a cord cutting delay for most full-term and preterm babies, whether they’re delivered vaginally or via C-section, until one to three minutes after birth. Two other groups, the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend a delay of 30 to 60 seconds.

What are the benefits of delayed cord clamping?

If you’re wondering whether delayed cord clamping is good or bad, you can rest assured that the work on this topic has been extensive. In the early 2000s, researchers studying very preterm infants realized that leaving the cord attached for 45 seconds, rather than the usual 15 or 20, reduced the chance that these tiny babies would need a blood transfusion later. 

After all, every second or minute that the cord stays attached is extra time that mom’s blood is being delivered to the baby’s body. The study revived delayed cord clamping, which had been the norm before the 1950s and since then, dozens of studies have looked at both the short-term and longer-term effects of cord-cutting timing in newborns. 

In 2013, a large review of these studies found that infants whose cord had been cut more than a minute after birth had higher levels of hemoglobin and iron in their blood — both molecules that are needed in those first days and weeks of life to help a baby thrive. Even six months later, babies in the later-cord-cutting group had a lower risk of iron deficiency or anemia. 

Other studies discovered that newborns have reduced inflammation with delayed cord cutting, perhaps because of stem cells that flow into babies’ body along with the blood, as well as less intraventricular hemorrhage, which is bleeding in the brain. And a 2015 study found that children, especially boys, whose cords were cut later had better motor and social skills at 4 years old.

What are the risks of delayed cord clamping? 

Fortunately, there aren't many risks of delayed cord clamping. But there could be a slight increase in cases of jaundice, a condition caused by excess levels of bilirubin that leads to a yellowing of babies’ skin. The fix for jaundice in this case would be phototherapy, which is exposure to light using a certain type of lamp, a blanket or pad to break down the bilirubin.

As for complications for mothers, delayed clamping doesn’t increase the risk of postpartum bleeding, but should this type of bleeding occur, or if there’s an issue with the placenta such as placenta accreta, immediate cord cutting may be necessary.

Is delayed cord clamping for everyone?

No, not everyone will be able to delay cutting their baby's umbilical cord. Maternal bleeding, placenta problems or bleeding relating to placental abruption or placenta previa are some of the complications that may rule out delayed cord clamping. And if your baby’s umbilical cord is knotted or twisted, or begins to come out before your baby does (a condition called cord prolapse), doctors might have to cut it early. 

Similarly, if your baby is having trouble breathing when he’s born, it might be important to cut the cord early so he can get all the help he needs to take those first few breaths. But delayed cord clamping is often still on the table for C-sections, so you still may qualify if you have that kind of birth.

When to talk to your doctor 

If you think you might want to delay the cutting of your baby’s umbilical cord after birth, make sure to talk to your practitioner about it before delivery day. You should also add it to your birth plan. You might also want to request that you hold your newborn on your chest before the cord is cut so you can cuddle your new baby while the extra seconds tick by.

And if you’re planning to bank your baby’s cord blood, cord blood collections can be done after the cord stops pulsating, which means it doesn’t necessarily interfere with delayed clamping. But to be sure you and your doctor are on the same page, talk over the details before your baby’s arrival.

Delayed cord clamping has many benefits if your labor and delivery situation allows for it, so talk to your health care provider about this option before your due date. If it turns out that you are able to delay cutting your baby's umbilical cord, your little one may well reap many healthy rewards for years to come.