Let's talk about delayed cord clamping, y'all!
It used to be that once baby was born, the umbilical cord was clamped and cut almost immediately. That was just the standard of care in most US hospitals.
There is now a more widespread understanding that when a baby is born, about 1/3 of their blood is not inside their body but is inside the placenta, the organ that filters & cleans the blood during pregnancy.
The baby needs that blood in their body for it to function optimally. In order for that to happen, clamping the umbilical cord must be delayed so the blood can flow from placenta to baby.
I've seen a lot of variation in what local OBs consider delayed cord clamping. Sometimes the cord is clamped around 30 seconds, sometimes around 2 minutes. Sometimes the delay happens while the mother is holding her baby skin to skin, sometimes the baby is not given to the mother until the cord has been clamped and/or cut.
Because of this variation in when a cord is clamped and cut, it's important to have good dialogue with your doctor or midwife about how long you'd like to leave your baby's cord intact, so your care provider will have a clear understanding of what your choice is with clamping.
The current gold standard is delayed cord clamping + immediate skin to skin between mother and baby.
Let's break that down a bit.
Immediate Skin to Skin
The benefits of skin to skin contact between the baby and mother are myriad: it facilitates mother/baby bonding, helps stabilize baby's body temperature, helps with initiating breastfeeding, and so much more. Skin to skin is ideal for both mother and baby immediately following birth.
It is important to clarify if you would like to receive skin to skin with baby while waiting for the cord to be clamped. Some OBs will do this routinely, others may not.
Deciding when to clamp the cord
Research has shown that when a baby is held below the level of the placenta after birth, blood transfusion happens fairly quickly because of the "downhill" flow. When the baby is elevated during skin to skin with mother, blood flow slows down but does not stop. Because of this, more time is needed before cord clamping to allow all of the baby's blood to move from placenta to baby.
Five minutes is the recommended minimum time for delaying cord clamping with skin to skin.
The recommendation to "wait 'til white" is helpful as well, showing how the umbilical cord gradually becomes flat and white as all the baby's blood finishes transfusing. This fabulous photo series below (courtesy of Stephanie Soderbloom, CPM, LM) shows what the cord looks like immediately after birth through what it looks like 15 minutes after birth. You can see the progression of the blood transfusing through the cord to the baby.
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