When Is The Right Time To Cut The Umbilical Cord?

You must have seen reels going viral on cutting the umbilical cord after the baby is born. The videos show where the nurse or a healthcare professional asks a mother to let them cut the cord, whereas the mother denies. It is in one such video posted by @doctormyro, Myro Figura, who is an Anesthesiologist, based in Los Angeles, on his Instagram channel, where he reacts to it. The mother can be seen saying she does not want to cut the cord right away and wants to wait until it turns white.

The doctor who is reacting to the video says, "You absolutely should wait because after the baby comes out, the cord is still pumping nutrient rich blood into the fetus and into your baby as much as 30 to 40% of its blood volume. Cutting that cord early does save a little bit of time for everybody but it robs the baby of critical nutrients in its first day of life." He further goes on to say that "as a patient, you absolutely must have to speak up, because most medical societies now recommend delayed cord clamping. But it is not routine (and) not always done."

The video brings about an important point which many new mothers do not know: the right time to cut the cord.

So, is there really a right time?

As per the World Health Organization (WHO), at the time of birth, an infant is still attached to the mother with the help of the umbilical cord, which is part of the placenta. After birth, the child is separated by clamping the umbilical cord.

WHO notes that early clamping is generally done within the first 60 seconds after birth, whereas later cord clamping is done more than one minute after birth or when the cord pulsation has ceased. These means the cord is no longer expanding and contracting to transfer blood and nutrients to your baby.

WHO also note that delaying this allows blood flow to continue, which can be beneficial for the baby. It can improve their iron status for up to six months after the birth. This is especially helpful in babies born in low-resource settings with reduced access to iron-rich foods. WHO also recommends delayed umbilical cord clamping, which is not earlier than 1 minute after birth for improved maternal and infant health and nutrition outcomes.

However, as per a 2022 study titled Differential effects of delayed cord clamping on bilirubin levels in normal and diabetic pregnancies, it was found that delayed cord clamping indeed led to neonatal hyperemia, erythrocytosis, and hyperbilirubinemia, which increases the risk of neonatal jaundice. It could also may be a risk factor for increase bilirubin levels in neonates of diabetic mothers.

So, how long is not too long? While a mother does not have to wait for the cord to turn white, as WHO recommends, the cord should only be clamped after a minute and not within the first 60 seconds.

What is the umbilical cord?

This connects your baby to the placenta in the uterus. The placenta helps your baby breathe and grow before birth, while the umbilical cord has blood vessels that carry oxygen and food from placenta to your baby. It also carries wastes from your baby to the placenta.