Delayed cord clamping for preterm births

What is delayed cord clamping?

Upon delivery of your baby, we will not immediately stop the flow of blood from the placenta to your baby by clamping the cord. The blood flow will continue for up to 60 seconds before the cord is clamped and cut. Delayed cord clamping (DCC) can be performed at both vaginal births and caesarean sections.

What are the benefits of delayed cord clamping for the baby?

Many research studies have been conducted showing specific benefits of DCC in babies who are born prematurely:

• Provides a gentler transition between life in the womb and life following birth
• Acts as a way of increasing the volume of red blood cells in the baby (placental transfusion)
• Reduces the need for blood transfusions and blood pressure support
• Reduces the risk of death
• Reduces the risk of bleeding in the brain
• Reduces the risk of developing necrotising enterocolitis (NEC), a serious condition where the intestines become inflamed

What does the process involve?

When your baby is born, they will be placed either onto your bed or on a specially adapted piece of equipment that will keep your baby warm and provide oxygen if needed whilst the cord remains unclamped. This equipment will be positioned near your bed and there will be several healthcare professionals present. After 60 seconds, the cord will be clamped and cut and your baby will be moved to another stabilisation platform. The neonatal team will continue to support your baby throughout this time. There may be some instances where your baby is stable enough to stay with you for a short while before being moved.

What are the risks associated with delayed cord clamping?

Babies are at risk of becoming cold – the smaller they are the bigger the risk. To reduce this risk during DCC, your baby may be placed into a special plastic suit and onto the specially adapted piece of equipment that will provide some warmth. We will be monitoring your baby’s temperature.

When will we not perform delayed cord clamping?

There are some circumstances where DCC is not appropriate.

The neonatologist will be working closely with the obstetric team to decide if DCC is appropriate for you and your baby. There are some recognised cases where DCC is not recommended. For example, if there is a significant risk of bleeding from the mother or from the cord then DCC may not be performed. You can find out more about these circumstances from the obstetric and neonatal team.

References / sources of evidence

British Association of Perinatal Medicine (2020) Optimal Cord Management in Preterm Babies (opens in a new tab). (Accessed: 23 April 2021).

European Resuscitation Council (2015) European Resuscitation Council Guidelines for Resuscitation 2015: Section 7. Resuscitation and support of transition of babies at birth (opens in a new tab). (Accessed: 23 April 2021).

Fogarty, M., Osborn, D. A., Askie, L., Seidler, A. L., Hunter, K., Lui, K., Simes, J. and Tarnow-Mordi, W. (2018) ‘Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis’ (opens in a new tab), American Journal of Obstetrics and Gynecology, 218(1), pp. 1-18. doi: 10.1016/j.ajog.2017.10.231.