Delayed Cord Clamping & Cord Blood Banking

Delayed cord clamping is a practice of waiting between the delivery of a newborn and the clamping of the umbilical cord to allow for extra blood to transfer from the placenta to the baby. Delayed cord clamping appears to be beneficial in preterm babies to improve blood circulation and decrease the risk of some complications. Today, many parents are also delaying the clamping of the cord in their term pregnancies to allow more blood to enter the baby and to increase the amount of hemoglobin and iron in the child. A lowered risk of iron deficiency may result. One study even found improvements in fine-motor and social skills. (A different study found no effect on overall neurodevelopment.)¹

Positive findings have prompted the World Health Organization, the Royal College of Obstetrics and, jointly, the American Academy of Pediatrics and American College of Obstetrics and Gynecologists (ACOG) to recommend delaying the cord clamping in both preterm and term deliveries. (ACOG does note a small increase in cases of jaundice with the increase of red blood cells from delayed clamping.)

What is the optimal clamping time?

The benefits of delaying have been demonstrated, but the optimal time to clamp the umbilical cord is not as clear. Studies have shown a benefit when the cord is clamped upto one minute with any benefits diminishing thereafter. ACOG recommends to delay clamping for 30–60 seconds.

Can I choose to do delayed cord clamping and cord blood banking?

Yes. While delays in clamping the cord can reduce the volume of cord blood available, a number of studies have found that a reasonable delay can still retain enough for banking. Because the benefits of clamping the cord start to diminish after one minute and a continued delay could have an impact on the amount of cord blood collected, we advise parents to follow ACOG recommendations and delay clamping of the cord for 30–60 seconds.

Even if the volume is low, there is a possibility your baby’s cord blood can still be used in regenerative medicine. In addition, scientists are working on ways to greatly multiply the number of stem cells found in a cord blood collection, possibly allowing smaller stored units to be utilized to a greater effect in the future.

Don’t Forget the Processing Method

A major factor weighing on the procurement of enough stem cells from a smaller volume collection is the method used to process the cord blood. There are four different processing methods available: AXP, HES, PrepaCyte-CB & Sepax. In our review of the four cord blood processing methods, we said PrepaCyte-CB can easily be recommended because it provides a very “clean” cord blood product and is also effective with small collections, which is important for people who want to delay the cord clamping. As noted by one defining study that showed the importance of the processing method and how they can perform with smaller volumes:

“PrepaCyte-CB was the most flexible method; the only processing type unaffected by volume. Results indicate that processing choice is important depending on your final intended use.”²

The Sepax device also provides a great cord blood product and can utilize Hestarch to help recover more stem cells from smaller collections.

Sources:
1. Ciubotariu, R., Scaradavou, A., Ciubotariu, I., Tarnawski, M., Lloyd, S., Albano, M., . . . Grunebaum, A. (2018, March 25). Impact of delayed umbilical cord clamping on public cord blood donations: Can we help future patients and benefit infant donors? Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/trf.14574
2. Basford, C., Forraz, N., Habibollah, S., Hanger, K., & McGuckin, C. (2010, May). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4022688/