You’ve been dreaming of this moment for the past 40 weeks (give or take)—your little one is finally here! But after the hard work of labor is done and before you can enjoy newborn bliss, there’s one more piece of the puzzle to deal with: baby’s umbilical cord.
The umbilical cord serves as a life preserver in the womb, so special care is needed as the baby transitions to its independent self after birth. As such, there’s a lot new parents need to know about clamping, cutting and caring for the umbilical cord after birth – from the stump of the umbilical cord to the belly button (aka baby’s belly button).
Cord of Life
For about eight months, the umbilical cord (fully formed at about seven weeks gestation) carries nutrients and oxygen from you to your baby and delivers deoxygenated blood and waste back to the placenta. In full period, it contains two umbilical arteries and an umbilical vein. On average, it’s around 20 inches long.
After childbirth, the blood vessels of the cord tighten and compress stop the flow of blood in any direction. This can happen soon after birth, separating the cord from the placenta, which has been standard care in hospital births for decades. According to American College of Obstetricians and Gynecologists (ACOG), it is best practice for doctors to clamp the cord between 30 and 60 seconds after birth.
Your doctor or midwife will use two (metal or plastic) clamps to reduce or stop blood leakage, and then your partner or care provider can cut the umbilical cord between the two clamps. Neither the birthing parent nor the baby feels pain as the cord is cut because, like your ears, contains no nerves.
Delayed tightening
Although most Western doctors still clamp the cord within a minute of birth, health care providers are taking note of research that suggests the baby benefits from late tightening of the cable, or wait until the cable stops pulsing to tighten. Research shows that the umbilical vein closes a little later than the umbilical arteries, allowing blood to return to the baby in the first few minutes of life, which can provide a healthy boost.
Mark Sloan, MD, MPH, pediatrician and author of Birth Day: A Pediatrician Explores the Science, History, and Miracle of Childbirth, has written about the benefits of delayed cord clamping. “At term, about one-third of the fetus’s blood supply is in the placenta. During labor and delivery, much of this blood is transfused from the placenta to the newborn, driven by the force of uterine contractions,” she explains. “This transfusion continues beyond the moment of birth. If left undisturbed for one to three minutes, the placenta will deliver about three extra ounces of blood to the newborn.”
Studies have shown that a small amount of extra blood can benefit the baby in a number of ways, including providing the healthy iron supply for up to six monthswhich is necessary for growth and development of the baby’s brain.
If you are interested in waiting to clamp the baby’s cord, talk to your healthcare provider about including this request as part of your birth plan. “Most doctors will take a [parent’s] considering wishes and as the benefits of delayed clamping become widely known, many hospitals are shifting to make delayed cord clamping standard care in their labor and delivery units,” says Dr. Sloan.
Cord Blood Banking
If you have selected it collection of umbilical cord blood at the bank for your family or for donation, this happens from the moment the cord is cut and the placenta is born. The healthcare provider retrieves the cord blood sample from the end of the umbilical cord, which is attached to the placenta, while you and your baby bond and remain undisturbed.
After the cord blood is collected in a special bag, it will be processed in a laboratory before being stored in a facility (this can be public or private, depending on what you choose). This blood can later be used to treat certain diseases, including offsetting the side effects of cancer treatment on the immune system.
Umbilical cord stump care
No matter how late you clamp, once it’s cut, you’ll be left with a short stump of wire. According to American Academy of Pediatrics (AAP), the baby’s umbilical cord stump falls out within a few weeks after birth and should heal without complications if dry cord care is practiced and allowed to fall out on its own—no pulling or picking.
Keep it clean and dry as it heals (no rubbing alcohol, which can kill helpful bacteria) and give your baby a sponge bath during this time instead of placing him in a tub of water. Dress the baby in loose clothing and fold the diaper down or cut an opening so it doesn’t rub against the log, allowing the air to dry.
It’s normal to see a few drops of blood in the baby’s diaper after the stump falls out (similar to how a scab might bleed a little). However, the notes the AAP that if the cord area has a yellowish discharge, you notice redness or swelling around the base of the cord stump, a pink fluid lump (granuloma) appears, or the baby cries when you touch the umbilical cord stump or the skin around it, it is signs of infection from the umbilical cord. If the symptoms do not go away on their own or the stump has not fallen after three weeks, contact your pediatrician immediately.
It’s truly incredible how much the umbilical cord does for your baby as it grows and develops in the womb. And even the aftercare required after birth is worth it—because your little one will be left with an adorable, tiny belly button (which is also a reminder of your body’s amazing work).
