Does Delayed Cord Clamping Increase the Risk of Jaundice?
Delayed cord clamping has become a popular practice in modern birth care, praised for its benefits to newborn health. But as more families opt for this approach, questions arise: One I recieved just this morning:
Does delayed cord clamping increase the risk of jaundice? And if so, how concerned should you be?
Let’s dive into the evidence to give you a clear, balanced view.
What Is Delayed Cord Clamping?
Delayed cord clamping means waiting at least 30 seconds (up to until the cord stops pulsing) after birth before clamping and cutting the umbilical cord. This pause allows extra blood from the placenta to flow into the baby, increasing their blood volume by up to 30%.
The benefits of this practice are compelling:
Higher iron levels and reduced anemia in the first year of life.
Improved transition to life outside the womb, especially for preterm infants.
Better oxygenation and cardiovascular stability right after birth.
For most babies, delayed cord clamping is a gentle, natural start that sets them up for long-term health.
The Jaundice Question
Jaundice is common in newborns, affecting about 60% of full-term babies. It happens when bilirubin, a byproduct of breaking down red blood cells, builds up faster than the liver can process it.
With delayed cord clamping, babies receive extra red blood cells from the placenta. While these cells boost iron stores, they also mean a slightly higher chance of bilirubin buildup.
Here’s what the research says:
A 2013 Cochrane review found that delayed cord clamping leads to increased hemoglobin and iron levels without significantly increasing severe jaundice.
A 2017 meta-analysis noted a slight uptick in jaundice cases needing phototherapy in babies with delayed cord clamping. However, the risk remained low and manageable.
The 2020 ACOG Committee Opinion Summary recommends 30-60 seconds of delayed cord clamping for all preterm infants who are “vigorous.”
In short, yes, delayed cord clamping may lead to slightly higher bilirubin levels, but in most cases, the increase is mild and doesn’t cause long-term harm.
The Benefits Outweigh the Risks
The potential for jaundice is small compared to the significant advantages of delayed cord clamping:
Babies born with higher iron stores are less likely to develop anemia, which supports healthy brain development.
For preemies, delayed cord clamping reduces the risk of complications like intraventricular hemorrhage (bleeding in the brain).
Enhanced blood volume can improve a newborn’s ability to transition to life outside the womb.
Even if jaundice does develop, it’s usually treatable with phototherapy—a common and effective intervention…. But if that’s the case- ask if they have any ‘bili blankets’ so you can hold your baby even if they need to be under lights.
How to Balance the Risks and Benefits
Here’s what to consider when deciding on delayed cord clamping:
Discuss Your Birth Plan: Talk with your provider about delayed cord clamping and how it fits into your overall plan. Most care teams are well-versed in managing the slight increase in bilirubin levels.
Monitor Your Baby: Jaundice usually peaks 2–5 days after birth. Your care team will keep an eye on your baby’s skin tone and bilirubin levels during this time.
Know the Risk Factors: Babies born prematurely, with bruising (like a cephalohematoma), or to moms with certain blood type incompatibilities (e.g., ABO or Rh factor) may have a higher risk of jaundice. Your provider will weigh these factors when considering delayed cord clamping.
In conclusion…
Delayed cord clamping is a beautiful practice that gives your baby a stronger start in life. While it does slightly increase the likelihood of jaundice, the benefits for your baby’s health and development far outweigh this small risk.
As always, the best decision is the one that feels right for your family and is made in partnership with your birth team. With proper monitoring, most babies who experience jaundice recover quickly and thrive.
Have questions about newborn care or how to navigate decisions like this? We’re here to help! Connect with us at Be Well Baby PDX to learn more about supporting your baby’s health from the very first breath.
Love,
Emily 💛
