There are both immediate AND long-term benefits for babies by delaying the cord clamping. There are benefits for BOTH pre-term and term babies.

Pre-term Specific Benefits:

• Improved Transitional Circulation (1)
  • This refers to the change in circulation during the time baby is born to the time the transition to extrauterine circulation is completed.
• Increased RBC Volume which can lead to decreased need for blood transfusions (1)
• Decreased incidents of necrotizing enterocolitis and intraventricular hemorrhage (1)
  • Necrotizing enterocolitis is inflammation of the intestine that can increase the chance bacteria can invade the body and cause damage or even cellular death to the colon and intestine. This can become life-threatening for the baby (10).
  • Intraventricular Hemorrhage is a brain hemorrhage seen more in babies born at 33 weeks or less, and it has a poor prognosis(11). 

Immediate Benefits:

• Increased SpO2 (Blood Oxygen Saturation) and HR in first 5 mins of life (2)
  • Gives the baby more time to transition to extrauterine life
  • By delaying clamping baby is given extra time to take their first breath and transition to life outside the womb because they are still receiving oxygen and nutrients from the intact umbilical cord
• Increased Hemoglobin and Hematocrit levels (1)
  • Hemoglobin is what contains iron and carries oxygen throughout the body
• Increased incidence of normal thyroid hormone levels (5)
• Increased incidence of Vitamin B12 (5)

Long-term Benefits: 

•  Increased Iron stores at 6 months of life, reducing anemia rates in infants (4)
  • This is likely due to the increase of Hemoglobin after birth from the increased blood volume, 95% of the iron in our body is recycled from old hemoglobin. Only around 5% of the iron is from our diets. Since babies diets are low in iron until they start eating more solid foods, having the increased “head start” from DCC for iron levels can be beneficial
• Increased Myelin content in the brain, which can lead to decreased incidence of neurodevelopmental delays (6,7,8)
  • In the region that controls motor function, visual/spacial and sensory processing at 1 year of age when delayed for 5 mins (7) and also seen as early as 4 months (6)

Risks: 

• There are not any risks aside from hyperbilirubinemia* that I could find in the literature on DCC. The below are two reasons I have seen providers reason against, so being aware of them can be helpful for discussions
• Hyperbilirubinemia* (1)
  • Elevated bilirubin, Bilirubin is a byproduct of red blood cell breakdown. It needs to be broken down by the liver to be excreted out of the body. When it builds up this can cause complications for baby as well as yellowing of the skin and eyes. Baby’s livers are immature and cannot always keep up with the demand of RBC breakdown leading to the build up of bilirubin. 
  • In initial studies, there was a small increased risk of hyperbilirubinemia that required phototherapy treatment but more recent research suggests that it may not increase the bilirubin levels. If it does for any reason, it is not to the point that it requires treatment (3)
• Thoughts that the blood can return to the placenta from baby, especially if lifted above the perineum to be placed skin-to-skin with baby