Delayed Cord Clamping: Benefits, 'Wait Until White', and NHS Guidance
Delayed cord clamping
Delayed cord clamping (DCC) is an evidence-based birth practice where the umbilical cord is not clamped immediately after delivery. Instead, healthcare professionals wait for at least one minute—or until the cord turns white and stops pulsating—before clamping. Supported by NHS and NICE guidance, DCC is increasingly standard in UK maternity care for its benefits to both term and preterm infants.
What Is Delayed Cord Clamping?
In the past, the umbilical cord was clamped and cut within seconds after birth. DCC delays this step, allowing the baby to receive additional blood from the placenta. One key approach is to "wait until white", a visual cue indicating that most placental transfusion has occurred. The cord loses colour and stops pulsing—signs that circulation is complete.
Benefits of Delayed Cord Clamping
For Term Infants
Improved Iron Stores: Increased iron levels support healthy brain development and reduce the risk of anaemia during infancy.
Smoother Cardiovascular Transition: Extra blood volume helps the baby adapt more effectively to life outside the womb.
Higher Haemoglobin Levels: Enhances oxygen transport and immunity in the early months.
For Preterm Infants
Reduced Mortality: DCC for at least 60 seconds can significantly lower the risk of neonatal death.
Fewer Complications: Decreased incidence of brain bleeds, gut issues, and infections.
Less Need for Transfusions: More stable blood pressure and volume reduce intervention rates.
NHS Guidance: 'Wait Until White'
The NHS recommends DCC for most births, aiming for at least 60 seconds or until the cord turns white, unless urgent neonatal care is needed. This “wait until white” approach provides a simple, visible way to maximise the baby's benefit while ensuring clinical safety. It’s endorsed by leading UK maternity units and is feasible in both vaginal and caesarean births, where conditions allow.
Are There Any Risks?
Delayed clamping is safe for most babies. However:
Mild Jaundice: Some babies may have slightly increased bilirubin levels, occasionally requiring phototherapy.
Exceptions: Immediate clamping may be necessary in cases of severe fetal distress or maternal complications.
Healthcare professionals always assess the baby’s condition to determine the safest timing.
Talking About DCC in Your Birth Plan
Expectant parents are encouraged to ask their midwives about DCC and mention it in their birth plans. Shared decision-making ensures that clinical needs and parental preferences are both respected.
Conclusion
Delayed cord clamping, especially the “wait until white” approach, supports newborn health with minimal risk. NHS-backed, this simple practice boosts iron stores, reduces preterm complications, and aligns with current best care standards in the UK. Talk to your maternity team to ensure it’s part of your birth plan.
For NHS information on delayed cord clamping, consult your midwife or visit uhs.nhs.uk and england.nhs.uk.
