text: Mama Knows Best: Delayed Cord Clamping vs Optimal Cord Clamping
  Delayed cord clamping (DCC) and optimal cord clamping are terms used to refer to the timing of when the umbilical cord is clamped and cut after the birth. In this blog, we'll explore the difference between one and the other, and the benefits of 'waiting for white'. You'll also find additional resources at the bottom of the page to help you choose what's right for you and your baby.
  What is Delayed Cord Clamping?
  Delayed cord clamping refers to the practice of delaying clamping the cord for a period of time after the baby is born, typically for at least 30 seconds and up to several minutes.
  Both the World Health Organisation and NICE (National Institute for Health and Care Excellence) recommend deferring cord clamping until at least 1 minute after birth to improve neonatal outcomes. Although the NHS is now using a delayed approach as standard practice, immediate cord clamping (before 30 seconds) is still routinely done in many places.
  What is Optimal Cord Clamping?
  Optimal Cord Clamping (OCC) refers to the practice of clamping the cord at the optimal time. The optimal time for cord clamping may vary depending on circumstances of the mother and the baby. As most babies have no complications at birth, the cord can be left until it has stopped pulsating ('waiting for white') and baby has fully transitioned naturally to life outside the uterus.
  What are the benefits of Optimal Cord Clamping?
  Although the following benefits are also true by simply delaying cord clamping by a minute or two (to some extent), waiting for the cord to stop pulsating and go limp and white means that baby as received all the goodness that was intended for them.
  Better transition to neonatal life, including a more stable blood pressure.
  Improved iron stores and reduced risk of iron deficiency anaemia.
  43% of all children under the age of 5 are iron deficient anaemic and the biggest cause is early clamping. - The World Health Organisation (WHO)
  "An additional 20-30mg/kg of iron is made available with DCC, which is sufficient for the metabolic needs of a neonate for the first 3-6 months of life" - NHS guidelines.
  Baby receives the remaining 30% of their intended blood volume (50% for premature babies) still present in the placenta at birth, including white cells which are also key to a strong immune system (ready to fight infections).
  Baby receives over a million more stem cells to boost their immune system.
  What if my baby is premature or requires immediate support at birth?
  Studies show that for babies that are premature or are compromised at birth, it is essential that the cord is left for 60 secs and longer if bedside resuscitaire trolleys are available. Premature and compromised babies benefit most from optimal cord clamping.
  Generalised improved outcomes in preterm and low birthweight infants with DCC:
  Reduced incidence of intra-ventricular haemorrhage
  Reduced blood transfusion requirements
  Reduced incidence of sepsis
  Reduced incidence of necrotising enterocolitis (intestinal disease)
  Improved circulatory stability
  More optimal oxygen transport with fewer days on oxygen and ventilation
  Are there any risks or side effects associated with DCC and OCC?
  Studies have shown a small increased chance of neonatal jaundice requiring phototherapy.
  Are there any contraindications to DCC or OCC?
  Here is the list of contraindications according to NHS guidelines: