Umbilical cord care

Who’s going to cut the cord—and when—is a hot delivery-room topic.

Steps Newborn

We all know how it works on television: A baby is born, the awestruck dad reaches for the scissors, and, with a simple snip, a new, separate life begins.

In reality, umbilical cord care is a little more complicated — and messy — than prime-time portrays, and not every dad or birthing partner wants to do the deed.

Luke Harriman didn’t want to cut his daughter’s cord, but felt pressured in the delivery room to do so. “I’m still unsure why there’s such an expectation that the father needs to do it,” he says.

Other fathers, and even some mothers, say they wouldn’t have missed the opportunity to cut their baby’s cord. The emotion can be overwhelming, even if the act itself is tougher (and more rubbery) than anticipated.

“I expected to be able to cut through with a quick snip, but it wasn’t that easy,” says Davindra Ramnarine, a dad from Mississauga, Ont.

The umbilical cord is about an inch thick. It connects the baby to the placenta and enables the transfer of nutrients, oxygen and blood in utero. If you do opt to do it yourselves, a midwife or medical attendant will attach two clamps to the cord, stopping the blood flow and leaving a space to make the cut. You’ll be clearly shown where to snip, and neither mom nor baby will feel a thing.

The umbilical cord is usually cut within 15 to 30 seconds of birth, before the placenta is delivered. But advocates for what’s called delayed cord clamping want medicine’s governing bodies to change their guidelines and extend that period to at least one or two minutes.

During those extra moments, much of a baby’s blood (about 40 percent) is transferred from the placenta, along with essential nutrients like iron, says Eileen Hutton, assistant dean of health sciences and the director of the midwifery education program at McMaster University in Hamilton, Ont. A two-minute delay can boost a baby’s blood levels, protect against iron deficiency and anemia, and transfer more stem cells to the child. These benefits last for at least six months, if not longer.

Delayed clamping may not be an option if your baby needs medical intervention immediately after birth

and waiting to cut the cord during a Caesarean birth is something that’s still being researched. Parents interested in cord-blood banking can’t do delayed clamping either — the blood that’s typically banked would have circulated into the baby’s system by then.

Read more: Cord-blood banking — is it really worth your while?>

If delayed clamping is part of your birth plan, have your birthing partner advocate for it again in the delivery room. “Parents who are knowledgeable can make that request. It’s the parents who can really make a difference,” Hutton says.

After the cut is made, your baby will have a little slug-like blob on his or her belly. In five to 15 days, the stump will shrivel up, turn black, and drop off, leaving a small wound that will become the belly button.

This process can be a bit icky, so it’s essential to keep the area clean using warm water and a sponge or cloth, with a gentle pat dry afterward. Protect the stump by folding down the front of diapers to prevent chafing, washing your hands before and after changing diapers or touching the tummy, and ensuring not to pull on it.

Once the stump falls off, it will take another seven to 10 days for the belly button to heal. Be on alert for signs of infection (fever or lethargy, not wanting to feed, or general unwellness) and seek medical help if the navel area is swollen and red, or the stump is swollen, smelly or oozing.

Father-of-five Sean Gustafson notes that babies might seem fragile, but they’re really quite tough. “It’s a scary thing to take scissors and cut something off a baby. I was nervous, but it does not hurt them at all.”

A version of this article appeared in our August 2013 issue with the headline “Umbilical issues,” p. 52.

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