The umbilical cord is a biological lifeline connecting a developing fetus to the placenta, a temporary organ inside the mother’s uterus. Throughout pregnancy, this coiled structure efficiently transfers oxygen and nutrient-rich blood from the placenta to the baby while simultaneously carrying deoxygenated blood and waste products back for disposal. At the moment of birth, the baby’s lungs and circulatory system take over, rendering the umbilical connection obsolete.
Immediate Post-Birth Procedures: Clamping and Cutting
Immediately after birth, the umbilical cord is separated. This process is painless for both the mother and the baby because the cord contains no nerves. Historically, the cord was clamped and cut almost immediately, often within the first 15 to 30 seconds. This practice, known as immediate clamping, has largely been replaced by delayed clamping in many medical settings.
Delayed umbilical cord clamping involves waiting at least 30 to 60 seconds, or sometimes longer, until the cord stops pulsating. This waiting period allows blood transfer, which can increase the infant’s blood volume by up to 30%. This extra blood is packed with red blood cells and hemoglobin. This significantly boosts the baby’s iron stores for up to six months, potentially lowering the risk of iron-deficiency anemia.
For premature infants, delayed clamping is particularly beneficial as it reduces the risk of serious complications, such as intraventricular hemorrhage. The separation process involves placing two small plastic clamps on the cord before a medical provider or family member cuts the cord between them. Immediate clamping is typically reserved only for medical situations requiring immediate neonatal resuscitation or severe maternal hemorrhage.
Caring for the Umbilical Stump
Once the cord is cut, a small remnant, known as the umbilical stump, remains attached to the baby’s abdomen. This stump, initially appearing white, shiny, and damp, begins a natural process of drying and healing. Over the next one to three weeks, the stump will shrivel, change texture, and darken in color before it eventually detaches on its own.
The primary care instruction for the umbilical stump is to keep the area clean and dry to prevent infection and promote detachment. Parents should give sponge baths rather than submerging the baby in a bathtub until the stump has fallen off and the resulting navel is completely healed. To ensure the stump is exposed to air and kept dry, the top of the baby’s diaper should be folded down below the stump.
It is normal to notice a small amount of discharge or blood as the stump nears detachment. However, signs of infection (omphalitis) require prompt medical attention. These include foul-smelling yellow or green discharge, excessive redness or swelling around the base, or if the baby develops a fever or seems generally unwell. After detachment, a small, moist, reddish lump called an umbilical granuloma may form, which often resolves with simple treatment.
Disposition of the Severed Cord
The portion of the umbilical cord that is removed, along with the placenta, is collectively known as the afterbirth. In most hospital settings, this biological material is treated as pathological medical waste and is typically disposed of through incineration. Families, however, have options to utilize this material for medical purposes or to keep it for cultural practices, primarily through stem cell banking.
Cord Blood Banking
Cord blood banking collects the blood remaining in the cord and placenta, which is rich in hematopoietic stem cells. These cells are currently used to treat over 80 blood-related and immune system disorders, such as leukemia and sickle cell anemia.
Cord Tissue Banking
Cord tissue banking involves preserving the cord itself, which contains mesenchymal stem cells (MSCs) found primarily in the gelatinous Wharton’s jelly. MSCs are the focus of research for regenerative medicine, with potential uses in repairing damaged tissues, treating neurological disorders, and managing autoimmune diseases. Families can choose to donate cord blood to a public bank for use by anyone in need, or they can pay to store the cord blood and tissue privately for their family’s exclusive use.