What is an umbilical cord tie?

An umbilical cord tie is a piece of thread (often be braided or crocheted) that is used to tie off the umbilical cord following a baby’s birth in place of a plastic clip.

Why might you choose to use an umbilical cord tie?

There are a number of reasons why you may prefer an umbilical cord tie rather than the plastic clip when. Here are some things that families I have worked with have discussed with me:

They felt that a cotton tie would be more comfortable for their baby.
A cotton cord tie was lighter and less bulky which meant the cord stump was less likely to be tugged or caught.
It makes skin to skin snuggles easier and more comfortable for parents.
They look nice and come in lots of different designs and colours.
Reducing single use plastic usage.
It is a more traditional practice.
They can make beautiful keepsakes.

Some parents prefer the gentle and more traditional approach of using a cord tie. Unlike clamps, which are made of plastic and can be bulky and uncomfortable for the baby, cord ties are made of soft and pliable materials like thread or ribbon. They can be wrapped around the cord in a way that is gentle and flexible, allowing for a more natural transition from the womb to the outside world.

Another reason some parents may choose to use a cord tie is because it allows for a longer delay in cutting the umbilical cord. Delayed cord clamping is a practice that involves waiting for an extended period of time after the baby is born before cutting the cord, ideally where possible waiting until the cord has stopped pulsating and is white often called optimal cord clamping. This allows for more blood and nutrients to transfer from the placenta to the baby, which can have health benefits such as:

Increasing

Blood volume.
Blood pressure.
Cerebral oxygenation.
Red blood cell flow.
Breast feeding duration.
Stem cell volume.

Reducing

Intraventricular haemorrhage.
Necrotizing enterocolitis.
Late-onset sepsis.
Need for blood transfusions for low blood pressure or anaemia.
Need for mechanical ventilation.
Umbilical infections.

Cord ties are more flexible and less bulky than clamps, which can make it easier to delay cord cutting while still maintaining a safe and secure tie.

Finally, some midwives and healthcare providers believe that cord ties may have benefits over clamps when it comes to healing and scarring. Because cord ties are made of softer materials and are less bulky than clamps, they may allow for a smoother healing process. However, it’s important to note that more research is needed to confirm these findings.

What do I need to consider when using an umbilical cord tie?

As a doula, I believe in providing information and support to help you make informed decisions about your childbirth experience. While umbilical cord ties can be a gentle and natural alternative to cord clamps, it’s important to understand the potential concerns associated with this method.

One concern is the risk of infection. The umbilical cord is a potential entry point for bacteria and viruses, so it’s important to ensure that the cord tie is sterile and that the cord is cut and tied in a clean and hygienic environment. Your healthcare provider can provide guidance on how to care for the cord after it’s been cut to help prevent infection. Delayed cord clamping can reduce this risk.

It’s also worth noting that there is no standardization for cord ties, which means that different types of ties may be used and tied in different ways. This can make it difficult to compare outcomes and ensure consistency in care. However, many midwives and healthcare providers who use cord ties have developed their own techniques and have found them to be safe and effective.

However, there is limited research on the safety and effectiveness of cord ties compared to cord clamps. While some studies suggest that cord ties may have benefits over cord clamps, more research is needed to confirm these findings and identify any potential risks or complications.

How do you use an umbilical cord tie?

Before your baby is born

Whilst there is no evidence that a cord tie needs to be be sterilised before your baby’s birth this is something that healthcare professional may ask you to do.

There are two ways to do this:

Boiling water sterilisation: The NHS recommends submerging in boiling water for 10 minutes, the umbilical cord tie will then need to be dried and kept clean until use.

Oven sterilisation: place the umbilical cord tie in an envelope and place in a hot oven for an hour. Keep in the envelope until needed

Once an umbilical cord tie or even the plastic clamp has been removed from its packaging and handled it is no longer sterile.

On the day of your baby’s birth

Once your baby’s umbilical cord has stopped pulsating, or at the time directed by your midwife the cord will be clamped.

Wrap the tie around the umbilical cord once, pull tight and tie a single knot.
Wrap the tie around to the other side of the umbilical cord, pull tight and tie a double knot.
Tie the loose ends into a bow or trim.
The cord can now be cut above where the tie is fastened.
The cord tie stays in place until the umbilicxal stump comes away naturally.