• Beneficial for all babies (especially preterm)
• When immediate resuscitation required, resuscitation with intact cord can be performed (if appropriate equipment available) 

• Monochorionic twins
• Conditions where placental circulation is not intact, including:
  • placental abruption
  • bleeding placenta praevia
  • bleeding vasa praevia
  • cord avulsion
• Antenatally diagnosed congenital abnormalities that may require medical intervention immediately after birth e.g.: 
  • congenital diaphragmatic hernia
  • gastroschisis
  • CCAM with thoraco-amniotic shunt
• Babies at high risk of a blood-based infection (e.g. newly diagnosed HIV or hepatitis)
  • most mothers who have low viral loads can safely have DCC
• Acute maternal obstetric emergency
• Baby requires immediate resuscitation 

• Neopuff™
• Single patient use face mask
• Suction
• Plastic bag
• Thermometer/temperature monitoring equipment
• If available, platforms, e.g. LifeStart™ or Concord^® trolley allow for assisted transition and stabilisation of babies whilst allowing for DCC

Pre-delivery

• Discuss benefits and risks of DCC with parents in antenatal appointments and before delivery 
• Provide parents with:
  • opportunity to ask questions
  • parental information leaflet 
• Parents have a choice to decline DCC − decision should be respected and supported by the team 
• Discuss plan for DCC with intact cord stabilisation with midwife/obstetrician before delivery

During delivery

• Babies born to parents who have consented to DCC to receive ≥1 min of DCC, unless clinically contraindicated

• Babies ≥28 weeks’, if DCC not possible, umbilical cord milking recommended
• Following delivery, dry and wrap baby, or if <32 weeks’ gestation and hat applied place immediately into plastic bag 
• Vaginal birth: hold baby below level of perineum, or if appropriate, place baby skin-to-skin with mother following drying and stimulation
  • use pre-warmed towels from resuscitaire to keep baby warm
• Caesarean section delivery: hold baby below level of incision site 
  • prevent heat loss, e.g. place sterile towel over baby, whilst allowing for drying and stimulation
• Where facilities (e.g. LifeStart™ or Concord^® trolley) available, assisted transition and assessment may be commenced while undergoing DCC
  • commence stabilisation as per NLS guidelines (see Resuscitation guideline)
• If deemed more appropriate by obstetric/neonatal team (i.e. in situations where cord is very short) and baby seen to be vigorous − perform DCC without equipment
  • may not allow assessment of heart rate, tone etc. during initial minute
• Babies born within intact amniotic sac: 
  • placental circulation is interrupted 
  • delay cord clamping until cord pulsations stop or up to 1 min if baby is vigorous
  • deliver baby into cot
  • rupture sac
  • if preterm, place baby in plastic bag and transfer to resuscitaire
  • if cord pulsations stopped, clamp cord
• If baby requires intubation/chest compressions, ask for umbilical cord to be cut immediately and commence NLS stabilisation
• Do not delay administration of prophylactic syntocinon 

• Record timing of cord clamping in medical notes

• Jaundice requiring phototherapy
• Hypothermia