What is an umbilical cord tie?
An umbilical cord tie is a piece of thread that is used to tie off an umbilical cord when separating the baby from the placenta.
Cord ties are woven with fibres like cotton, wool, linen, bamboo, or a blend, for example with nylon. Personally I prefer using cotton because it’s strong, it’s natural so there’s no microplastics, it’s also vegan-friendly, and it’s easy to get hold of in the form of embroidery threads. All my cord ties are made with cotton thread.
A cord tie is an alternative to the plastic clamp that is traditionally used in almost all settings.
Why would you use a cord tie?
There are several reasons why you might choose to use a cord tie.
The clamps are big, bulky, awkward to move around when changing nappies and dressing the baby, and frankly, they’re really ugly to look at.
In comparison, cord ties are soft against the baby’s skin and take up much less room under the clothes, which makes them more comfortable for baby. They are less likely to get caught as you change baby's nappy and they’re also prettier - especially if you splash out on a crocheted one.
Anecdotally, cords tied off with ties seem to fall off sooner than clamped ones. However, it would be wrong to make a causal link here. It is possible that they fall off sooner because of optimal cord clamping (waiting for the cord to turn white before cutting it), not because of the method used to clamp them. Or it is possible there is no link and it is just coincidence.
How do you use a cord tie?
Tie it in a regular knot around the cord, but make sure it's really tight. Ideally you would hold the ends of the tie under your little fingers, and push your index fingers against each other for leverage in order to get it as tight as possible. Then loop it round to the other side of the cord and repeat. When you're happy it is as tight as you can get it, tie a second knot and then a bow so that the long ends don't dangle, or simply cut the excess off if you don't want a bow.
I appreciate that is a bit woolly as a description, so for those who can see it, here’s a video demonstration:
Some common concerns and questions about cord ties
Not everyone is comfortable with using a cord tie. It’s understandable that we are slightly nervous about using new things, especially when it comes to our children.
Is it more likely to catch than the clamps? In my experience, no. The cord ties are much less bulky which means they don't catch as much, even though they have loose ends or loops if they've been tied in a bow. If you really feel like your cord tie has too much excess, you can cut the ends shorter.
Are there any times where using a cord tie is not the best course of action? Yes there are! Cord ties are just one tool in the box. In the next section I talk about times where you might choose not to use one.
What about oozing or leaking from the stump, is this more likely when using a tie? The short answer is that it depends. A small amount of oozing from the stump can be normal, and you can clean it with some cooled boiled water and sterile gauze. If the cord tie has been used appropriately, then it shouldn't leak any more than a clamp. It is important to tie the cord tie really tight, as tight as you can manage it. Don't bother with fancy knots, just get it super tight.
Do they need to be sterilised in advance? No. You can, if you are concerned, but it isn't necessary. Babies aren't sterile. Birth isn't sterile. Baby clothes aren't sterile. It is incredibly rare for a baby to develop problems around their unbilical cord stump. That being said, don't go dipping your baby in mud or anything. Do clean your baby after nappy changes as you would normally. Standard baby cleanliness is fine!
My cord ties come packaged in a cellophane wrapper with instructions on the back, and they can be used straight from the pack.
The umbilical cord and how it works
The blood in the cord belongs to the baby, not to the mum or gestational parent. At the time of birth, the three blood vessels in the cord are full of blood which is travelling to and from the placenta to collect oxygen and nutrients, and drop off carbon dioxide and waste. The cord is thick with blood, and because it is the baby's blood it carries the baby’s pulse.
In a physiological birth where no early clamping occurs, the baby’s circulatory system slowly changes from pumping blood to the placenta to pick up oxygen, to pumping blood to the lungs instead. The blood in the placenta, which often accounts for around a third of their total blood volume, drains slowly back into the baby. The baby breathes and cries and this circulatory shift occurs, but the speed at which it happens varies from baby to baby - if a baby is slow to breathe then the shift takes longer.
Once all the blood has returned to the baby and the baby is relying exclusively on their own lungs for oxygen rather than their mother or gestational parent, their cord will no longer be filled with blood. It will be limp and floppy and no longer carry a pulse. The best way to describe it is like a piece of cooked spaghetti. The clear/translucent substance that the cord is made from is called Wharton’s Jelly, and it turns white and solidifies. The blood vessels collapse as there is no blood to hold them open, and the Wharton’s Jelly is acting to clamp them shut. Using a cord tie to tie the cord off in this scenario is a very gentle end to this process.
There are some circumstances where a cord will need to be clamped and cut immediately or very soon after birth. In those circumstances the cord blood vessels are still wide open and full of blood. The plastic clamp is the right tool to counteract the pressure of the blood in the cord and close the blood vessels when they haven't shut down by themselves. Using a cord tie in this scenario would potentially lead to more risk of oozing blood, because the cord did not shut itself down physiologically.
Midwives can sometimes be reluctant to use cord ties at births, and want to stick with what they know. If your midwife is not sure about the tie, you can ask them to apply the clamp further down the cord away from the baby (approx 4 inches), and then you can tie the cord tie onto the cord yourself later, and trim off the excess cord with scissors. This is also possible if your birth circumstances mean that the baby’s cord is clamped before the cord has stopped pulsating and turned white.
Did you use a cord tie when your baby was born? Are you thinking about using one for your next birth? Or maybe you have a question that I haven't covered!
Leave me a comment below!