The Delicate Balance: Oxygen and Deferred Cord Clamping in Neonatal Care

In neonatal care, when to clamp the umbilical cord has always been a big question. For a long time, doctors clamped it right away. But now,more and more evidence shows that waiting to clamp – called deferred cord clamping (DCC) – is better. It helps boost a baby’s iron levels and keeps their blood pressure stable. However, figuring out how oxygen fits into this picture is tricky, and researchers Katheria and Lakshminrusimha recently tackled this in a study published in Pediatric Research in 2025.

Oxygen is essential for life,but giving newborns too much can actually be harmful,especially when they’re adjusting to life outside the womb. The study asks if giving babies extra oxygen during DCC might actually cause problems, even though we usually think of oxygen as always being helpful. The authors wonder if giving supplemental oxygen – something commonly done during newborn resuscitation – could unintentionally increase stress on cells and worsen the outcomes DCC is meant to improve.

When a baby is born, their oxygen needs change quickly. Inside the womb, the baby gets oxygen from the mother. Once they’re born, their lungs start working, and they breathe in air. DCC lets the baby’s lungs start this process while still getting blood from the placenta, making it easier for their heart and lungs to adjust. But adding extra oxygen during this time might disrupt this natural balance, possibly causing cell damage.

Katheria and Lakshminrusimha’s research shows that too much oxygen right after birth could be risky. It might increase the production of reactive oxygen species (ROS), which can damage cells. This is especially concerning for premature babies, whose bodies aren’t as good at protecting themselves from this damage. The authors suggest that giving controlled amounts of oxygen – or even just letting the baby breathe room air – during DCC might be better to avoid thes harmful effects.

Their work highlights the importance of finding the right amount of oxygen for newborns. It suggests we need to update guidelines for newborn resuscitation to reflect the risks of giving too much oxygen during DCC. They also call for better ways to monitor a baby’s oxygen levels and signs of cell damage in real time, so doctors can adjust oxygen delivery more precisely.

This study also explains how too much oxygen can be harmful at a molecular level.