Infection Prevention and Control Perspective on Parents Cutting the Umbilical Cord
From an infection prevention and control standpoint, there is no evidence-based contraindication to parents cutting the umbilical cord, provided standard aseptic technique is maintained with sterile instruments and proper hand hygiene.
Evidence-Based Rationale
The available infection control guidelines and research do not address parental cord cutting as a specific infection risk. The critical infection prevention principles that apply are:
Standard Aseptic Technique Requirements
The cutting instrument must be sterile and the procedure should follow the same aseptic principles used when healthcare workers perform cord clamping 1.
Hand hygiene by anyone handling the cord is protective - studies demonstrate that hand washing by birth attendants reduces umbilical infections by 27% (RR 0.73,95% CI: 0.64-0.84) 2.
The timing of cord clamping (delayed vs. early) does not affect infection transmission rates - neonatal infection positivity was 1.2% with delayed clamping versus 1.3% with early clamping in COVID-19 studies, showing no infection risk difference based on timing 1.
What Actually Matters for Infection Prevention
The infection control literature consistently identifies these modifiable risk factors for umbilical infections:
Application of unclean substances to the cord increases infection risk by 62% compared to clean care 2.
Post-cutting cord care is more critical than who performs the cutting - keeping the cord clean and dry after separation prevents infection in hospital settings 1, 3.
Avoiding topical antiseptics in hospital settings - multiple studies show no advantage of antiseptics over dry cord care for preventing infection or mortality in developed country hospital settings 1, 4, 5.
Practical Implementation Algorithm
Pre-Cutting Requirements
- Ensure sterile scissors or cutting instrument is available 1
- Parent performs hand hygiene with soap and water or alcohol-based hand rub 2
- Healthcare provider supervises and guides the cutting location (between clamps)
During Cutting
- Parent cuts between two clamps placed by healthcare staff
- Standard sterile technique is maintained throughout 1
Post-Cutting Care
- Apply dry cord care protocol - no antiseptics needed in hospital settings 1, 3
- Promote skin-to-skin contact, which reduces infection risk by 36% (RR 0.64,95% CI: 0.43-0.95) 2
- Ensure rooming-in to promote colonization with maternal nonpathogenic flora rather than hospital organisms 1
Critical Infection Control Pitfalls to Avoid
Do not allow application of traditional materials (oils, herbal poultices, ash) which provide contamination sources including Clostridium tetani 1, 2.
Do not use non-sterile instruments - umbilical vessels provide direct vascular access, making sterile technique essential 1.
Do not apply topical antibiotics or antiseptics post-cutting in hospital settings - these provide no benefit and may select for resistant organisms 1, 4, 5.
Ensure proper hand hygiene by all caregivers - this single intervention reduces infection risk by 24-27% 2.
Supporting Context
The infection control evidence focuses on what is applied to the cord and hygiene practices, not on who performs the cutting 1, 2, 4. In community settings with high neonatal mortality, chlorhexidine application reduces mortality by 23% (RR 0.77,95% CI: 0.63-0.94), but this benefit has not been demonstrated in hospital settings in developed countries 4. The key determinant of infection risk is exposure to pathogenic organisms through contaminated substances or poor hand hygiene, not the identity of the person performing the cord cutting 2, 6.