The moment a newborn baby takes his very first breath, there is still about one-third of his blood volume remaining in the placenta. Instead of leaving it in the placenta, delaying clamping and cutting of the cord allows the baby’s own blood to return to his body and has been shown to lead to higher blood counts and iron stores — both useful in the baby’s first few months of life. In fact, one study demonstrated a 90% reduction of iron-deficiency anemia at 4 months of age when cutting of the umbilical cord was delayed. But cutting of the cord quickly has its own advantages, including making more blood available if parents choose to store the baby’s stem cells.

When, then, should the umbilical cord be cut? Its timing, says Azadeh Ansari, has historically been controversial:

Doctors say before the mid-1950s, when many babies were delivered by midwives, most cord cutting happened when the umbilical cord stopped pulsating, around five minutes after birth. Despite a growing body of medical evidence, the exact time frame when the cord should be clamped continues to be a controversial topic among the medical community.

According to the American College of Obstetrician and Gynecologists, or ACOG, generally most umbilical cord clamping happens within 15 to 20 seconds after birth. The ACOG does not endorse the practice of delayed cord clamping but rather suggests cord clamping should take place between 30 to 60 seconds after birth, since the ideal timing for cord clamping has yet to be established.

Many international health organizations, including the World Health Organization, now recommend umbilical cord clamping be performed from one to three minutes after birth.


New research from Sweden, published in last week’s JAMA Pediatrics, indicates that delayed cord cutting has positive developmental outcomes. 263 children were divided into an “early” cord-clamping group (within 10 seconds of birth) and a “late” cord-clamping group (at least 3 minutes after birth) and then followed for their first 4 years. Psychological testing assessed IQ, motor skills, and behavior; parents reported on developmental skills such as communication, problem solving, and social skills. While IQ and behavior were similar in both groups, the researches found better fine motor and social skills in the group whose cord clamping was delayed. Interestingly, these differences were noticed only among boys. Kathryn Doyle learned from the study’s lead author that preventing iron-deficiency by delaying cord clamping has its developmental benefits:

Iron deficiency is much more common among male infants than among females, Andersson said.

“Girls have higher iron stores when they are born,” he said.

Delaying cord clamping by three minutes allows an extra 3.5 ounces of blood to transfuse to the baby, which is equivalent to a half a gallon of blood for an adult, Andersson said.

“There’s a lot of iron in that volume,” he said. “Even three minutes can have quite a lot of effect on the iron in the blood in the body for a long time after birth.”


Is there harm in waiting at least three minutes before cutting the umbilical cord? For most healthy full-term newborns who require no immediate resuscitation, the answer appears to be no. How long it takes for obstetricians and midwives to come around and refrain from cutting the cord too quickly remains to be seen.