Understanding Delayed Cord Clamping: What the Research Says

During the moments following birth, there are a few key decisions that can shape a baby’s early start—and one of them is when to clamp the umbilical cord. This practice, known as delayed cord clamping (DCC), has gained increasing attention over the past decade as more evidence has emerged about its potential effects on newborn health.

Whether you’re planning a hospital or home birth, understanding the research around delayed cord clamping can help you make informed decisionsand note your preferences in your birth plan.

Delayed cord clamping refers to waiting a short period of time—typically 30 seconds to several minutes—before clamping and cutting the umbilical cord after birth. This allows blood to continue flowing from the placenta to the newborn for a brief period, which can influence certain health markers during the first months of life.

Over the years, multiple studies have examined how delaying cord clamping might impact newborns, especially when compared to immediate clamping (within the first few seconds after birth).

1. Increased Iron Stores
Delaying clamping for 1–3 minutes can result in higher iron levels at birth and during infancy. One randomized trial published in JAMA Pediatrics found that babies who had delayed clamping had 30–50% higher iron stores at 4–6 months old.
📌 Source: Andersson et al., JAMA Pediatrics, 2011

2. Greater Blood Volume and Red Blood Cells
During delayed clamping, an estimated 20–35% more blood volume can transfer from the placenta to the baby, which may support oxygen delivery and early circulation.

3. Stem Cells and Immune Support
Placental blood is rich in stem cells, which play a role in organ development, immune function, and tissue repair.

4. Benefits for Preterm Infants
In preterm babies, delayed clamping has been associated with a lower risk of complications such as intraventricular hemorrhage, late-onset sepsis, and necrotizing enterocolitis.
📌 Source: ACOG Committee Opinion No. 684, 2017

One consideration occasionally raised is the potential for jaundice, as the extra red blood cells may increase bilirubin levels. However, recent studies suggest the increase in jaundice is minimal and manageable with standard newborn care. Most professional organizations state that for healthy, term infants, delayed cord clamping is generally safe.

There’s no universal rule, but several organizations offer general guidelines:

• World Health Organization (WHO): Wait at least 60 seconds before clamping the cord. 
• American College of Obstetricians and Gynecologists (ACOG): For both term and preterm infants, a delay of at least 30–60 seconds is supported unless medical concerns arise. 
• Some families opt to wait until the cord stops pulsing, which typically takes 2–5 minutes—referred to as physiologic cord clamping. 

It’s worth noting that cord blood banking and delayed clamping may not always be fully compatible. The longer the delay, the less blood remains in the cord for collection. If you’re considering banking, it’s a good idea to have a conversation with your provider about how to balance both goals.

While delayed cord clamping is becoming more common in hospitals and birthing centers, it’s still helpful to include it in your birth plan and discuss your preferences with your provider ahead of time. In some cases, immediate clamping may still be advised. For example, if the baby needs urgent medical attention. Therefore, it’s important to stay flexible while still communicating your wishes clearly.

Delayed cord clamping is one of many choices parents can consider as part of their birth preparation. Understanding the current research and professional recommendations can help you feel more confident in discussing your options with your care team. Including your preferences in your birth plan and reviewing them with your provider ahead of time helps ensure your goals are understood and respected whenever possible.

Sources:

• Andersson O, et al. (2011). Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomized controlled trial. JAMA Pediatrics. Link 
• ACOG Committee Opinion No. 684 (2017). Delayed Umbilical Cord Clamping After Birth. Link 
• World Health Organization (2014). Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Link