When a baby is born, the umbilical cord is clamped to stop the flow of blood before it is cut. Clamping the cord can be done right away, or it can be done anywhere from 30 seconds to a few minutes after birth. Waiting to clamp the umbilical cord keeps blood flowing to the infant.

In term infants (those born at 37 weeks of pregnancy or later), delayed cord clamping appears to boost a newborn’s iron stores. Iron is the substance in the blood that carries oxygen. Infants who have delayed cord clamping have less risk of anemia in the first year of life. Along with extra iron, the baby receives more antibodies, which help fight infection. There may be ​other ​long-term benefits as well, but research is limited.

​​Delayed umbilical cord clamping in term infants may increase the risk of elevated bilirubin levels. Bilirubin is a yellow pigment made when the body breaks down red blood cells. In adults and older babies, the liver removes bilirubin, but a newborn’s liver may be unable to keep up with this task. When bilirubin levels become too high, infants can develop jaundice (yellow skin coloring). Usually, jaundice goes away by itself. If bilirubin levels are very high, light therapy (also called phototherapy) is given to lower bilirubin levels. ​ ​​

​​Experts conclude, though, that as long as infants are checked for jaundice, the benefits of delayed cord clamping outweigh this small risk.  ​

A preterm baby is one who is born early (before 37 weeks). Preterm babies may have trouble staying warm, are more likely to have low blood pressure, and may need a blood transfusion.

Based on recent studies, delayed umbilical cord clamping has many benefits for preterm babies. It may reduce the number of blood transfusions, improve blood pressure, decrease the risk of bleeding in the brain, and lower the risk of a serious bowel complication called necrotizing enterocolitis. As in term infants, delayed umbilical cord clamping is associated with increased bilirubin levels. However, it doesn’t appear to increase the need for phototherapy. Information on the long-term effects of delayed umbilical cord clamping is limited.

​​In most cases, d​elayed cord clamping does not appear to cause any problems for moms.

Milking or stripping is done by squeezing the blood down the umbilical cord. The doctor or midwife will “strip” a segment of the umbilical cord towards the baby’s abdomen 3 or 4 times before clamping the umbilical cord. This practice shortens the time from delivery to clamping the umbilical cord. It may also transfer a small amount of blood to the baby. Stripping the cord hasn’t been as well studied as delayed cord clamping in infants 32 weeks and older. For very preterm infants (23 to 27 weeks), one recent study found that those who had umbilical cord milking developed bleeding in the brain more often than those who had delayed cord clamping.

The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) support delaying umbilical cord clamping for term and preterm infants for 30 to 60 seconds after delivery. Experts don’t recommend umbilical cord stripping for very preterm infants. They also don’t have enough information to support its use in infants born at 32 weeks or greater.

Cord blood can be collected and stored in either a public or private bank. Donating to a public bank does not cost anything. The cord blood is stored for the use of anyone who needs it. You can also store blood in a public bank for use by an ill sibling or family member. This is called “directed donation.” Special arrangements need to be made for this type of donation.

A private bank charges a fee for you to store your baby’s cord blood for future use by your family. There is only a very small chance you’ll use the cord blood in the future. For this reason, SMFM and ACOG don’t recommend banking (storing) a baby’s cord blood in a private bank.

If you’re considering collecting your baby’s cord blood, delayed cord clamping reduces the amount of cord blood for collection and storage by as much as 40%.

There are some situations where delayed umbilical cord clamping shouldn’t be done, or the benefits have not been demonstrated. Pregnancies with more than one baby, such as twins and triplets, have not been studied. Delayed umbilical cord clamping should not be done in infants needing help with breathing or​ immediate care by the pediatrician.​ If there are certain problems with the placenta, delayed umbilical cord clamping shouldn’t be done because of the increased risk of bleeding for the mother and the possible need for urgent care of the ​newborn​.