Cord clamping for the prevention of iron deficiency anaemia in infants: optimal timing

For centuries, people have been clamping and cutting the umbilical cord at birth. However, the timing of cord clamping continues to vary according to clinical policy and practice, and the optimal timing has not yet been defined.

Early cord clamping is generally carried out in the first 60 seconds after birth, whereas later cord clamping is carried out greater than one minute after the birth or when cord pulsation has ceased.

Delaying cord clamping allows blood flow between the placenta and neonate to continue, which may improve iron status in the infant for up to six months after birth. This may be particularly relevant for infants living in low-resource settings with less access to iron-rich foods.

WHO recommends cord clamping one to three minutes after birth while initiating simultaneous essential newborn care. Early cord clamping (less than one minute after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation.