All interventions Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants
Intervention | Last updated: 9 August 2023
At the time of birth, an infant is still attached to the mother via the umbilical cord, which is part of the placenta. The infant is usually separated from the placenta by clamping the umbilical cord.
Early cord clamping is generally carried out in the first 60 seconds after birth, whereas later cord clamping is carried out more 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 reduced access to iron-rich foods.
WHO Recommendations
Delayed umbilical cord clamping (not earlier than 1 min after birth) is recommended for improved maternal and infant health and nutrition outcomes. Guidelines and guidance documents Learn More 
GRC-approved guidelines
Evidence
Systematic reviews used to develop the guidelines
Rabe H, Diaz-Rossello JL, Duley L, Dowswell T. Cochrane Database of Systematic Reviews. 2012; Issue 8. Art. No.: CD003248.
Summary of this review Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes
McDonald SJ, Middleton P, Dowswell T, Morris PS. Cochrane Database of Systematic Reviews. 2013; Issue 7. Art. No.: CD004074.
Summary of this review Related Cochrane reviews
Rabe H, Gyte GML, Díaz‐Rossello JL, Duley L. Cochrane Database of Systematic Reviews. 2019; Issue 9. Art. No.: CD003248.
Related systematic reviews
Van Rheenen P, Brabin BJ. Annals of Tropical Paediatrics. 2004; 24(1):3–16.
Mathew JL. Indian Pediatrics. 2011; 48:123–129.
Hutton EK, Hassan ES. The Journal of the American Medical Association. 2007; 297(11):1241-1252.
Cost-effectiveness Learn More
Relevant cost-effectiveness analyses have not yet been identified.
Category 1 intervention
Guidelines have been recently approved by the WHO Guidelines Review Committee
