How to Cut the Umbilical Cord of a Baby

Co-authored by Gloria Hines and Cheyenne Main

Last Updated: October 24, 2024 Fact Checked

The umbilical cord is the connection between a mother and their baby.^{[1]
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University of Rochester Medical Center
Leading academic medical center in the U.S. focused on clinical care and research

Go to source} It enters your baby through what eventually becomes their navel, or belly button, and is pretty big, averaging about 50 cm (20 inches) in length and 2 cm (about ¾ inch) in diameter in a full-term baby.^{[2]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} Blood passes through the umbilical cord from your baby to the placenta and then back to your baby by way of a single vein and two arteries.^{[3]
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Research source} Your baby’s umbilical cord will gradually dry up, become hard stiff tissue, and fall off within 1 to 2 weeks, but as a new parent, you have the option of cutting off the umbilical cord.^{[4]
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Part 1

Part 1 of 4:

Clamping and Cutting the Cord at the Hospital

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1
Be aware that clamping and cutting the umbilical cord are not necessary. In fact, some new parents decide to leave the umbilical cord and placenta attached to their baby’s navel and the placenta until it falls off naturally. However, the blood in the placenta may get an infection which could infect your baby.^{[5]
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Michigan Medicine
The University of Michigan's medical center, which provides patient care, supports research, and educates the public on health topics

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- Keeping the umbilical cord on until it falls off naturally can also be cumbersome. Most parents have the cord cut shortly after birth because they don’t feel comfortable with the idea of carrying the placenta with their baby until the umbilical cord separates.
- If you plan to bank your baby’s cord blood, the cord will need to be cut.^{[6]
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  Cleveland Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source} Since the umbilical contains no nerves (like hair or finger nails), neither the mother nor the baby will feel the cut.^{[7]
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  Cleveland Clinic
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2
Your doctor may perform “immediate” clamping within the first moments of your baby’s life. Immediate clamping used to be a common practice because it may reduce postpartum hemorrhage and it allows the baby, especially if they are high risk or premature, to be evaluated right after they are born.^{[8]
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American College of Obstetricians and Gynecologists
Professional association of OB/GYNs focused on education and public outreat initiatives

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- However, delayed clamping is more commonly practiced now.^{[9]
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  PubMed Central
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- One study shows that cutting the umbilical cord at least 60 seconds after birth also reduces the risk of death or the development of a major disability at 2 years old by about 17%.^{[10]
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3
Keep in mind your doctor may do “delayed” clamping. Recently, there has been a shift to delayed clamping, where the umbilical cord is not clamped until 30 seconds or longer after birth.^{[11]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} Waiting 30 to 60 seconds is considered the best amount of time for the infant to receive the largest amount of cord blood in the placenta.^{[12]
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- Some physicians feel that delayed clamping is a more natural process, and provides better circulatory support during the baby’s transition out of the womb.^{[13]
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- At birth, a significant amount of the baby’s blood is still in the placenta and umbilical cord. Delayed clamping allows the baby’s circulatory system to recover much more blood, often as much as ⅓ of the baby’s total blood volume.^{[14]
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  PubMed Central
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- Similar to the procedure in immediate clamping, the newborn is placed on the mother’s chest. Cesarean-delivered babies are held below the mother’s waist so the blood can return to the baby.^{[15]
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  American College of Obstetricians and Gynecologists
  Professional association of OB/GYNs focused on education and public outreat initiatives
  
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Understand the benefits of delayed clamping. In full-term infants, babies with delayed clamping had less anemia and iron deficiency during the first 3 to 6 months. However, in some cases, phototherapy for neonatal jaundice was required.^{[16]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

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- Premature infants whose clamping is delayed have a 50% lower chance of an intraventricular hemorrhage, or bleeding into the fluid cavities in their brain.^{[17]
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- Clamping may be delayed longer if the baby is placed skin-to-skin on the mother.^{[18]
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Be clear about your expectations for clamping your baby’s umbilical cord with your doctor before giving birth.^{[19]
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Part 2

Part 2 of 4:

Clamping and Cutting the Cord at Home

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1
Make sure you have access to the right medical supplies. Cutting the cord is a simple procedure that requires:^{[20]
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Harvard Medical School
Harvard Medical School's Educational Site for the Public

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- Sterile surgical gloves, if available.
- A clean mixing bowl.
- A clean cotton pad or (preferably) sterile gauze.
- A sterile clamp, string, or strip of woven umbilical tape.
- A sterile sharp knife or pair of scissors.
- A plastic bag for the placenta.
2
If the cord is wrapped around your newborn’s neck, slide your finger under the cord. Then, gently pull it over your newborn’s head or loosen it so their body can slip through the loop of the cord. Try not to tug or pull too tightly on the umbilical cord.^{[21]
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- With your baby’s first breaths in the first few seconds after delivery, your baby’s circulation shifts away dramatically from the placenta. In fact, flow of your baby’s blood through the placenta usually completely stops within the first 5 to 10 minutes of birth.
- You can determine when blood flow through the umbilical cord has stopped when you can no longer detect the umbilical cord’s pulse (similar to what the pulse in your wrist or neck feels like).^{[22]
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  Harvard Medical School
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3
Use sterile plastic clamps or umbilical tape to tie off the cord. You can find sterile plastic clamps in bulk online. If you don’t have plastic clamps, use a clean thick string or shoelace to tie around the cord.^{[23]
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Harvard Medical School
Harvard Medical School's Educational Site for the Public

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- While these clamps are very secure, they are bulky and catch easily on clothing.
- If you are using sterile woven umbilical tape, make sure it is at least ⅛ inches wide. You can find this product online in single-use lengths.
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Use cord rings to clamp the cord instead if they’re available. These rubber umbilical rings can be used instead of plastic clamps, umbilical tape, or string.^{[24]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} You can find them at a medical supply store.
- Keep in mind that some brands require additional equipment to place the band on the umbilical cord.
- One type that requires no additional equipment is the AGA umbilical cord ring.
5
Sterilize strings or shoelaces before using them to tie off the cord. In a pinch, you can use woven materials like a shoelace or cotton string. To sterilize it, put the string in a pan of boiling water for 20 minutes. Pour out the water but leave the items in the pan until they’re needed.^{[25]
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- If you can’t boil water, wash the string or lace with soap and water and soak them in alcohol during labor.
- Avoid using thin, strong materials such as dental floss, which could rupture the cord if they are tied too tightly.
6
Tie the knots firmly on the umbilical cord. Wash your hands and put on gloves if available. Double-knot one of the laces around the cord very tightly about 3 in (7.6 cm) from the newborn’s stomach. Tie the other string around the cord about 2 in (5.1 cm) away from the first knot, towards the mother.^{[26]
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- Wait until the cord has stopped pulsating before tying it off.^{[27]
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  Harvard Medical School
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- Keep in mind that although a pulse in the umbilical cord may stop shortly after delivery, significant bleeding may still occur if the cord is not clamped or tied.
7
Prepare the umbilical cord by swabbing between the clamps or ties with an antiseptic solution. Antiseptic solutions may help prevent cord infection and illness. However, there’s limited research on whether using antibiotics or antiseptics is more effective than simply keeping the cord clean and uncontaminated.^{[28]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

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- Try not to use betadine to clean the cord. Betadine is a solution that contains iodine, which could interfere with neonatal hyperthyroidism screening.^{[29]
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  PubMed Central
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- This step may be important if delivery occurs in a public or unhygienic setting.
8
Use a sterile, sharp blade such as a scalpel or a strong pair of scissors. Pick up the tool without touching the blade. The umbilical cord is much tougher than it looks, and will feel like rubber or gristle.^{[30]
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- If the blade or pair of scissors are not sterile, boil them in water for 20 minutes or clean them thoroughly with soap and clean water, and then immerse them in alcohol (70% ethanol or isopropyl alcohol) for 2 to 3 minutes.^{[31]
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If you’re wearing gloves, simply grab the cord.^{[32]
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Research source} The cord may be slippery so this can ensure you have a firm grip on the cord.
10
Cut cleanly between the ties or clamps. Cut between the knots or clamps. Make sure you hold the cord firmly to ensure the cut is clean. Place the end of the cord that’s still connected to the mother’s placenta in a clean medium-sized mixing bowl.^{[33]
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- Place the baby on the mother’s chest and cover them with a towel to keep them warm.
- When the placenta is ready to come out, put the mixing bowl under the mother’s vagina, ask them to sit up and have them push out the placenta into the bowl.

Part 3

Part 3 of 4:

Caring for the Cord Stump

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1
Bathe the baby 24 hours after birth. Most institutions used to bathe the baby an hour or two after birth, however, the World Health Organization recommends delaying the bath for 24 hours.^{[34]
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World Health Organization
Health information and news provided by the World Health Organization

Go to source} If waiting isn’t possible for cultural reasons, wait at least 6 hours.^{[35]
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HealthyChildren.org
Health information from the American Academy of Pediatrics.

Go to source} Sponge baths can be done for the first few days.
- The newborn baby’s risk of hypothermia and dry skin increases if the first bath isn’t delayed. It also can interrupt skin-to-skin bonding and early breastfeeding success.^{[36]
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  HealthyChildren.org
  Health information from the American Academy of Pediatrics.
  
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^{[37]
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Research source} Always dry your hands well before touching the stump as you want to keep the cord stump dry, and exposed to air as much as possible.
3
Avoid touching the cord stump or exposing it to unclean substances. While you need to ensure it is not in contact with any dirty or unclean surfaces or substances, you also don’t want to cover it tightly with a diaper or dressing.^{[38]
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Mayo Clinic
Educational website from one of the world's leading hospitals

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- Parenting specialist Jami Yaeger says it’s “important before the cord falls off to fold the front of the diaper down so that we don't irritate that area.”
- Yaegar also advises parents not to “pull the umbilical cord as it’s healing, even if it's attached by only the tiniest bit. We really want the body to heal itself, and we could do more damage by pulling it off.”
4
Clean the cord stump with a warm damp sponge. Topical substances like antiseptics are not necessary to keep the stump clean. Instead, wrap your baby in a towel and wash each body part with a damp sponge or washcloth. Allow the cord to dry completely to avoid infection.^{[39]
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Cleveland Clinic
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- If stool gets on the cord, gently wipe it off with a washcloth dipped in warm water and soap. Pat it dry with a clean cloth and let it air dry completely.^{[40]
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  Mayo Clinic
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- Alcohol (ethanol and isopropyl alcohol) should be avoided.^{[41]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source} The antibacterial effect of alcohol is brief and can be harmful to the baby. It can also delay the usual 7-14 days of cord drying and separation by a day or two.
- As the area heals, Yaeger says to look for signs of infection. If you see any kind of “oozing, pus, or the area becomes red or pink or swollen, that could be a sign of infection. So that would be the opportunity for the family doctor, doctor, or the pediatrician.”

Part 4

Part 4 of 4:

Collecting Cord Blood

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1
Be aware of your option as a parent to collect and store your baby’s cord blood. You can do this at the time of delivery.^{[42]
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- Long-term cord blood frozen storage can be a source of stem cells that may be used for future treatment of your child or another child.
- Currently, the diseases that may benefit from cord blood are not common. However, as medical science advances, other future uses for cord blood are very likely.^{[43]
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  Harvard Medical School
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Keep in mind you can still collect your baby’s cord blood even if you use delayed clamping. It is not true that delayed clamping of the UC removes the option of cord blood banking.^{[44]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} Delayed clamping may only lessen the amount of cord blood that can be stored or donated.^{[45]
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- Even after the transfer of blood from placenta to baby, additional blood may be acquired from the placenta for storage, if desired.