Dr. Greene at TEDxBrussels on TICC TOCC – Transitioning Immediate Cord Clamping To Optimal Cord Clamping

The practice of immediately clamping the umbilical cord after a baby is born was made popular in 1913. We have now discovered that this can result in up to 10x the risk of developing iron deficiency anemia. There has been a movement to end immediate clamping that is known as delayed clamping, but that does not capture the essence of what is best for baby.  I prefer the term optimal cord clamping because there are times when clamping immediately is indeed what is best for baby. Normally waiting an extra 90 seconds to allow the blood in the cord to pump into baby isn’t a delay at all, but is optimal.

Watch this TEDxBrussels video for more detailed information and my introduction of the campaign to change when we clamp the cord. The campaign is  TICC TOCC.

The solution: Wait until the cord stops actively pumping fetal blood into the baby, unless there is a strong reason otherwise. This has been studied in countries such as Argentina, Australia, Bangladesh, Canada, India, Libya, Mexico, Pakistan, United Kingdom, USA, and Zambia. Optimal cord clamping (a more accurate term than the more frequent ‘delayed’ cord clamping) has been shown to be both safe and effective at significantly reducing the risk of iron deficiency. Other benefits may include reducing birth asphyxia (inadequate oxygen to the brain) and cerebral palsy. The health benefits from receiving the cord’s pluripotent stem cells may be the most significant impact, but has yet to be understood.

Immediate cord clamping is an active medical intervention with unproven benefit. The WHO no longer recommends immediate cord clamping.

More than a quarter million babies will be born today. The clock is ticking.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. kirsty

    Hi , I am very interested to have come across your campaign- I am currently writing my dissertation for my Midwifery degree in the UK on optimal cord clamping and creating an audit proposal for the local trust. Any further info is greatly received.

    • Thanks Kirsty. There’s a nice bibliography on the topic at the bottom of this article TICC TOCC.

      Good luck with your dissertation.


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