Clamping of the umbilical cord is one of the first interventions that occurs after birth. This separates the infant from the placenta, signifying a landmark period during which the newborn transforms into an independent entity. The transition from a fetus to a neonate at birth represents a critical phase in our life. Early or immediate cord clamping is standard practice where delivery of the fetus is followed by immediate clamping of the umbilical cord (<15 seconds). In 2010, the International Liaison Committee on Resuscitation (ILCOR) recommended that cord clamping could be delayed for at least 1 min. Since then for low risk infants, delayed cord clamping has become routine with the delivering providers delaying clamping of the cord for 1 minute prior to initiating routine newborn care. In these low risk infants there have been many published reports demonstrating benefit with delayed cord clamping. The benefits are primarily attributed to an increase in neonatal blood volume, secondary to placenta-fetal transfusion. More recently the benefits of delayed cord clamping have been demonstrated in higher risk infants. In preterm infants, delayed cord clamping decreased the need for inotropic support after birth, decreased the need for blood transfusions and reduced the incidence of necrotizing enterocolitis and intraventricular hemorrhage. These improvements appear more in line with improvements in cardiac function, which may or may not be associated with an increase in blood volume. More recently, in infants with congenital heart disease delayed cord clamping has been shown to be feasible and decreased the need for packed red blood cell transfusions after birth. Despite the benefits of delayed cord clamping on both the cardiopulmonary transition as well as postnatal outcomes, delayed cord clamping has never been employed in infants with congenital diaphragmatic hernia. This is due to the need for immediate resuscitation after birth and the risk of adverse outcomes by delaying the initiation of postnatal care.