Many questions remain about both delayed cord clamping (DCC) and umbilical cord milking (UCM). Al-Wassia and Shah1 report the first meta-analysis of UCM in infants. We review current recommendations and concerns impeding their translation into widespread practice. We next review new meta-analyses in the literature that address some of the remaining knowledge gaps for placental transfusion, including the aforementioned UCM meta-analysis. Finally, we highlight some remaining reasons clinicians should proceed cautiously in adopting these practices.