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16 November 2012

Umbilical cord milking has benefits

Umbilical cord milking (UCM), in which cord blood is stripped or "milked" towards the baby, is a safe procedure and in most newborns should be standard practice.

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Umbilical cord milking (UCM), in which cord blood is stripped or "milked" towards the baby, is a safe procedure and in most newborns should be standard practice, according to Indian researchers.

As Dr Amit Upadhyay said, the findings show the approach should be used "on all babies born at near term or term gestation. UCM leads to better blood pressure control soon after birth, without increasing risk of respiratory distress and jaundice. Most importantly, it increased haemoglobin and iron status (checked by ferritin) in babies at 1.5 months of age."

In a November 2 online paper in the American Journal of Obstetrics and Gynecology, Dr Upadhyay of LLRM Medical College, Meerut, and colleagues note that delayed cord clamping (DCC) and umbilical cord milking (UCM) have been shown to prevent anaemia in infants. Whether there was a benefit for full term neonates wasn't clear, however.

How the study was done

The 200 newborns in the current study, all born at more than 35 weeks gestation, had cords clamped within 30 seconds and were randomly assigned to cord milking after cutting and clamping at 25 cm from the umbilicus, or cord clamping near the umbilicus (2 to 3 cm) and no milking.

The mean haemoglobin and haematocrit at 12 hrs and 48 hours was significantly higher in intervention group. Mean blood pressure was also significantly higher in the milking group at up to 48 hours, but was within the normal range.

At six weeks, mean haemoglobin was significantly higher in the milking group (11.9 vs 10.8 mg/dL). This was also the case for mean serum ferritin (355.9 vs 177.5 mcg/L).

No significant differences between groups were seen in heart rate, respiratory rate, polycythemia, serum bilirubin and need for phototherapy.

The researchers believe the method can be used routinely in term neonates but they also point out, "Further studies with longer follow up are needed to establish the sustainability of the advantage in haemoglobin and ferritin later in infancy. Another trial is needed, to compare umbilical cord milking with delayed cord clamping, in term babies."

Nevertheless, Dr Upadhyay concluded that it "should be a standard practice, considering its advantages and simplicity."

(Reuters Health, November 2012)

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