Umbilical Cord Milking Helpful in Extremely Preterm

Aug 16, 2013

By David Douglas

NEW YORK (Reuters Health) Aug 16 - Milking the umbilical cord of preterm neonates had some beneficial effects in a recent trial.

Dr. Melissa Marsh of Beth Israel Deaconess Medical Center, Boston and colleagues studied women who were expected to deliver after only 24 to 28 completed weeks of gestation. The researchers randomly assigned the women to cord milking before clamping, or immediate cord clamping.

In all, 36 in the milking group and 39 in the immediate clamping group completed the study. The risk of the primary outcome - need for transfusion - was lower in the milking group, but the difference did not reach significance (risk ratio, 0.86).

Babies in the milking group did have significantly higher hematocrits and were significantly less likely to develop an intraventricular hemorrhage.

"Given that intraventricular hemorrhage is an important contributor to mortality and serious long-term neurodevelopmental disability, if this finding is replicated in other studies, active milking of the umbilical cord could substantially improve neonatal outcomes," the authors wrote in a paper online in the Journal of Perinatology.

There were no significant differences in between-group median Apgar scores at up to 10 minutes, or in rates of other diagnoses or complications of prematurity, including neonatal death.

Summing up, Dr. March noted in an email to Reuters Health, "Our study showed that milking may lessen the need for blood transfusion and reduce brain hemorrhage in these babies. Further study is warranted to validate our findings but preliminary data is certainly encouraging."

In the meantime, the researchers conclude, "routinely implementing this simple practice could potentially have a dramatic benefit on outcomes for preterm infants."

"Milking the umbilical cord when delivering preterm infants, rather than immediately clamping the cord, is an easy intervention that seems to improve outcomes in this extremely susceptible population," Dr. Marsh said.