Cord 'milking' improves blood flow in pre-term infants

A technique to increase the blood flow from the umbilical cord into the infant's circulatory system improves blood pressure and red blood cell levels in premature infants delivered by Caesarean section, shows a study by Indian-origin researchers.

The technique, known as cord milking, consists of encircling the cord with the thumb and forefinger, gently squeezing, and slowly pushing the blood through the cord to the infant's abdomen.

For infants delivered by Caesarean section, cord milking appears to offer benefits over the standard practice of waiting 45 to 60 seconds before clamping and then cutting the umbilical cord.

"The study results are very encouraging," said Tonse Raju, chief of National Institute of Child Health and Human Development, NICHD's pregnancy and perinatology branch.

"The results need to be confirmed in a larger number of births, but it appears that umbilical cord milking may prove to be of great benefit to preterm infants delivered via Caesarean."

The team enrolled 197 infants, of which 154 were delivered by Caesarean, with 75 assigned at random to the umbilical cord milking group and 79 assigned to the delayed clamping group.

Of the infants undergoing Caesarean deliveries, those in the cord milking group had higher blood flow in the superior vena cava, the large vein carrying blood from the brain to the heart.

First author Anup C. Katheria, another Indian-American neonatologist at the Neonatal Research Institute at the Sharp Mary Birch Hospital, noted that some studies failed to find a reduction in intraventricular haemorrhage from delayed cord clamping among preterm infants delivered by Caesarean.

Among preterm infants, the delay is believed to protect from intraventricular haemorrhage, or bleeding in the ventricles -- the cavities inside the infant's brain.

The haemorrhage is thought to result from low blood pressure, brought on by having too little blood in the circulatory system.

Cord milking might compensate for diminished blood flow through the umbilical cord and increase the amount of blood available to the infant.

The study was published online in Pediatrics.