Effect of Milking Versus Delayed Umbilical Cord Clamping on Physiologic Anemia of the Newborn Infant

Abstract

O ptimal timing for clamping the umbilical cord at term birth is unclear. Early clamping allows for immediate transfer of the infant to the neonatologist. Delaying clamping allows blood flow between the placenta, the umbilical cord and the baby to continue. Milking cord allows blood flow between the placenta, the umbilical cord and the baby to continue in short time and transfer of fetus to the neonatologist.The blood which transfers to the baby between birth and cord clamping is called placental transfusion. Placental transfusion may improve circulating volume at birth, which may in turn improve outcome for term infants. Delayed cord clamping has been associated with increased placenta-to-neonate transfusion, leading to an increase in neonatal blood volume at birth. This increases iron stores and hemoglobin concentration, decreasing in the risk of anemia, intraventricular hemorrhage and necrotizing enterocolitis. On the other hand, milking of the umbilical cord five times within 10 to 12 seconds seems to be as effective in terms of placental transfusion as delaying cord clamping. However, this observation is based on one randomized controlled trial in the preterm population only.