Umbilical Cord Milking – Benefits For Preterm Newborns

Umbilical cord milking has been gaining recognition in the medical community in recent years. It shows signs of being an answer to some of the health risks faced by preterm babies.

Umbilical Cord Milking For Preemies

A preterm baby or preemie is a child born earlier than 37 weeks. It is not an exceptionally rare occurrence, with one in ten births each year being preterm births. The majority of them grow up to be healthy and happy adults with no long term health conditions.

However, preterm births do carry an increased risk of particular health problems, including apnea, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis (NEC), and jaundice to name but a few.

In addition to these, premature infants also experience a higher rate of anemia than those babies born full term. This condition is a lower concentration of red blood cells in the body and results in decreased oxygen flow.

For infants, anemia can have dire consequences, as decreased blood flow may lead to developmental abnormalities or abnormal brain development.
Luckily, new research on a practice known as umbilical cord milking has started to reveal many benefits that can significantly improve the health of preterm babies.
By initiating healthy blood flow within the first seconds of birth, infant development can become normalized, leading to long term benefits.

Learn more about umbilical cord milking, when it is encouraged, and the results of research completed thus far.

What Is Umbilical Cord Milking?

The process of umbilical cord milking consists of a doctor holding the umbilical cord of a newborn child between the thumb and forefinger, squeezing gently, and gradually pushing the contents of the umbilical cord into the newborn’s abdomen.

The idea is that newborns, especially premature births, need access to all of the additional blood flow they can get. By helping the child gain access to the last drops of his or her mother’s nutrients and hemoglobin, they stand a better chance over the next few hours and days.

When is Umbilical Cord Milking Used?

Typically, premature infants born by cesarean delivery are treated with a process known as delayed cord clamping (DCC). This process means that the doctor waits until the pulsations through the umbilical cord have stopped before cutting, typically at least 1 minute after birth.

The benefits of this practice mostly involve improving the newborn’s blood volume. After extensive research, delayed cord clamping has proven to offer consistent results with no serious side effects.

Newer research points to the likelihood that umbilical cord milking provides improved benefits over direct/immediate cord clamping.
Specifically, in the case of premature babies born via cesarean delivery, the increase in blood pressure and blood flow are substantial. While we do not currently have all the answers regarding this new practice, continued research shows promising results.

How Does It Work?

In a 2015 study, researchers randomly assigned a group of 154 infants either delayed cord clamping or umbilical cord milking to compare the results of each practice.
When focusing specifically on premature babies born earlier than 32 weeks, a range of increased benefits was found for those who received the umbilical cord milking.

These include improved blood flow to and from the heart, higher blood pressure, and a higher red blood cell level.

For premature births, these benefits are highly valuable to the newborn and give them a better chance of fighting the various health problems they may face. Increased blood flow means their small bodies will be able to enjoy a more steady stream of oxygen, feeding their brains and growing bodies.

Are There Any Risks?

Initial research has not yet found any serious health risks or side effects derived from umbilical cord milking. Some studies report a higher incidence of neonatal jaundice after umbilical cord milking (and with DCC); however, jaundice may be easily treated with phototherapy.

A relatively small portion of the sample populations did not receive the same benefits from the process though, which could mean that it is not 100% efficient for all premature births. However, other procedures like delayed cord clamping, in particular, show similar inconsistencies.

Additionally, new found medical procedures need more thorough testing before it can be considered the standard practice. As it is right now, umbilical cord milking still requires additional research before it will be a regular procedure.

Is Umbilical Cord Milking Right for Your Baby?

As time goes on, more and more parents are requesting umbilical cord milking for their baby. As research continues, we are becoming aware of more of the unique benefits of this practice and how it can improve the health and safety of premature newborns.

While these initial results look promising, medical professionals continue to call for larger sample sizes and continued analysis to ensure its long term benefits for infants.

If you are interested in making use of the umbilical cord milking process for your child, ask your doctor or midwife about the most up to date research to find out if it would be available to you at birth. Your healthcare provider may be less willing to perform the umbilical cord milking if your baby is born at term and appears healthy; however, if you’re considering it, it is best to talk to your provider before you are in labor or headed to your C-section!

If this is something you are interested in and is available from your provider, be sure to add it to your birth plan.

Compiled using information from the following sources:

1. AAP News & Journals Gateway. “Umbilical Cord Milking Versus Delayed Cord Clamping in Preterm Infants”. Pediatrics July 2015, VOLUME 136 / ISSUE 1.

https://pediatrics.aappublications.org/content/136/1/61

2. NIH.gov, U.S. Department of Health and Human Services. “Umbilical cord ‘milking’ improves blood flow in preterm infants”. National Institutes of Health and Eunice Kennedy Shriver National Institute of Child Health and Human Development. 29, June 2015.

https://www.nih.gov/news-events/news-releases/umbilical-cord-milking-improves-blood-flow-preterm-infants

3. Upadhyay A, Gothwal S, Parihar R, et al. “Effect of umbilical cord milking in term and near term infants: randomized control trial.” Am J Obstet
Gynecol 2013;208:120.e1-6.

https://www.ajog.org/article/S0002-9378(12)02031-5/pdfSummary

4. WHO.int. “Optimal timing of cord clamping for the prevention of iron deficiency anemia in infants.” e-Library of Evidence for Nutrition Actions (eLENA). Geneva, World Health Organization.

5. NeonatalResearch.org. “Delayed cord clamping or cord milking for the very preterm newborn… or both?”. 18, May 2015.

https://neonatalresearch.org/2015/05/18/delayed-cord-clamping-or-cord-milking-for-the-very-preterm-newborn-or-both/

6. Kumar B, Uphadhyay A, Gothwal S, Jaiswal V, Joshi P, Dubey K. “Umbilical Cord Milking and Hematological Parameters in Moderate to Late Preterm Neonates: A Randomized Controlled Trial.” Indian Pediatr. Sept 2015;52(9):753-7

https://www.ncbi.nlm.nih.gov/pubmed/26519708