Umbilical Cord Milking and Hematological Parameters in Moderate to Late Preterm Neonates: A Randomized Controlled Trial

Abstract

Objective: To investigate the effect of umbilical cord milking on hematological parameters at 6 weeks of age in late preterm neonates.

Design: Randomized controlled trial.

Setting: A tertiary care center of Northern India during 2013-14.

Participants: 200 moderate to late preterm neonates randomly allocated to early cord clamping or umbilical cord milking group (100 in each).

Intervention: In milking group, 25 cm length of cord was milked towards the baby thrice after separating (within 30 s) it from placenta.

Main outcome measures: Hemoglobin and serum ferritin at 6 weeks of age.

Results: Mean (SD) serum ferritin [428.9 (217.6) vs. 237.5 (118.6) ng/mL; P< 0.01] and hemoglobin [12.1 (1.5) vs. 10.4 (1.2) gm/dL; P<0.01] at 6 weeks were significantly higher in umbilical cord milking group. In early neonatal period, hemodynamic and hematological parameters were not significantly different. Higher incidence of jaundice with higher phototherapy rates (33% vs. 9%; P<0.01) were noted in umbilical cord milking group.

Conclusions: In preterm neonates, umbilical cord milking at birth enhances iron stores at 6 weeks of age. Higher phototherapy rates with this intervention are a matter of concern.