Many new parents are familiar with delayed cord clamping. It was once the norm to clamp and cut the umbilical cord immediately after birth. Now we know babies benefit from waiting at least 90 seconds to 2 minutes before clamping and cutting.
With up to one third of baby’s blood volume can remain in the placenta and umbilical cord immediately following birth. Umbilical cord milking is another option to help babies get as much of their blood as possible following birth.
By waiting to clamp, baby receives more of its blood, which can help guard against iron deficient anaemia in the first six months of life.
Instead of waiting for the cord to finish pulsating and naturally passing the blood to baby, a bit of ‘milking’ can speed up the process.
How Is Umbilical Cord Milking Done?
Shortly after birth, the midwife or obstetrician squeezes the blood down the umbilical cord, from the placenta towards baby. This is done with a few swipes to ensure baby receives as much blood as possible.
The umbilical cord doesn’t have nerves, so neither mother nor baby feels any pain.
Does Umbilical Cord Milking Have Any Benefits?
We know that delayed cord clamping has benefits. Are there any benefits in milking instead of waiting? The Journal of the American Medical Association (JAMA) reviewed data from 501 infants; some had cord milking and others did not.
There was no difference in overall mortality risk.
However, they did note that infants who had umbilical cord milking were less likely to need oxygen in the NICU, and had higher levels of haemoglobin (the oxygen carrier in red blood cells).
Is Umbilical Cord Milking Better Than Delayed Cord Clamping?
The JAMA’s published study showed improved outcomes for babies who received umbilical cord milking compared with those who didn’t. For babies in general, however, there doesn’t seem to be any benefit in cord milking, when compared with delayed cord clamping.
The World Health Organization (WHO) recommends delayed cord clamping for all infants unless they need to be removed quickly, for neonatal resuscitation or other immediate medical concerns. For those infants who require quick clamping, so they can receive other care, umbilical cord milking could prove extremely beneficial. It can be done quickly – once, if not a few times – before clamping.
It could also be beneficial during emergency c-sections, where mother or baby needs immediate medical attention, and where a few minutes of delay in cutting the cord could cause risks.
Why Wait Instead Of Milking Every Cord?
Umbilical cord milking can be wonderful for babies who need to be removed quickly – especially early preterm infants (24-28 weeks gestation). However, what about full term babies?
While cord milking can speed up the process, there are no benefits in rushing through the immediate postnatal period. For mother and baby, it is best to have as gentle a transition as possible from womb to mother’s chest.
Letting the baby simply lie on his mother’s chest, so that she can cuddle him, provides the same opportunity for the baby to receive as much of his own blood as possible. This is much better than having a midwife or doctor messing with the cord during those first precious seconds.
Should I Discuss Umbilical Cord Milking With My Midwife Or Doctor?
It is helpful for you and your maternity care provider if you make your preferences known prior to the birth. Current research supports delayed cord clamping, because it provides plenty of benefits for term infants. Many birthing facilities are beginning to do delayed cord clamping routinely, but it’s still a good idea to ask your provider how to make sure delayed cord clamping will happen.
If you’re at risk for a preterm birth, or other birth complications, you might want to discuss this option with your maternity care provider. If you’re not, you might ask about it simply because preterm birth sometimes happens unexpectedly.
In the absence of preterm birth or other complications, most families opt to go with delayed cord clamping and reap the many benefits of it.