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Squeezing blood from the umbilical cord prior to cutting it can improve the health of infants who are born limp, pale or barely breathing.听听

As a matter of routine, doctors typically wait a few minutes after birth before cutting the umbilical cord. This practice, known as delayed cord clamping, allows more nutrient-rich blood to transfer from the placenta to the newborn baby.听

Yet when a newborn is what doctors refer to as non-vigorous, there is no time to delay: they usually snip the umbilical cord immediately so that they can start resuscitation as quickly as possible. The issue with this method, called early cord clamping, is that it reduces blood supply in already ailing babies.听听

Previous research has shown that squeezing blood from the umbilical cord can increase blood volume in healthy and preterm infants within seconds. at Sharp Mary Birch Hospital for Women & Newborns in California thought the method, called , could be a beneficial alternative to early cord clamping in non-vigorous infants.听听

To test this, he and his colleagues worked with 10 hospitals in the US, Canada and Poland for more than two years to compare the outcomes of infants whose delivery involved the different procedures. All of the infants were non-vigorous and were born between 35 and 42 weeks of gestation. 听

Half of the hospitals had providers milk the umbilical cord four times before cutting, while the other half used early cord clamping. After one year, hospitals switched to the opposite protocol. By the end of the trial, information was collected on 1730 non-vigorous infants, of whom 872 had umbilical cord milking and 858 had early cord clamping. 听

The researchers found that umbilical cord milking significantly increased levels of haemoglobin, a protein in red blood cells responsible for transporting oxygen. Infants in this group had, on average, 0.68 more grams of haemoglobin per decilitre of blood compared with those in the early cord clamping group.听听

鈥淐linically, it鈥檚 not a huge number, but it鈥檚 demonstrating that they actually are getting more blood,鈥� says Katheria. 鈥淗aemoglobin is what we measure, but in cord blood, there鈥檚 lots of [other beneficial] things like stem cells and immune cells.鈥�听

This may explain why infants in the umbilical cord milking group also had better health outcomes. For example, 61 per cent of infants in this group required cardiorespiratory support compared with 71 per cent in the early cord clamping group. Additionally, only 1 per cent developed moderate-to-severe hypoxic-ischaemic encephalopathy 鈥� a brain injury caused by a lack of oxygen 鈥� versus 3 per cent in the other group. There were, though, no significant differences in admission rates to neonatal intensive care units between the two groups.听 听

鈥淚 think this is a very big step forward in our efforts to provide what we call optimal management of the umbilical cord,鈥� says at Brighton and Sussex Medical School in the UK. 鈥淚f you are poorly at birth with brain damage, that will affect your whole life鈥� So, the better start we can give, the better they鈥檙e going to do later on.鈥�听