Pre-Term and Cesarean Delivery: Blood Flow Through Cord Milking

Pre-term infants delivered by cesarean section could benefit from cord milking, a process that increases blood flow into a baby's umbilical cord--thus boosting blood pressure and the amount of red blood cells, according to a study published recently in the journal Pediatrics.

The study was conducted by researchers at the Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns in San Diego, and Loma Linda University. It was supported by the National Institutes of Health, according to a release.

While the standard procedure involves waiting up to 60 seconds before clamping and cutting the umbilical cord, researchers say that for those delivered by cesarean section, it can help to gently squeeze the cord and encircle it with fingers to slowly push blood through the cord and into the abdomen of an infant, according to a release.

Researchers worked with 197 infants from mothers who went into labor before or at their 32^nd week of pregnancy. Of the study subjects, 154 were delivered by cesarean, 75 of whom were randomly assigned to undergo cord milking. Seventy-nine were administered delayed clamping. The vaginal birth group had 43 infants, according to a release.

Scientists think the massaging improves blood flow, increasing the amount of blood supplied to the infant. Due to anesthesia used for cesarean delivery, such babies might already experience a reduction in blood flow through the cord. Anesthetic reduces the uterine contractions -- thereby also reducing the blood flow through the umbilical cord, according to the release.

Both cord milking and delayed clamping are intended to improve blood flow through the cord, protecting the child from intraventricular hemorrhage or bleeding in brain cavities called ventricles. The latter can cause cerebral palsy, developmental delays and, in some cases, death, the release said. 

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