Umbilical cord milking may benefit nonvigorous newborns

Clinical Question

Does umbilical cord milking reduce neonatal intensive care unit admissions among nonvigorous neonates?

Bottom line

UCM for nonvigorous infants born at 35 to 42 weeks' gestation was not associated with a statistically significant reduction in NICU admissions. However, it was associated with reduced need for delivery room cardiorespiratory support, lower incidence of moderate-to-severe hypoxic-ischemic encephalopathy, and less use of therapeutic hypothermia. The UCM intervention took an average of 9 seconds to perform and was not associated with evidence of harm. 1b-

Study design: Cross-over trial (randomized)

Funding: Government

Setting: Inpatient (ward only)


Linda Speer, MD
Professor and Chair, Department of Family Medicine
University of Toledo
Toledo, OH

Discuss this POEM



cord milking benefit

no ob for me; done that


Impact assessment

Very good


Umbilical Cord Milking

UCM has been standard practice since medical school - in my case, 1962-68. The physiological base should be obvious.


UCM of value

Good to know

Pieter Richard Verbeek

Umbilical cord milking in nonvigorous newborns.

Interesting that there was no difference in the general principle outcome (ICU admission) but several clinically important secondary outcomes showed a difference. It makes one naturally wonder if the difference in ICU admission was driven by less clinically important outcomes such as observed wrt phototherapy. The ease of the procedure and the lack of evidence for harm is encouraging. It may be a procedure that could be considered for paramedics to perform when indicated.