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Women’s health and midwifery
Cord milking in non-vigorous infants: promising, but further information is needed
  1. Haribalakrishna Balasubramanian1,
  2. Shripada C Rao2
  1. 1 Department of Neonatology, Surya Hospitals, Mumbai, Maharashtra, India
  2. 2 Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia
  1. Correspondence to Dr Haribalakrishna Balasubramanian, Surya Hospitals, Mumbai, Maharashtra 400054, India; doctorhbk{at}

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Commentary on: Katheria AC, Clark E, Yoder B, et al. Umbilical cord milking in nonvigorous infants: a cluster-randomized crossover trial. Am J Obstet Gynecol. 2022;S0002-9378(22:)00649-4. doi: 10.1016/j.ajog.2022.08.015.

Implications for practice and research

  • Intact umbilical cord milking (UCM), when compared to early cord clamping can result in higher haemoglobin levels and potentially better haemodynamic stability in non-vigorous term and late preterm infants.

  • Clinical trials addressing long-term efficacy and safety of UCM in such infants are required.


Delayed cord clamping, a placental transfusion strategy, may be difficult to implement in infants requiring resuscitation at birth. Umbilical cord milking (UCM) could be an alternative approach in such infants. While UCM has been shown to improve short-term outcomes in vigorous infants,1 2 there is limited information on non-vigorous infants. Recent …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.