Effect of 40-cm segment umbilical cord milking on hemoglobin and serum ferritin at 6 months of age in full-term infants of anemic and non-anemic mothers.

Abstract

To assess the effect of early clamping and milking of a 40-cm umbilical cord LUCM (long umbilical cord and milking) on hemoglobin (Hb) and serum ferritin concentrations at 6 months of age and to evaluate whether the effect is different in infants of anemic and non-anemic mothers. Eligible term-infants of anemic (maternal Hb<11.0 g dl(-1)) and non-anemic mothers (Hb ⩾11.0 g dl(-1)) were randomized to LUCM or control groups (N=100 each). In the LUCM group, the umbilical cord was clamped at 40-cm length and milked. The control group had the cord clamped at 5 cm and not milked. Neonatal morbidities until discharge and Hb and serum ferritin at 6 months of age were compared. Effects in infants of anemic and non-anemic mothers were compared. Compared with infants of non-anemic mothers, cord Hb was similar (14.50±1.90 g dl(-1) vs 14.67±1.73 g dl(-1)), but cord ferritin lower (85.8±55.4 ng ml(-1) vs 119.4±58.5 ng ml(-1), P<0.01) in infants of anemic mothers. Mean Hb concentration at 6 months was 9.60±1.42 g dl(-1) in the LUCM group and 9.07±1.10 g dl(-1) in the control group (P=0.004). Mean serum-ferritin concentration at 6 months was 113.9±43.8 ng ml(-1) in the LUCM group and 70.8±39.5 ng/ml in the control group (P<0.001). The effectiveness of LUCM did not vary with the maternal anemia status. Keeping the umbilical cord long and milking may be an effective method for improving Hb and iron stores at 6 months of age in term-infants.