Efficacy and Safety of Umbilical Cord Milking Compared to Deferred Cord Clamping in Term Infants: A Randomized Clinical Trial

Deferred cord clamping (DCC) or umbilical cord milking (UCM) are two proposed methods of placental transfusion for term infants; however, it is still controversial as to which method is the best. We aimed to compare the efficacy and safety of DCC and UCM for term infants and their mothers. We conducted a single center, randomized clinical trial (RCT) of mother-infant pairs delivered at King Abdulaziz University Hospital. Infants were randomly allocated to deferring clamping of the cord for 60 seconds or manual stripping of approximately 20cm of the cord over 2-3 seconds that is repeated three times. Seventy-six infants were allocated to UCM group and 73 to DCC group. There were no significant differences between groups with regards to maternal outcomes. There were no differences in the need for resuscitation, apgar scores at one and five minutes and admission to intensive care unit between groups. Of the enrolled infants, 57% (43/76) and 53% (39/73) of the UCM and DCC groups had completed the study respectively. Apart from a significantly higher Hct in infants allocated to DCC both at 24 hours and at 8-12 weeks, there were no significant differences between the two groups in hematological outcomes. Our results showed the efficacy and safety of UCM compared to DCC in term infants. The adoption of UCM may be considered as an alternative care treatment, especially in cases that are not candidates for DCC.