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

Objective: 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. Study design: 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. Result: 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. Conclusion: 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.