Research into how to reduce anemia risk in preterm babies is expanding the options available to clinicians. A study published in Pediatrics examines a technique that uses the newborn’s own blood from the umbilical cord to help the infant after birth, particularly for those born after 28 weeks of gestation. The development of safer strategies for managing blood flow at birth is an ongoing priority in neonatology, and this work adds important data to the field. (Pediatrics, 2023)
Cord milking is a hands‑on method that involves gently compressing the umbilical cord with the thumb and index finger to push blood toward the fetus’s abdomen. Delayed cord clamping—letting blood continue to transfer from the placenta to the baby for a short period—also contributes circulating blood volume, though in smaller quantities. Expressions of this type have previously shown promise for preventing anemia in premature infants. However, earlier observations noted a possible link with intracerebral hemorrhage when the procedure was used in very early preterm births. In the current trial, researchers sought to determine whether the risk of this complication is confined to babies born before 28 weeks’ gestation. (Pediatrics, 2023)
In this randomized study, more than 1,000 newborns were assigned to receive umbilical cord expression or to experience delayed cord clamping. The researchers tracked severe intracerebral hemorrhage and survival as primary outcomes, alongside other health indicators. Across the groups, no significant difference emerged in these major endpoints. The findings suggest that umbilical cord expression may not increase short‑term risk for infants born after 28 weeks and could serve as a viable alternative to extended placental compression when clinically appropriate. Longitudinal follow‑ups are planned to assess neurodevelopmental and health outcomes over two years. (Pediatrics, 2023)
The trial was conducted across multiple centers, including Sharp Mary Birch Women’s and Newborn Hospital in San Diego, along with collaborating hospitals in Canada and several European countries. The geographic spread helps to ensure that results are applicable to diverse healthcare settings and patient populations, potentially informing guidelines and practice patterns in North American and European neonatal care. (Pediatrics, 2023)
Beyond the immediate findings, the study contributes to a nuanced discussion about how best to optimize blood transfer at birth in premature infants. Clinicians weigh the benefits of higher circulating blood volume against the potential risks associated with any intervention near the time of birth. The evolving evidence base supports a personalized approach, where the choice between cord expression and delayed clamping is informed by gestational age, maternal health, and the infant’s clinical status. Ongoing monitoring and data collection will help refine recommendations and ensure that improvements in anemia risk do not come at the expense of other critical outcomes. (Pediatrics, 2023)
Overall, the research underscores a shift toward evidence‑driven, flexible strategies for managing the transition from intrauterine to extrauterine life in preterm neonates. As more data accumulate from diverse patient groups, clinicians will be better equipped to select the most appropriate method for boosting blood volume while minimizing complications, with the ultimate goal of improving short‑ and long‑term health for preterm babies. (Pediatrics, 2023)