Table 1

Guidelines and practice concerning deferred Cord Clamping and cord milking for very preterm birth in 7 practising sites in the UK 2012

Site	Guideline content pertaining to DCC in very preterm birth	Guideline content pertaining to CM in very preterm birth	Reported practice of DCC	Reported practice of CM	Recommended duration DCC	Duration reported in practice	Specific instructions about execution of CM in guideline (number of milkings, length of cord, height of baby etc	Delivery into plastic bag prior to cord ligation mandated in guideline	Guideline exclusions	Comments
Site 1 Tertiary Hospital	Presented as alternative options		Very few	All	None	5–10 s	No	No		Most babies <28 weeks delivered by caesarean section had CM—more variability at higher gestations
Site 2 tertiary hospital 6000–7000 deliveries	Discouraged	Recommended	Few	‘standard practice’	NA	?	Yes	Yes		CM seen as safer than DCC in all circumstances
Site 3 medium size district hospital 5000–6000 deliveries	Recommended	Only if DCC seen as unsafe	70% in recent audit	Minority	30 s	30s	No	No	None	DCC considered as part of resuscitation process
Site 4 tertiary hospital 6000–7000 deliveries	Nil	Nil	Minority	Minority	No recommendation	?	No	No		DCC recommended for term births
Site 5 tertiary hospital	Recommended	Nil	Majority <28 weeks	Few, if any	45 s	30 s	No	No	Need for immediate resuscitation. Absent cord pulsation, or cord incised. Placental separation. Concerns for health of mother
Site 6 smaller district hospital 2000–3000 births	Discouraged	Nil	Minority	Minority	Discouraged	0–30 s	No	No		‘The consensus paediatric view, therefore, is that DCC should not be practised routinely on preterm babies., Policy advised CM where DCC could not be achieved.
Site 7 4000–5000 births tertiary hospital	Nil	Nil	Minority	Minority	NA	15–60 s	No	No	None

CM, cord milking/stripping; DCC, deferred cord clamping.