Umbilical Cord Care Overview
Parents, especially new parents, tend to get concerned about their newborn's umbilical stump. The most important advice
ias to keep it clean and dry until it falls off.
Umbilical Cord Stump
The umbilical cord connects the developing fetus to the mother through the placenta from the sixth week of pregnancy until birth. As a lifeline, the cord supplies the developing fetus with oxygen, nutrients, and a means of waste elimination while in the womb. At birth, because the baby is able to breathe, eat, and void the bladder and bowel, the umbilical cord becomes unnecessary; so it is clamped and cut shortly after delivery. Since there are no nerve fibers in the cord, your newborn will not feel it.
It is important to provide proper care for this portion of remaining cord at the baby's navel until it heals and separates from the umbilicus - usually within two weeks after birth. The stump will change from a yellow-green color to black as it dries out and may have an odor. Be aware that at this point it will not be possible to determine whether your child will grow up with a so-called "inny" or an "outy."
Umbilical Cord Care: After the Visit
Followup care for your child's umbilical cord stump is as important as anything the doctor does.
Make sure to keep the area clean and dry, and look out for infection, as indicated by redness or swelling around the area of the stump after it falls off.
When to Seek Medical Care
Any fever, a rectal temperature of 100.4° F or higher in a newborn is considered a medical emergency. You should contact your physician immediately. There are a couple of common conditions which should lead you to seek medical attention:
- Omphalitis: If you notice any redness, warmth, swelling, or tenderness in the skin around the belly button, or a lot of discharge from it (especially if it is foul smelling), you should call your pediatrician and go to the hospital's Emergency Department right away. This could be omphalitis, a potentially life-threatening infection of the umbilical stump and the surrounding area, which must be promptly checked and treated in the hospital.
- Umbilical granuloma: If you notice a persistent, yellow-green drainage from the belly button without any redness, warmth, swelling, or tenderness of the surrounding skin in a baby without a fever, it may represent an umbilical granuloma - a small nodule of firm, pinkish-red tissue. The baby's doctor can treat this condition in the office. It is treated with silver nitrate applied to the umbilical stump with a cotton swab. The silver nitrate acts to cauterize and dry up the tissue at the base of the stump, allowing normal skin to grow over. This may be repeated until the granuloma is healed. After a treatment, a little bit of dark discharge from the area is nothing to worry about, and sometimes there is some temporary staining of the skin. Furthermore, the procedure is not painful to the baby. He or she cries because the medicine is applies with a stick inside the belly button.
- Persistent bleeding: As mentioned above, a little dried blood at the site is normal. If you notice that that there is persistent and significant bleeding from the umbilical stump, it may be a sign of a clotting problem, and you should see your doctor.
- The umbilical stump is what's left of the umbilical cord after it is cut in the delivery room.
- Keep the stump clean and dry until it falls off, usually by two weeks.
- Omphalitis is a potentially serious infection of the umbilicus.
- An umbilical granuloma is a common treatable condition.
- Persistent bleeding from the stump should be evaluated by a medical provider.