Umbilical Cord

Symptoms

• Umbilicus (navel) has a cloudy discharge or even some dried pus on the surface
• Bleeding occurs from cord's point of separation
• Separation of cord is delayed past 3 weeks

Omphalitis: Serious Complication

• Definition. Bacterial infection of the umbilical stump with spread to the skin around it. It's a medical emergency.
• How Often. 1 out of 200 newborns.
• Symptoms. Redness spreads around the navel. The area may be tender, swollen and have a foul odor.

Umbilical Granuloma: Minor Complication

• Definition. Small round growth in center of navel after the cord falls off. It's red. Covered with clear mucus. Not dry like normal skin.
• How Often. 1 out of 500 newborns.
• Outcome. Usually grows in size if not treated. Can become an entry point for umbilical infections.
• Treatment. Easily treated in the doctor's office by putting on a chemical called silver nitrate.

Dry Cord Care or Alcohol Cord Care

• The AAP and ACOG both advise dry cord care (natural drying). (Guidelines for Perinatal Care, 2012). It has become common practice in US hospitals.
• The book advises against using alcohol for routine umbilical cord care.
• Alcohol cord care is advised in less developed countries with high infection rates.

Treatment for Normal Umbilical Cord

1. What You Should Know About Normal Umbilical Cords:
   • Normal cords don't need any special treatment.
   • Just keep them dry (called dry cord care or natural drying).
   • Reason: Cords need to dry up, before they will fall off.
   • As they dry up, cords normally change color. They go from a shiny yellowish hue, to brown or grey.
   • The cord will normally fall off between 1 and 3 weeks.
   • Here is some care advice that should help.
2. Normal Dry Cord Care:
   • Check the skin around the base of the cord once a day.
   • Usually the area is dry and clean. No treatment is needed.
   • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
   • You will need to push down on the skin around the cord to get at this area. You may also need to bend the cord a little to get underneath it.
   • Caution: Don't put alcohol or other germ killer on the cord. Reason: Dry cords fall off sooner. (Exception: instructed by your doctor to use alcohol).
3. Bathing:
   • Keep the cord dry. Avoid tub baths.
   • Use sponge baths until the cord falls off.
4. Fold Diaper Down:
   • Keep the area dry to help healing.
   • To provide air contact, keep the diaper folded down below the cord.
   • Another option for disposable diapers is to cut off a wedge with a scissors. Then seal the edge with tape.
5. Poop on Cord:
   • Getting some poop on the cord or navel is not serious.
   • If it occurs, clean the area with soap and water.
   • This should prevent any infections.
6. Call Your Doctor If:
   • Develops a red streak or redness around belly button
   • Fever occurs
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Navel After Cord Falls Off

1. What You Should Know About Navels After the Cord Falls Off:
   • The cord can't fall off too early.
   • The average cord falls off between 10 and 14 days. Normal range is 7 to 21 days. Even if it falls off before 7 days, you can follow this advice.
   • After the cord has fallen off, the navel will gradually heal.
   • It's normal for the center to look red at the point of separation.
   • It's not normal if the redness spreads on to the belly.
   • It's normal for the navel to ooze some secretions.
   • Sometimes the navel forms a scab. Let it heal up and fall off on its own.
   • The navel has a small risk of becoming infected.
   • Here is some care advice that should help.
2. Normal Navel Care:
   • Keep the navel (belly button) clean and dry.
   • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
   • Do this gently to prevent any bleeding.
   • Caution: Don't use any rubbing alcohol. Reason: can interfere with healing.
3. Bathing:
   • After the cord falls off, continue sponge baths for a few more days.
   • Help the belly button area dry up.
   • Then, tub baths will be fine.
4. Fold Diaper Down:
   • Keep the navel dry to help healing.
   • To provide air contact, keep the diaper folded down below the navel.
5. What to Expect: The belly button should be healed and dry by 7 days.
6. Call Your Doctor If:
   • Develops a red streak or redness around belly button
   • Fever occurs
   • Cloudy discharge occurs
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Minor Infection of Cord or Navel

1. What You Should Know About a Minor Infection of Cord or Navel:
   • The belly button will ooze secretions for several days.
   • Normal secretions are clear or blood tinged mucus.
   • A cloudy discharge is usually a mild infection.
   • This can be from normal skin bacteria.
   • A small amount of pus may be present.
   • Here is some care advice that should help.
2. Clean the Navel:
   • Clean the navel (belly button) 2 times a day.
   • Use a wet cotton swab or cloth.
   • Clean away any dried secretions or pus.
   • Do this gently to prevent any bleeding.
   • Caution: Don't use any rubbing alcohol. Reason: Can interfere with healing.
3. Antibiotic Ointment for Pus:
   • If any pus is present, use an antibiotic ointment (such as Polysporin).
   • No prescription is needed.
   • Put a tiny amount on the belly button.
   • Do this 2 times per day after the area has been cleaned.
   • Do this for 2 days. After that, use the antibiotic ointment only if you see more pus.
4. Bathing:
   • Do not use tub baths until the cord falls off. The navel should be well healed.
5. Fold Diaper Down:
   • Keep the belly button dry to help healing.
   • To provide air contact, keep the diaper folded down. Keep it below the cord and belly button.
6. What to Expect:
   • With treatment, the cloudy discharge and pus should be gone in 2 to 3 days.
   • The navel should become dry and healed by 7 days.
7. Call Your Doctor If:
   • Develops a red streak or redness around the belly button
   • Fever occurs
   • Cloudy discharge not gone after 3 days of using this care advice
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Bleeding Around Cord

1. What You Should Know About Mild Bleeding Around the Cord:
   • A few drops of blood are normal when the cord falls off or catches on something.
   • The diaper rubbing against the belly button may make it start up again.
   • Here is some care advice that should help.
2. Bleeding:
   • To stop bleeding, put direct pressure on the navel for 10 minutes. Use a clean cloth.
   • Clean the area beforehand, rather than afterwards.
   • Reason: This helps prevent bleeding from starting back up.
3. Diaper:
   • Prevent the diaper from rubbing on the belly button.
   • Do this by folding the diaper down away from the belly button.
   • You can also cut a wedge out of the diaper.
4. What to Expect:
   • The bleeding may come back a few times.
   • It should only be a small smear of blood.
   • The bleeding site should heal up by 2 days.
5. Call Your Doctor If:
   • Bleeding gets worse
   • Few drops of blood lasts more than 3 days
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Delayed Separation of the Cord Beyond 3 Weeks

1. What You Should Know Cords Falling Off:
   • Most cords fall off between 10 and 14 days. Normal range is 7 to 21 days.
   • All cords slowly fall off on their own.
   • Continue to be patient.
   • Here is some care advice that should help.
2. Stop Alcohol:
   • If you have been using rubbing alcohol to the cord, stop doing so.
   • Rubbing alcohol can kill the good bacteria that help the cord fall off.
3. Diaper:
   • Help the cord dry up faster by keeping the diaper folded below it.
   • Another approach is to cut out a wedge of the diaper (if disposable).
   • Air contact helps the cord stay dry.
4. Call Your Doctor If:
   • Cord starts to look infected
   • Fever occurs
   • Cord is still on for more than 6 weeks
   • Your baby starts to look sick or act abnormal
   • You think your child needs to be seen