Sunday, July 25, 2021

Umbilical Care in the Newborn

This is an INFORMATION page, verified by physician

Most umbilical cords will fall off before 15 days of age. But sometimes this might take longer in a moist humid environment such as the Caribbean.

Do not try and speed up the process by pulling or tugging at the cord.

It is important to allow nature to take its own natural course. Over the first few days of life the cord will gradually dry up. It will chang from a clear colour and gelatinous appearance to black and hard. The umbilical cord contains no nerves, so this whole process is completely painless.

How Should I Care for My Child’s Cord Before it Drops Off?

Keep the cord clean and dry. Clean the cord using previously cooled boiled water and cotton wool.

Do not use rubbing alcohol solution or alcohol wipes as they result in delayed separation of the cord. Do not use antibiotic powder. as This will result in delayed cord separation and increases the risk of infection. Additionally, powder is dangerous in babies. They can inhale it into their lungs causing damage.

Keep the cord dry. Buy special shaped nappies that allow the umbilicus to remain free. Or turn down the top of the nappy to allow the cord stump to be free of the nappy. Dress your baby in just a nappy and a t-shirt where possible to improve air circulation.

In Cayman, because of the humidity, a lot of umbilical cords get stuck down to the surrounding skin. Carefully with clean hands, lift the black hard cord away from the skin so that the underlying green, soggy umbilical cord can dry out. If the umbilical cord is not showing any signs of falling off at 1 week of age your paediatrician will give you some more guidance.

After the stump comes off, it usually takes about 7 to 10 days for the tummy button to heal completely.

When Should I Worry About the Umbilical Cord?

If the skin around the umbilicus starts looking red or the cord is smelly then your baby may have an infection. You must contact your paediatrician immediately.

If the umbilical cord has not fallen off by 28 days of age your paediatrician will want to do a blood test. This is to rule out any underlying causes.

My Baby’sCord has Fallen Off and is Now Bleeding?

It is very normal for the umbilical cord to bleed a little after it falls off. This should dry up in a day or so. If there is excessive bleeding (an extremely rare situation) seek urgent medical advice. If the umbilical cord continues to spot blood for more than a few days, speak to your paediatrician.

My Baby’s Cord Clamp Has Been Left On

This is not a problem and it will come off when the cord falls off.

My Baby’s Cord Fell Off, But the Stump is Red and Moist and Does Not Appear to be Healing

Your baby probably has a granuloma. This is nothing to worry too much about, but baby needs to see your paediatrician who can advise on treatment.

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about the author

Dr Sara Watkin

MB ChB, MRCP (paeds), FRCPCH, MD

SPECIALIST PAEDIATRICIAN & NEONATOLOGIST

Dr Sara Watkin is a highly experienced, tertiary trained paediatric and neonatal (newborn) specialist, based out of Grand Pavilion on West Bay Road, with paediatric & neonatal admitting rights at George Town. She has 25+ years experience as a consultant in the United Kingdom, including as Chief of Service at the world-renowned University College London Hospitals.



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