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n Umbilical Cord Care n

(To keep your baby warm, baths should be quick during During , the umbilical cord is the the first few weeks anyway.) baby’s connection to the mother. After , the  cord is cut, and the stump remains connected to At every diaper change, use soap and water to clean the the baby. This is where the (belly button) will area around the cord stump. Pull up gently on the stump be. You’ll be taught some simple steps to care for and clean around its base. A little foul odor and moisture the cord stump after taking your baby home. are normal in this area. Although there are a few things to watch out for,  Some doctors may recommend cleaning the stump with problems with the umbilical cord stump are rare. rubbing alcohol. You may clean the area with a small It usually falls off within a few weeks. amount of rubbing alcohol on a cotton ball or swab or use packaged alcohol wipes. Try not to use more rubbing alcohol than is necessary.  Keep the cord stump over the diaper; it should not be What is the umbilical cord? inside the diaper. You may need to fold down the top While your baby was in the womb, he or she was edge of the diaper. connected to you by two important organs: the and the umbilical cord. The umbilical cord is the ’s Are there any possible problems? “life support system” during pregnancy; it contains vessels that provide and nutrition. At birth, the Problems related to the umbilical cord stump are possible umbilical cord is cut, and the stump remains attached to but uncommon: the baby.  Infection. Infection of the cord stump (called “omphali- During the first few weeks after birth, the umbilical cord tis”) is the most serious problem. Although a little mois- stump gradually dries and heals. It falls off on its own within ture and foul odor can be normal, draining fluid and a few weeks. During this time, some simple care is needed redness of the skin around the stump may mean infection to keep the cord clean and dry. You should be alert for any is present. If drainage and redness are present, see your ! signs of infection or bleeding; however, these and other com- doctor right away. (Just fluid, without redness, is most plications are uncommon. If any problems occur, or if the common with granuloma—not a serious problem.) stump hasn’t fallen off within 4 weeks, call your doctor’s office.  Bleeding. There should be little or no bleeding from the cord stump. Bleeding is most likely to occur if the cord What does it look like? is pulled off too early.   Granuloma. If the skin around the cord stump is slow to Immediately after birth, the umbilical cord is cut. A clamp heal, umbilical granuloma may be present. The granuloma is placed near the cut end to prevent bleeding. The doctor looks like a small, round growth. There is usually some examines the umbilical cord and placenta to make sure wetness in the belly button. Umbilical granuloma is a rela- they are normal. tively common problem that is not serious. Simple treat-  Within a few days, the stump begins to dry out and ment may be needed, most commonly the use of silver becomes darker. nitrate to speed healing.  For the first few weeks, simple care is needed to keep the  Prolonged separation. This occurs when the umbilical cord stump dry and clean. You should sponge-bathe cord stump takes longer than 3 to 4 weeks to fall off. It your baby during this time rather than bathing him or is usually not a serious problem. her in a tub.  Umbilical . Part of the intestines may stick out  The cord stump gradually becomes dry and black. It through the belly button after the cord stump falls off. should fall off on its own around this time. The area You may notice a swollen area that gets larger when your around your baby’s new belly button will be a little red baby coughs or cries. Usually, the swelling is easily pushed at first but should soon look like normal skin. back into place. Treatment is usually not needed unless the hernia is very large or doesn’t go away on its own. How do you care for the umbilical  Embryologic abnormalities. These are problems occur- cord stump? ring when the baby was forming in the mother’s womb. They may include cysts or connections between the umbi-  Keep the cord stump clean and dry until it falls off. Wash licus (belly button) and the urinary system or intestines. your baby with a sponge or wash cloth and warm water. Surgery may be needed to repair the abnormality.

430 Copyright 2007 by Elsevier Umbilical Cord Care n 431

Can umbilical cord problems  Active bleeding—more than a drop or two of blood from be prevented? the cord stump.  — Following steps to keep the umbilical cord stump clean Drainage or moisture a lot of fluid coming from the and dry may help to prevent infections. cord stump, or if moisture or drainage is present for more than a few days.  When should I call your office? Very foul odor. Call our office if any of the following nonemergency Umbilical cord problems are uncommon, but it is conditions occurs: important to watch out for signs of infection or other problems.  The cord stump doesn’t fall off on its own within 4 ! Call our office immediately if any of the following occurs: weeks.  Redness beyond the area immediately around the base of  Swelling is present under the skin around the belly but- the cord stump. ton area.

Copyright 2007 by Elsevier