Umbilical Cord Care By Dr. Prashanth Gowda

In the womb, the umbilical cord connects the fetus to the mother. After birth, the cord is no longer needed. It is cut, then clamped. The stump of the cord usually dries and falls off the newborn in a 7-12 days or so. Sometimes the stump falls off before the first week. Other times, the stump may stay longer. You may notice a red, raw-looking spot right after the stump falls off. A small amount of fluid sometimes tinged with blood may ooze out of the navel area. It is normal for this to last up to 2 weeks after the stump falls off. If it doesn't heal or dry completely within 2 weeks, call your doctor.

General care of the umbilicus / belly button:
Keep the belly button clean and dry
Cleanse belly button with soap and warm water when it gets soiled with urine or stool.
Expose the belly button to the air by rolling back the top of the nappy.
Do not apply anything over it.

When to call a doctor?
Call your baby's doctor if you see any signs of an infection. These signs include:
Pus (yellowish fluid) that is around the base of the cord and smells bad.
Red, tender skin around the base of the cord.
Your baby crying when you touch the cord or the skin around it.
Fever.

What is an umbilical granuloma?
An umbilical granuloma is an overgrowth of tissue during the healing process of the belly button (umbilicus). It usually looks like a soft pink or red lump and often is wet or leaks small amounts of clear or yellow fluid. It is most common in the first few weeks of a baby's life.

General Care:
Follow the doctor's instructions for cleaning the granuloma and area around it. Use a clean, moist cloth or cotton swab. Gently lift the stump to clean the navel underneath. Be sure to remove all drainage and clean an inch around the base.
Pat the area with a clean cloth and allow it to air-dry. You may have to roll the diaper down below the navel to expose the granuloma to air.
Wash your hands well before and after caring for the stump. This will help prevent infection.
Watch for signs of infection

How is an umbilical granuloma treated?
If there is an umbilical granuloma and no obvious infection, then your General Physician, pediatrician, midwife or health visitor may suggest salt treatment. This has been found to be an effective and safe treatment which you can do at home.
Other treatment option copper sulphate, silver nitrate treatment will be suggested. This has to be done by a health professional. The health professional who advised the treatment can provide you with the gauze swabs needed (or you can buy extras from a pharmacy if needed).

How to do the salt treatment:
Apply a small pinch of table or cooking salt onto the umbilical granuloma.
Cover the area with a gauze dressing 'swab and hold it in place for 10-30 minutes. This may be easiest to do when your baby is asleep.
Now clean the site using a clean gauze dressing soaked in warm water.
You should repeat the procedure twice a day for at least two days.
If it's not getting better visit your pediatrician.

By
Dr. Prashanth Gowda, MBBS DNB DCH FIPM