Umbilical Cord Care
After the baby is born, the cord will be clamped and cut leaving a stump that is approximately 2-3cm in length. During the first week or two, the stump will shrivel up and dry out, usually changing in colour from a yellow-green to a deep reddy-black or brown colour and shrinking significantly in size; at the end of this period the stump should naturally fall off. If it does not fall off after four weeks, then medical advice should be sought as this could indicate underlying issues with the baby’s immune system.
Once the stump has fallen off, it will take a further one to two weeks for the belly button to heal completely. During this time there may be some crusting around the belly button and a small amount of blood on the nappy and this is completely normal; if there is quite a lot of blood, then you should speak to your midwife or GP. Throughout this important process, due care and attention should be given to the umbilical cord stump to ensure that no complications or infections arise.
Caring For The Baby’s Umbilical Cord Stump
One of the most important things to do when caring for the baby’s umbilical cord stump is to make sure that it is kept clean and dry. Infection-causing bacteria will thrive in moist, warm conditions and the belly button and stump are prime targets for this since they are located in an area that is often covered for long periods of time. There are, however, ways to prevent this becoming an issue and that is to take proper care of the stump:[/vc_column_text]
Firstly, always try to make sure that you wash your hands before handling the cord stump or changing the baby’s nappy; when out and about, alcohol-based hand gel will be just as good if there are no washing facilities nearby. Also be sure to clean your hands afterwards as well.
To prevent the area becoming too moist, it will help to dress the baby in loose fitting clothing, ideally cotton, to allow dry air to circulate; try to avoid buttons and zips until the area has completely healed. If it is possible, the baby should be able to have periods of time lying completely naked, perhaps on a changing mat or towel. Doing this every day will allow the stump to dry out and drop off much more quickly. It is important, however, to make sure that the baby is in a warm place whilst doing this.
For the first couple of weeks, it is best to give the baby a top and tail wash rather than a bath because it is easier to keep the stump as dry as possible. If you do decide to bath the baby, you will need to make sure that the stump has been thoroughly but gently dried using a clean towel or cloth – the best way to do this is by gently patting the area and then letting the baby lie naked on a towel or changing mat, in a warm place, until the stump is fully dried.
When cleaning the stump, and washing the baby in general, it is best to just use plain water until the belly button has completely healed. If you wish to use something to wash the baby with, then it should really be one of the mild baby soaps or bath liquids that are available and not regular soap. There has been much discussion over the suitability of using rubbing alcohol to keep the stump free from germs and help it dry out faster, but medical professionals don’t seem able to agree – if in doubt, leave it out and stick to the advice your midwife or doctor has given you. Be careful when handling the baby to make sure that the stump is not prematurely knocked off; it will come off of its own accord, but if it is knocked off before it is ready, then it can cause bleeding and infection. If this happens, seek medical advice.
Whenever possible, try to make sure that the top of the nappy is folded down to help keep the area from becoming moist. Folding down the nappy also helps to prevent rubbing that can cause irritation and damage to the stump and belly button, thus preventing healing. There are some brands of newborn nappies that have cut outs at the top where the stump would be, they are a good way of helping to ensure that the stump does not get caught or become too damp. Whenever possible, you shou
ld try to ensure that the nappy is changed as soon as it becomes soiled to prevent any infections occurring from waste material in the nappy coming into contact with the stump.
Premature babies and those who have been in special care baby units will still need their stumps to be kept clean and dry, but they usually cannot be bathed. In this instance, it is important to seek the advice of the neonatal team to find out the best way to care for your baby’s umbilical cord stump.
Important Things To Be Aware Of When Caring For the Umbilical Cord Stump
As tempting as it might be to pull at the umbilical cord stump when it is hanging on by a thread, it is important not to do so – the stump simply must be allowed to drop off on its own. The reason for this is because the stump will only come off naturally once the initial stages of healing are complete. If the stump is pulled off before this happens, then it can cause bleeding to occur and will increase the risk of infection.
On occasion, babies develop small, pink, lumpy bits of flesh around the belly button area when the stump falls off – this is known as an umbilical granuloma. It is not a serious condition, nor does it cause any pain. This scar tissue should normally disappear without any need for intervention, but if it doesn’t, then a paediatric doctor or a nurse will usually cauterise the area using a stick of silver nitrate. This will not hurt the baby since there are no nerve endings in that area. It is a good idea to keep an eye on an umbilical granuloma for signs that it needs this treatment; these signs tend to include a yellowy-green discharge or if the wound looks red, sore and not fully healed, but is otherwise clean.
Despite the old wives’ tales, it is not possible to determine if your baby will develop an “inny” or an “outy” belly button and it is not possible to ensure that either outcome is achieved.
Signs Of Infection
All of the precautions and care tips mentioned above are designed to assist healing and prevent infection in the umbilical cord stump, post-birth. If there does appear to be an infection, then initially it may be localised to the area of the stump or belly button and will not make the baby unwell; advice should still be sought, however, and signs of an early infection include:
* A foul-smelling pus or discharge that is yellow in colour.
* The stump, if it is still attached, is swollen, tender or red.
* The area around the belly button, whether the stump is attached or not, is swollen, tender or red.
If left untreated, this infection can spread and develop into something called omphalitis, which in turn can develop into sepsis, or blood poisoning. Thankfully, this condition is both preventable and uncommon, but it is so dangerous to a newborn’s health that it must be taken seriously, hence the need for good care of the umbilical cord.
Generally speaking, omphalitis occurs in newborns during the first two weeks of life, although it can occur at any time during the healing process. As well as the redness and discharge mentioned above, other symptoms to look out for include:
* Fever, which is usually a temperature of around 37.5’c or higher.
* An unusually fast heart rate – newborn babies normally have a resting heart rate of around 120-160 beats per minute.
* Poor feeding or no appetite at all.
* Baby is floppy or appears lethargic.
* The skin appears yellow in colour.
If the baby experiences any of these signs whilst the umbilical cord stump is healing, then it is important to seek medical attention as soon as possible in order to prevent the infection from spreading and evolving into sepsis.
Following the above advice will help to ensure that the umbilical cord stump is well cared for and can heal properly; thus allowing the baby to enjoy its early days without any issues.