How soon should the umbilical cord fall off

Umbilical Cord Symptoms

Is this your child's symptom?

Umbilical cord or navel questions about newborns
The navel is also called the belly button or umbilicus

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.

When to Call for Umbilical Cord Symptoms

Call Doctor or Seek Care Now

Age less than 1 month old and looks or acts abnormal in any way
Bleeding won't stop after 10 minutes of direct pressure applied twice
Spot of blood more than 2 inches (5 cm) across
Red streak runs from the navel
Red skin spreads from around the navel
Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Small bleeding lasts more than 3 days
Pimples, blisters or sores near navel
Lots of drainage (such as urine, mucus, pus) from the navel
You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

After using care advice for 3 days, navel is not dry and clean
Small piece of red tissue inside the navel
Cord stays attached more than 6 weeks
You have other questions or concerns

Self Care at Home

Normal cord care
Normal navel care after cord falls off
Minor infection of cord or navel
Normal bleeding from cord or navel
Normal delayed separation of the cord after 3 weeks

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Care Advice

Treatment for Normal Umbilical Cord

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 gray.
- The cord will normally fall off between 1 and 3 weeks.
- Here is some care advice that should help.
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).
Bathing:
- Keep the cord dry. Avoid tub baths.
- Use sponge baths until the cord falls off.
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.
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.
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

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.
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.
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.
Fold Diaper Down:
- Keep the navel dry to help healing.
- To provide air contact, keep the diaper folded down below the navel.
What to Expect: The belly button should be healed and dry by 7 days.
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

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.
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.
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.
Bathing:
- Do not use tub baths until the cord falls off. The navel should be well healed.
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.
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.
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

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.
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.
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.
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.
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

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.
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.
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.
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

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/07/2022

Last Revised: 01/13/2022

Umbilical cord care in newborns: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus.gov/ency/article/001926.htm

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When your baby is born the umbilical cord is cut and there is a stump left. The stump should dry and fall off by the time your baby is 5 to 15 days old. Keep the stump clean with gauze and water only. Sponge bathe the rest of your baby, as well. Do not put your baby in a tub of water until the stump has fallen off.

Let the stump fall off naturally. Do not try to pull it off, even if it is only hanging on by a thread.

Watch the umbilical cord stump for infection. This does not occur often. But if it does, the infection can spread quickly.

Signs of a local infection at the stump include:

Foul-smelling, yellow drainage from the stump
Redness, swelling, or tenderness of the skin around the stump

Be aware of signs of a more serious infection. Contact your baby's health care provider immediately if your baby has:

Poor feeding
Fever of 100.4°F (38°C) or higher
Lethargy
Floppy, poor muscle tone

If the cord stump is pulled off too soon, it could start actively bleeding, meaning every time you wipe away a drop of blood, another drop appears. If the cord stump continues to bleed, call your baby's provider immediately.

Sometimes, instead of completely drying, the cord will form pink scar tissue called a granuloma. The granuloma drains a light-yellowish fluid. This will most often go away in about a week. If it does not, call your baby's provider.

If your baby's stump has not fallen off in 4 weeks (and more likely much sooner), call you baby's provider. There may be a problem with the baby's anatomy or immune system.

Cord - umbilical; Neonatal care - umbilical cord

Umbilical cord healing
Sponge bath

Esper F. Postnatal bacterial infections. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 48.

Nathan AT. The umbilicus. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 125.

Taylor JA, Wright JA, Woodrum D. Newborn nursery care. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 26.

Wesley SE, Allen E, Bartsch H. Care of the newborn. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 21.

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

UMBILICAL WOUND IN NEWBORN

UMBILICAL WOUND IN NEWBORN

Primary treatment and ligation of the umbilical cord is performed even in the maternity hospital after the complete cessation of pulsation of its vessels, which usually occurs 2-3 minutes after the birth of the fetus. Before crossing the umbilical cord, it is wiped with alcohol and two sterile clamps are applied at a distance of 10 and 2 cm from the umbilical ring. The umbilical cord between the clamps is treated with 5% iodine solution and crossed with sterile scissors. The umbilical stump (residue) remains in this place, which dries up and falls off on its own naturally after a few days. The umbilical cord is cared for by a doctor.

There is no need to keep the baby in the hospital until the rest of the umbilical cord falls off. This is even reflected in Order N 345 of the Ministry of Health of the Russian Federation “On improving measures to prevent nosocomial infections in obstetric hospitals”: “From an epidemiological point of view, a course for early discharge (2-4 days after birth), including before the umbilical cord falls off, is justified.”

However, in the history of the development of a newborn, one can often read "the umbilical cord fell off on the second day." In life, surgical removal is practiced - cutting off or unscrewing the umbilical cord residue after the newborn has two full days of life. This is due to the fact that not even all district pediatricians and patronage nurses are ready for a child with a bracket to come under their supervision, not to mention a young mother.

So, by the time of discharge from the hospital, as a rule, the umbilical cord is no longer there, but there is an umbilical wound, or rather, a scar (navel), which must be carefully looked after. This area must be kept clean and dry at all times. To reduce the risk of infection of the umbilical wound and in order to prevent purulent diseases of the navel and the development of umbilical sepsis (in which the infection enters the bloodstream, causing infection of the whole body), it is necessary to treat the umbilical wound twice a day (in the morning during the first swaddling and in the evening after bathing).

To do this, you will need sterile cotton swabs, 3% hydrogen peroxide solution, alcohol infusion of greenery (or 5% potassium permanganate solution or 5% iodine solution).

Wash your hands thoroughly before handling the navel. Grasp the skin around the navel with your thumb and forefinger and open the wound a little. Moisten a cotton swab or drip a few drops of a 3% hydrogen peroxide solution and treat the wound from the center to the outer edges, carefully removing the wound discharge, while the peroxide will foam. Dry (wetting movements) with a sterile cotton ball. After that, we treat the umbilical wound with an antiseptic solution: iodine or brilliant green, or potassium permanganate. It should be noted that a solution of brilliant green causes weeping, and a solution of potassium permanganate (potassium permanganate) dries. Therefore, it is better to treat the wound with potassium permanganate.

It is necessary to treat the umbilical wound until the navel heals and there are no crusts, serous or sanious secretions, and when treated with peroxide, foam is formed.

As a rule, the umbilical wound heals (epithelizes) by the end of the second week of life, at the same time there is a contraction of the skin umbilical ring.

By the age of 2 weeks, the child will be a normal navel, the shape of which, by the way, does not depend on the skill of the one who cuts the umbilical cord, but depends solely on the individuality of the child.

If the wound starts to become wet, discharge appears, and the surrounding skin turns red, it is quite possible that an infection has got into it - in this case, call a doctor immediately!

A few tips:

Bathe the baby until the umbilical wound has healed in water with the addition of a weak solution of potassium permanganate.

Before each dressing, leave the umbilical wound open so that there is air access - this way it is easier to keep it dry.

Do not put a patch on the umbilical wound, as the baby's skin does not breathe through it and this may cause skin irritation.

It is possible to use disposable diapers with a special cutout for the navel, so the edges of the diaper will not touch the umbilical wound to avoid chafing, and the top layer closes the cutout and protects this place from moisture and infections

Proper care of the baby's umbilical cord in the first month after birth

While in the mother's womb, the baby is connected to the mother by the so-called "cord" of the umbilical cord, through which he receives oxygen and nutrients for a full existence. After the birth of a child, the medical staff of the maternity hospital treats the umbilical cord with alcohol and cuts it with sterile scissors, after which a clamp is applied. Before the umbilical cord residue disappears, it does not require special care, it is enough to wipe it twice a day with clean boiled water.

Of course, while the mother and baby are still in the maternity hospital, everything is easier, because there is a neonatologist nearby who controls this process. But when he gave permission for discharge, the care and custody of the kids falls on your shoulders.

Young mothers are interested in how many days the umbilical cord falls off the newborn. On the 4-5th day, the umbilical cord, which was a knot, dries up and detaches itself. It happens that this happens only after 10-15 days, this range is considered acceptable. A small wound remains at this place, which also needs to be processed. In no case should you try to speed up the approach of this moment, because this is a completely natural process, and it should proceed spontaneously. The only thing you can do is to provide free access to the baby's navel of air. Thanks to air baths, the remainder of the umbilical cord will dry out a little faster and, accordingly, will fall off much earlier.

In the first days after the umbilical cord falls off, the wound may bleed, this may occur because the blood vessels pass close to the navel and are damaged quite easily, most likely the result of damage to the crust on the wound during a change of diaper or clothes, a frequent case is the pressure on this area, caused by the strong crying of the baby.

During this period, it is very important to properly care for her. And then, if you act according to the recommendations, the umbilical wound will heal very quickly and will not be able to create any complications for the tiny organism.

Therefore, the general rules, under which, your baby will be fine:

First of all, any intervention in the treatment of a wound should begin with washing hands.
all things that touch the wound should be sterile clean, the baby's clothes while the wound is not healed should be well washed and ironed.
when washing a child under running water, you also need to make sure that dirty water does not fall on the navel.
you should not treat the skin around the navel with brilliant green, because if the skin starts to turn red and inflamed, you will not notice it right away.
treatment of the navel should not be done more than twice a day. Often disturbing the wound, you prevent it from healing quickly.
do not put a baby that has not reached 3 weeks of age on the tummy. It is worth waiting until the wound heals.
do not cover the navel with plaster
an important component in this case is the diaper. You can choose with a cutout for the navel, choose exactly those among the variety, look for the NEWBORN mark “newborn” or with the abbreviation NB, although it happens that this cutout is not provided in some models. Also, when choosing, you should focus on the weight of the child indicated on the package, because the smallest size is usually up to 5 kilograms. If necessary, the notch can be cut out on its own, or, if necessary, wrapped, making sure that it does not overlap the wound, but does not pinch it, and does not interfere with the free access of air
If all these rules are not followed, even with proper processing, it can become inflamed and start to get wet.

To treat an umbilical wound after the root has fallen off, you will need:

3% hydrogen peroxide solution, 1% alcohol solution of brilliant green, or in some cases 5% alcohol solution of potassium permanganate, cotton wool, cotton swabs, pipette. Having all the necessary attributes with you, after washing your hands, you can start washing. To begin with, on the crust formed on the wound (since such a formation serves as an excellent breeding ground for harmful bacteria), we drip a few drops of hydrogen peroxide (it will create unacceptable conditions for the development of microorganisms), after 10-15 seconds, when the crust on the wound gets wet, remove it with a cotton swab if necessary, you can repeat the procedure again, or make a compress. It is strictly forbidden to remove the skink dry, or to do it by force, as the umbilical wound may begin to bleed. After the cleaning procedure, carefully stretch the wound with the thumb and forefinger, and with a cotton swab (previously dipped in brilliant green), lubricate the wound, while it is advisable not to smear the skin around, because brilliant green has the property of drying, moreover, if there is some kind of inflammatory process, the consequence of which is usually redness at the edges, then with inaccurate smeared inflammatory processes simply will not be visible. In order to make it easier to monitor the condition of the wound, you can use, with the permission of the doctor, another antiseptic. For example, Chlorophilipt's solution or Xenoform

This procedure should be carried out twice a day, in the morning and after bathing. Ideally, it should heal in about two weeks. But much depends on the thickness of the umbilical cord, and on the depth of the notch that was formed during its excision.

If the wound is in no hurry to heal, and you notice that:
the navel of a newborn becomes wet (this means that an infection has got there)
the umbilical wound bleeds too much and often, and the discharge does not stop after treatment.
edema, suppuration or an unpleasant odor appeared.
the skin around the navel is reddened and inflamed
grayish or yellowish liquid comes out of the wound
the child is restless, does not eat well, sleeps, is nervous, she has a fever, does not gain weight.
the navel bleeds and does not heal at the end of the month after the umbilical cord falls off
sometimes in children there is a hernia in the navel, in the form of a bump, which becomes larger when the baby starts to cry or scream (most often it disappears after the wound heals)
with all these symptoms, you need to urgently contact a specialist to prescribe antibiotic therapy, according to the patient's condition, in order to avoid complications. After all, sometimes, even with all the rules of hygiene, the navel of a newborn gets wet. Finding out this by the behavior of the child is almost impossible. If you start the process, then the development of serious complications is not ruled out: inflammation of the navel (omphalitis), a fungal tumor, and even peritonitis and sepsis - blood poisoning. Do not think that we want to scare you with this article, just "familiar means reinsured", so do not panic. Such diseases will not come if timely measures are taken.

If parents are faced with a similar situation, the child should be taken to the doctor immediately. Only a specialist can assess the condition of the wound and prescribe an adequate treatment for this problem. After all, sometimes simple antiseptics are not enough, and additional procedures will be needed, for example, quartz treatment. With strong inflammatory processes, sometimes you even have to use an antibiotic - in the form of a powder or ointment. But in any case, you should not worry, because in most cases everything is solved much easier.
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