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When should umbilical stump 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

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

Care Advice

Treatment for Normal Umbilical Cord

  1. 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.
  2. 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).
  3. Bathing:
    • Keep the cord dry. Avoid tub baths.
    • Use sponge baths until the cord falls off.
  4. 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.
  5. 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.
  6. 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

  1. 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.
  2. 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.
  3. 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.
  4. Fold Diaper Down:
    • Keep the navel dry to help healing.
    • To provide air contact, keep the diaper folded down below the navel.

  5. What to Expect: The belly button should be healed and dry by 7 days.

  6. 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

  1. 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.
  2. 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.
  3. 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.
  4. Bathing:
    • Do not use tub baths until the cord falls off. The navel should be well healed.
  5. 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.
  6. 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.
  7. 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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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

  1. 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.
  2. 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.
  3. 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.
  4. 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: 10/12/2022

Last Revised: 01/13/2022

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.

Umbilical cord care in newborns Information | Mount Sinai

Cord - umbilical; Neonatal care - umbilical cord

The umbilical cord connects the baby to the mother's placenta. During fetal development in the womb, the umbilical cord is the lifeline to the baby supplying nutrients. After birth, the cord is clamped and cut. Eventually between 1 to 3 weeks the cord will become dry and will naturally fall off. During the time the cord is healing it should be kept as clean and as dry as possible.

A sponge bath is the best way to clean your baby until the umbilical cord falls off. To give a sponge bath, dip a soft cloth in the warm water and wring out the excess. If needed, a mild soap can be used in the water. Wipe the baby's skin gently starting from the area of the baby's head and work your way down to the rest of the body. Pay special attention to the skin creases and diaper area. Rinse your baby with clean warm water and dry him or her completely.

Information

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.

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.

Last reviewed on: 12/10/2021

Reviewed 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

Daily care for a newborn

Basic procedures

What is the daily care of a newborn, how to wash the baby and take care of the umbilical wound, how to change diapers, take care of nails, feed the baby and walk with him - we will tell about these basic procedures for caring for a newborn in our article.

When it comes time to return home with a newborn from the maternity hospital, every mother begins to worry about how she will take care of her child without the help and competent advice of medical staff.

Without exception, all mothers are worried about whether they will be able to provide their child with the care necessary for his healthy growth: properly bathe the baby, cut off his nails, treat the umbilical wound.

Therefore, before mothers cross the threshold of their home, they have many questions about caring for a child: is it worth washing the baby after each urination, what is the best way to treat the navel: brilliant green or calendula tincture?

Today we will try to find answers to the main questions about the hygiene of the child and talk about the basic procedures for daily care of the baby.
Newborn's morning toilet

Like every person, a baby should wash his face in the morning, of course, his mother should help him in this.

After the newborn wakes up, strip him naked, let him lie naked for a while - this is good for the baby's skin. Then carefully examine the baby, check for redness on the skin, prickly heat. If there is, then prepare a baby cream to lubricate problem areas after washing the baby.

The baby is washed with cotton pads soaked in warm boiled water. Washing the newborn is carried out from top to bottom.
Rub your baby's eyes from the outer edge to the inner. For the hygiene of each eye, it is recommended to take a new cotton pad.
Gently wipe the baby's face, ears - outside, skin behind the ears, neck with a damp cotton pad.
Listen to the baby's breathing, it should be free. If breathing is difficult, clear your baby's nose. To do this, you can use a special saline solution for children under one year old and an aspirator (a device that helps suck out mucus).
You can also use two small cotton swabs soaked in baby oil to remove scabs from your nose. The flagella must be carefully inserted alternately into each nostril of the child's nose and scrolled several times. If the baby's nose breathes well, then it does not need to be cleaned.
Then it is necessary to wipe all the folds of the baby's skin with a damp cotton pad, change the child's dirty diaper to a clean one, washing the baby or using baby wipes to cleanse the skin.

Caring for the umbilical wound

During the newborn period, the umbilical wound is a special place on the body of a child, it requires careful care.
As a rule, the umbilical wound is treated once a day, you can do this after bathing, when all the crusts are soaked from the water and the mucus is washed out.

How to treat the navel of a newborn? There are several ways to treat the umbilical wound, each of them is quite effective: dry the navel for a few minutes;

  • treatment of the navel with hydrogen peroxide and antiseptic (chlorhexidine, baneocin, levomekol, iodine, brilliant green, alcohol-based chlorophyllipt) - to treat the navel, take two cotton swabs, dip one in peroxide, the other in antiseptic, first treat the navel with peroxide , with which we wash all the crusts from the navel, and then with an antiseptic.

    • Advice on which navel treatment is usually given by the nurses at the maternity hospital, as well as by the health visitor who will visit your baby during the first month of life.

    Important! If you notice that the skin around the umbilical wound is inflamed, be sure to consult a doctor.
    If you see that the umbilical wound does not heal within a month, it is better to take the child to the doctor. Usually, up to 14 days of life, the umbilical residue disappears and the wound heals.

    Washing the newborn

    Wash your baby under running water after every bowel movement.

    It is convenient to wash your newborn like this:
    Place the baby on your belly on your left palm facing you or with his back on your forearm with his head towards you.
    Place the child's lower body under running water.
    Lather baby's buttocks and genitals with baby soap (liquid soap for babies is better, it's easier to use).
    Then rinse the soap thoroughly with water, pat the baby's skin dry with a towel or diaper.
    If the baby has just urinated into the diaper, then you can not wash it, but use wet wipes when changing the diaper. Choose special baby wipes that are fragrance- and alcohol-free.
    Changing diapers

    Most often, mothers use disposable diapers for baby care. There are a few simple rules that are important to follow in this case:

    When using them, remember that the child should not be in one disposable diaper for more than 4 hours.
    Putting a diaper on a newborn should be done in such a way that the umbilical cord is not covered. This is necessary for the fastest healing of the umbilical wound.

    It is desirable that a few hours a day the baby just lie on the diaper without a diaper, so that the skin can breathe.

    It is also important to ensure that diaper rash does not form on the skin under the diaper. To prevent diaper rash, it is necessary to dress the baby according to the weather, that is, do not overheat it, and you can also use a special diaper cream.

    If diaper rash has already formed, you need to see a doctor, he will recommend a remedy for their healing, most likely it will be a cream containing dexpanthenol, an effective healing medicine.

    Of course, it is better to prevent diaper rash, as they can be very painful and disturb the baby.
    Bathing a newborn

    All mothers are interested in the question: when can you start bathing a child after discharge from the hospital?

    “You can bathe the child immediately after discharge, but if you have been vaccinated with BCG, but within a day or two after the vaccination, it is better not to bathe the child so as not to wet the injection site.”

    After the umbilical wound has healed, you can already bathe the child in a regular bath in tap water, gradually increasing the bathing time from 5 minutes to 30-40.

    Every day while bathing the child, it is necessary to wash his genitals and buttocks, 1-2 times a week you need to wash the whole baby with soap, and also wash the child's head with a special baby shampoo.

    Important! Always bathe your child with the bathroom door open, because this child will not be so cold after you take him out of the water, as the temperature difference will not be too big.

    Each time the baby should be lowered into the water slowly, starting from the legs. In the water it is necessary to support the entire body of the child. If water gets into the baby's ears or eyes while bathing, it's not scary, it's quite natural!

    From the first days of life, you can start easy hardening of the child. To do this, before you start bathing the baby, prepare and place a vessel with water in the bathroom, the temperature of which will be 0.5-1 degrees lower than the temperature of the water in the bath. At the end of the bath, pour water over the child from this vessel.

    After bathing the baby, blot with a diaper or towel, but do not dry it, as this procedure can damage the delicate baby skin.

    You also need to prepare two small cotton buds and gently twist them into the baby's ears so that the cotton absorbs the water that got into the ears during the bath. After the baby's skin is dry, it is advisable to treat the folds with baby oil.
    Newborn nail care

    Baby's nails should be cared for 1-2 times a week, because nails grow very quickly in children. To cut nails, you need to purchase special scissors with rounded ends. On the legs, the nails should be cut evenly, and on the hands - rounding the edges.
    Walking with a baby

    In summer, you can walk with your baby the day after you leave the maternity hospital. It is advisable to protect the child from direct sunlight. It is better to go for a walk in the summer either in the morning (before 10 am) or in the evening (after 6 pm), at this time it is not so hot.

    In winter, walks are recommended to start 2-3 days after discharge from the hospital. If the temperature outside is below 10 degrees, it is better not to go for a walk with the baby.

    The first walk should be very short - 10-15 minutes. Then every day it is worth walking for 10 minutes longer.

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