Umbilical Cord Care

The umbilical cord is the baby’s lifeline to the mother during pregnancy. It is the “super highway” for the baby to receive and dispose of nutrients and oxygen. With normal growth and development, there will be three vessels inside to transport these nutrients between mom and baby, which are clamped immediately after delivery.

There are no nerve fibers in the umbilical cord, so pain is not felt by the baby when the cord is clamped and cut. The remaining cord attached to the baby is referred to as the stump and will remain intact for about 10 to 15 days as it dries and falls off. The navel will be exposed after the stump falls off and also will need to be cared for until completely healed.
Providing care to the cord stump over the next two weeks requires diligence and often makes parents and caregivers feel uneasy. This umbilical site is a source where infection can enter the baby’s body, so providing good care is important. There are different methods suggested for caring for the umbilical cord, ranging from an application of medicine by the hospital staff or using alcohol daily to simply just “leaving it alone.” Follow your hospital’s guide for providing care to the umbilical cord, and always remember these key principles to providing cord care:

Keep the stump clean. Gently clean the umbilical cord stump daily and as needed with diaper changes to wipe away any wet, sticky, or dirty substances that may be present. Again, ask your hospital and baby’s doctor for their approved method of cleaning. They may suggest using water and a mild soap, or rubbing alcohol with a cotton swab.

Keep the stump dry. Give sponge baths until the cord falls off to prevent a higher chance of infection. After the cord is cleaned, wipe using a dry cotton swab, then allow the stump to air dry. After the cord falls off, continue to sponge bathe until the navel appears dry and completely healed.

Let the stump fall off on its own. Never try to pull the cord off. It will take one to two weeks for the cord to be dry enough to fall off on its own. Some cords stay intact longer. Adjust the baby’s diaper to avoid irritating the cord by turning the top down or even using special diapers that have a notch cut out around the cord.

Report abnormal findings. Umbilical cord infections are not very common but need to be reported early in order for treatment to be started. Call your baby’s doctor if you find any of these signs of infection:

• Bleeding from the end of the cord
• Yellow or white discharge with foul smelling odor
• Swelling or redness around the navel
• Signs that the navel area is painful to the baby
• Fever

Small protrusions of the baby’s abdominal muscles at the base of the navel are common especially with crying. If you are worried, check with your pediatrician as weakened abdominal muscles, an umbilical hernia, may be present. It will require monitoring.

The size of the stump, the length of time it remains intact and how you care for the cord will not affect the navel’s appearance in the future. Parents often are concerned with their baby’s navel being an “innie” or an “outie.” There is no way to predict this or make the navel look one way or another. Every cord is different … just like the baby you are caring for.

Mary Lou Bowers is an registered nurse at Carolinas Medical Center.