Umbilical Cord Care

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Topic Overview

After the umbilical cord is cut at birth, a stump of tissue remains attached to your baby's navel (umbilicus). The stump gradually dries and shrivels until it falls off, usually between 1 and 2 weeks after birth. It is important that you keep the umbilical cord stump and surrounding skin clean and dry. This basic care helps prevent infection. It may also help the umbilical cord stump to fall off and the navel to heal more quickly.

Cleaning

Gently clean your baby's umbilical cord stump and the surrounding skin at least once a day and as needed during diaper changes or baths.

1. Soak a cotton swab in warm water and mild soap. Squeeze out the excess water. Gently wipe around the sides of the stump and the skin around it. Your health professional may recommend using rubbing alcohol instead of soap and water. If you use rubbing alcohol, first apply a gentle lotion around the stump. This can help protect your baby's sensitive skin.
2. Wipe away any wet, sticky, or dirty substances.
3. Gently pat dry the area with a soft cloth.

After the stump falls off—usually within a week or two but sometimes longer—continue cleaning around the navel at least once a day until the navel has completely healed.

Keeping the area dry

You can help your baby's umbilical cord stump fall off and heal faster by keeping it dry between cleanings.

• Keep your baby's diaper folded below the umbilical cord stump. If folding does not work well, try cutting out an area in the front of the diaper (before you put it on your baby) to keep the stump exposed to air. It also helps prevent diaper contents, such as urine, from irritating the stump.
• Bathe your baby carefully. Keep the umbilical cord stump above the water level until the stump falls off and heals. Many baby baths are gently sloped. This helps to position your baby for a sponge bath and avoids keeping the umbilical cord under water.

Knowing what to expect

• Most umbilical cord stumps look worse than they really are. Right after birth, an umbilical cord stump usually looks white and shiny and may feel slightly damp. As the stump dries and heals, it may look brown, gray, or even black. This is normal. Usually no problems will develop as long as you keep the area clean and dry.
• The umbilical cord stump usually falls off within a week or two. Sometimes the stump falls off before the first week; other times, the stump may remain 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. This is normal. The navel area should dry out within a few days. It should dry completely and look mostly healed within 2 weeks after it falls off.

When to call a health professional

Call your baby's health professional if signs of an infection develop. These signs include:

• Pus around the base of the cord.
• Fluid that continues to ooze out of the cord a few days after the stump falls off. (It is normal to notice some fluid the first day or two after the stump falls off.)
• Red, tender skin around the base of the cord.
• Crying when you touch the cord or skin around it.
• Fever.

Also call your baby's health professional if you notice any other problems with the umbilical cord, such as:

• Swelling and moistness on your baby’s navel that lasts for more than 2 weeks after the umbilical cord has fallen off. This may be a piece of extra tissue called an umbilical granuloma. This minor problem usually is treated with medicine to dry the area. Sometimes a couple of stitches are also needed.
• Bulging tissue around the navel, usually noticed after the umbilical cord falls off. This may be an umbilical hernia, which usually goes away on its own. But it should be monitored by a health professional.

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Last updated:	April 06, 2007
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Louis Pellegrino, MD - Developmental Pediatrics
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman