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Umbilical Cord Symptoms

Definition

  • 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

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

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

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