I am expecting my first baby in two weeks’ time. I have received varying pieces of advice on how I should take care of the umbilical cord. Should I clean it using spirit, water or soap?
Jane
Dear Jane,
When a woman is pregnant, the umbilical cord supplies nutrients and oxygen to her developing baby. After birth, the umbilical cord is no longer required, and it is cut leaving a stump. There is no exact number of days within which the stump should fall off, but on average, it should dry and fall all by the time your baby is five to 15 days old. Keep the stump clean.
In the past, parents were instructed to clean/swab the stump using surgical spirit or rubbing alcohol after every bath. Research now shows the stump might actually heal faster if left alone. If the stump becomes dirty or sticky, clean it with plain water, after which you dry it by holding a clean, absorbent cloth around it or fanning it with a piece of paper.
Try to keep the stump dry, and expose it to air to help dry out the base. Sponge baths for the baby might be the most practical during the healing process. Afterwards, when the stump is gone, you can bathe your baby in a tub or sink. Recent research has shown that, the baby may not be bathed during the first three days, only chlorhexidine gel is applied. It prevents infection and quickens drying and dropping off of the cord stump.
You should let the stump fall off naturally. Do not try to pull it off, even if it is only hanging on by a thread. If the cord stump is pulled off too soon, or falls off, the stump could start active bleeding, meaning every time you wipe away a drop of blood, another drop appears. If the cord stump continues to bleed, take the baby for urgent medical checkup. It is important to watch the umbilical cord stump for infection. Infections are often not very common, but can spread very quickly when they do occur.
Some pointers to infection may include fever, refusal to breast feed, irritability, malaise or floppiness, and general lethargy. Around the cord stump, local signs of infection include foul smell, yellowish drainage from the stump, redness, swelling or tenderness of the skin around the stump.
In some situations, instead of completely drying, the cord will form pink scar tissue that is called a granuloma.
The granuloma usually drains a light-yellowish fluid, that should not be confused for an active infection, and this most often disappears in about a week. If it does not, take the baby for checkup and further medical advice. If your baby’s cord stump has not fallen off in 4 weeks or generally after two weeks, you need to consult your doctor too. Delayed falling off of the cord may be an indicator of a problem with the baby’s anatomy or immune system.
Dr Ombeva Malande is a paediatrics and child health expert