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Umbilical cord stump basics
During pregnancy the baby receives nourishment through the placenta attached to the inside wall of the uterus. The umbilical cord is the flexible cord containing blood vessels that connects the baby from their navel (‘belly button’) to the placenta. After birth, the special jelly (Wharton’s Jelly) surrounding the blood vessels and the blood vessels themselves collapse within about 5-20 minutes. How fast this happens depends on whether the umbilical cord is exposed to air or water (such as in a water birth) and the temperature it is exposed to. In cooler temperatures, this happens much quicker. In a water birth, this may happen slower. This collapse creates a natural clamp (called “physiological clamping” or “umbilical occlusion”).
The cord may be left (as in Lotus Birth or non-severance) or most commonly has a clamp attached and is then cut. The small part of the umbilical cord left attached to the baby is called the umbilical cord stump. This stump remains attached until it dries out and falls off anywhere between three days and two weeks (on average around one week).
How to care for the umbilical cord stump
Cord stump care is very simple. Keep it dry, uncovered and clean. Nappies/diapers or EC wear should be kept folded down and away from the stump so they aren’t covering or rubbing it. Clothing should be loose and body suits should be avoided if possible to allow air to circulate around the stump. Generally, the stump shouldn’t need cleaning – if necessary you can use some soft gauze or cloth (like muslin) and some breast milk or water to gently and carefully clean the stump. Allow it to air dry after.
After the cord falls off, there may be a small raw spot and/or a small amount of bleeding. This is normal and should heal on its own.
Do’s and Don’ts
- Let the stump fall off naturally.
- Keep it dry. Baths and showers should be avoided until the stump falls off. Give baby a clean using a wash cloth or sponge instead.
- Keep it clean. No lotions, antiseptics, powders, etc. need be applied. If it becomes soiled in some way (such as with baby poo), gently wipe it clean with some gauze/muslin moistened with breast milk or water and then allow to air dry.
- Pull on the stump or pull it off (even if it is hanging only by a small amount).
- Cover it with a plaster, nappy/diaper, EC wear, close-fitting clothing, etc.
- Put creams, lotions, antiseptics, alcohol, iodine, etc,. on a healthy cord stump. Applying alcohol has been found to increase the time it takes to heal.
What to look out for
Infections are rare. Yellow drainage and an unpleasant odour could be a sign of infection, especially if coupled with redness, swelling and tenderness of the skin around the cord stump. If the redness is localised to the base of the stump, you can apply some breast milk and/or a small amount of antimicrobial herbs or oils (such as pure lavender essential oil) to the stump. The cord stump should be monitored carefully.
See a healthcare provider as soon as possible if:
- The infection does not improve within a few days
- The redness spreads to the skin around the base of the stump and/or the infection gets worse
- Baby cries due to skin tenderness in the area
- Red streaks, pimples or blisters appear around the navel
- Baby gets a fever, seems unwell and/or won’t feed.
Constant bleeding around or from the cord stump may be of concern and should be seen by a healthcare provider (such as a GP).
After the cord falls off there may be a small raised pink or red lump. This is an overgrowth of tissue called a granuloma. Sometimes they appear wet or sticky and can leak clear or yellowish fluid. Most of the time they resolve by themselves. If it does not appear to be healing on its own, talk to a health care provider.
If the umbilical cord stump is still attached after 3 weeks, talk to a health care provider.
- Delayed Cord Clamping – Why You Should Demand It | BellyBelly
- Common Questions about Neonatal Umbilical Integrity (Lotus Birth): A Resource | Lotus Fertility
- Placenta Challenges and Options – Information Sheet [Image] | Birth Matters
- Video of an umbilical granuloma | YouTube
References [ + ]
|1.||↑||PDF: Umbilical cord clamping is not a physiological necessity: Hutchon 2010, BJM April 2010, Vol 18, No. 4.|
|2.||↑||Umbilical Cord Fall in Preterm and Term Newborns in Vaginal and Caesarean Deliveries. Indian Pediatrics 1999; 36:588-590|
|3.||↑||Cleaning solutions and bacterial colonization in promoting healing and early separation of the umbilical cord in healthy newborns. Can J Public Health. 1997 Nov-Dec;88(6):380-2.|
|4.||↑||Herbal Treatment of Children: Western and Ayurvedic Perspectives – Page 138|
|5.||↑||PDF: Umbilical Granuloma in Babies – Information for Parents and Carers. Royal United Hospital Bath NHS Trust.|