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Resources

Is Your Child Sick?TM


Umbilical Cord Symptoms

Is this your child's symptom?

  • 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 for Umbilical Cord Symptoms

When to Call for Umbilical Cord Symptoms

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
  • Age less than 12 weeks old with fever. 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

Call 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

Call 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

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
  • Age less than 12 weeks old with fever. 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

Call 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

Call 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

  1. 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 grey.
    • The cord will normally fall off between 1 and 3 weeks.
    • Here is some care advice that should help.
  2. 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).
  3. Bathing:
    • Keep the cord dry. Avoid tub baths.
    • Use sponge baths until the cord falls off.
  4. 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.
  5. 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.
  6. 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

  1. 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.
  2. 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.
  3. 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.
  4. Fold Diaper Down:
    • Keep the navel dry to help healing.
    • To provide air contact, keep the diaper folded down below the navel.
  5. What to Expect: The belly button should be healed and dry by 7 days.
  6. 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

  1. 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.
  2. 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.
  3. 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.
  4. Bathing:
    • Do not use tub baths until the cord falls off. The navel should be well healed.
  5. 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.
  6. 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.
  7. 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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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

  1. 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.
  2. 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.
  3. 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.
  4. 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

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

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


Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.

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