For the nine long months your baby grows within your womb, the umbilical cord functions as the life-line for him, carrying oxygen and nutrients from the placenta to his body.
What happens to the umbilical cord after birth
At birth, the cord remains attached to the baby and the placenta, before being cut by the doctor. [1, 2] Once it is cut and clamped on the navel, all that remains of the cord is about an inch long gelatinous stump, having three blood vessels at the center.
How to take care of your newborn’s umbilical cord stump
It is necessary to keep the area around the stump clean and dry till it falls off and the belly button is healed. Otherwise, it may get infected. WHO has added the antiseptic 7.1% chlorhexidine digluconate to its List of Essential Medicines for Children, especially for umbilical stump care. Consult your doctor if you are considering using it.
How to clean the umbilical cord stump
Sponge baths are often recommended during the healing period to keep your baby clean, as bathing him in a tub may increase the chances of infection because it may be difficult to dry the stump after a full bath.
You can use a cotton-tipped applicator, dipped in warm sterile water to gently clean out any dirt around the cord stump. Once done, use a clean cotton cloth to pat dry the stump. There is no risk of hurting your baby as there are no nerve endings in the umbilical cord, so your baby won’t feel anything. However, be gentle to avoid bleeding.
Earlier it was believed that using rubbing alcohol to clean the stump accelerated the healing process. However, recent research does not support this practice, showing natural drying to be more effective in making the cord fall off sooner.[10, 11]
Additional tips to care for the cord stump
- Expose the cord stump to air as much as possible, as this speeds up the drying process. When the weather is hot, dress your baby in light t-shirts and diapers, avoiding tight, bodysuit style clothes.
- Make sure the stump does not come into any friction while changing diapers.
- Use special diapers with a cut-out around the belly to keep the belly button exposed. If using cloth diapers, you can simply fold the front of the diaper, so it does not cover or jostle the cord stump.
- Change the diapers as soon as they get wet, to prevent anything leaking toward the navel.
- Clean the stump promptly with a cotton swab and water in case some urine or poop leaks toward it. It does not pose any dangers as long as it is cleaned properly.
- Never pull on the cord stump or try to pull it off to hasten healing, even if it seems to be attached only by a thread. Let it come off on its own.
- It is normal to notice a little clear or yellowish secretion now and then. Make sure to gently clean it away and dry the area well.
Some studies conclude that topical application of breast milk speeds up the healing procedure, helping the stump to fall off earlier.[16, 17, 18] Cleaning the stump with witch hazel, and applying tea tree oil, echinacea, or goldenseal root powder  are also considered to help in getting rid of the stump faster. However, there is no scientific evidence to prove it.
Keep in mind that a little blood or crusting around the cord is completely normal and nothing to worry about, unless there are other signs of infection or discomfort.
How long does the umbilical cord stump take to fall off
Due to lack of any blood supply, the stump gradually dries up, shrivels, and turns black, finally falling off within 1 to 3 weeks after birth. In most cases, it happens between 10 and 14 days.
However, there is usually nothing to worry about even if it falls off within the first week.[21, 22]
Delayed umbilical cord separation — is it normal
Sometimes, the cord does not come off, even after your baby enters the fourth week of his life. Usually, there is nothing to worry about, unless there is a sign of infection. Consult your pediatrician in any case, as sometimes it may indicate an immune system abnormality. Sometimes, doctors use a little silver nitrate to make the cord stump come off when it is over four weeks.
Your baby’s belly button after the umbilical cord falls off
When the cord stump falls off, it leaves behind your baby’s belly button in the form of a small, round wound that takes around a week to 10 days to heal completely. It is normal to spot a little bleeding as well as some yellowish discharge from the site at this time. Make sure to keep the area clean till the belly button heals.
Covering the cord stump with bandages or coins does not help your baby have an innie belly button. Babies are born with outies/innies and trying anything on the area only irritates or even infects the stump.
Umbilical cord stump infections and other problems
What does an infected umbilical cord look like
Call your doctor or pediatrician if the stump looks red and swollen with or without any pus discharge.
Other signs of infection
- Yellowish, foul smelling discharge
- Baby looking or acting sick (lethargic, unwilling to feed)
- Running a fever
- Crying when the skin around the stump is touched
- Continuous bleeding from the stump (no sooner than you wipe away a drop of blood, it is replaced by another)
- Poor muscle tone
Sometimes, you may notice some reddish lumps of tissue on your infant’s belly button after the cord stump falls off. It is referred to as umbilical granuloma, and may require medical attention if they do not go away on their own within a few days. Although not painful, lack of treatment may cause them to ooze a mucusy discharge, irritating your baby for months.
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