Before leaving the hospital, you remembered to bring the car seat and ask your doctor about diapering and feeding your new bundle of joy. But one topic that is often overlooked is your newborn’s belly button: what is that shriveled up remnant and what am I supposed to do with it? The umbilical cord, which provided blood flow between your baby and the placenta in utero, gets clamped and cut at birth. This little stump slowly shrivels and dries, eventually falling off to create the umbilicus (a.k.a. navel or belly button).
Keeping the umbilical stump clean and dry is imperative in preventing complications and promoting healing.
Top 5 tips in caring for the umbilical stump:
- Do not soak baby - give sponge baths only to minimize water exposure to the stump.
- Do not use rubbing alcohol, ointments, betadine, etc, as the stump requires no actual wound care.
- Keep the top of diaper folded down away from the stump to prevent urine from reaching the area. Many newborn diapers have a notch built in for this purpose.
- Dress baby in loose fitting clothing (e.g. our favorite babySTAT™ Kimono shirt).
- Never attempt to pull off the stump.
For decades, doctors recommended daily use of alcohol swabs to keep the umbilical stump clean. However, there is little evidence proving the benefits of using alcohol, and now the American Academy of Pediatrics (AAP) advises against it. It is now recommended simply to keep the area clean and dry, using care tips such as those listed above.
Most umbilical stumps will naturally fall off on their own in the first few weeks of life, but some can last up to two months of age. If it remains longer, you should see your pediatrician. It is possible to see a tiny drop of blood from the area, which is common and normal. Active bleeding, however, is a concern and should be seen emergently.
One of the rare complications that can occur is an infection of the stump known as omphalitis. Omphalitis is a severe infection that can progress rapidly and warrants immediate attention.
RED FLAGS for an umbilical stump infection include:
- Redness or dark skin color changes around/at the base of the stump
- Foul-smelling drainage
- Pain or crying when the stump or surrounding areas are touched
- Lethargic or ill-appearing baby
If any of these signs or symptoms are present, head to the nearest emergency department.
There will be plenty to think about during the first few weeks of life, and the umbilicus is just one of them. Remember to keep it simple with umbilical care - clean and dry. Just as the umbilical stump phase is fleeting, so is having a newborn. Enjoy the wonderful chaos!
1. Imdad A, Bautista R, et al. Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database Syst Rev. 2013 May 31;5:CD008635.
2. Palazzi D, Brandt M. et al. Care of the umbilicus and management of umbilical disorders. Uptodate. updated: Dec 02, 2015.
3. McConnell T, Lee C, et al. Trends in Umbilical Cord Care: Scientific Evidence for Practice. Newborn & Infant Nursing Reviews
4. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Umbilical-Cord-Care.aspx Umbilical Cord Care. Caring for Your Baby and Young Child: Birth to Age 5. American Academy of Pediatrics, Nov 21, 2015