Umbilical Cord Stump – Care, Healing & Complications

What Is the Umbilical Cord Stump?

The umbilical cord stump is the short piece of umbilical cord that remains attached to a newborn after the cord is cut at birth. Initially soft and yellowish-green in colour, it dries out over the first few days and turns brown or black. Within approximately 7 to 21 days, the stump shrivels and detaches on its own, leaving behind the navel (belly button).

Function and Formation

During pregnancy, the umbilical cord connects the unborn baby to the mother via the placenta. It carries oxygen and nutrients to the baby and removes waste products. After birth, the cord is clamped and cut. The remaining stump no longer contains active blood flow and is naturally shed by the newborn as the surrounding tissue heals.

Care of the Umbilical Cord Stump

Proper care of the stump is essential to prevent infection. Key guidelines include:

• Keep it dry: Moisture increases the risk of infection. Allow the stump to air-dry as much as possible.
• Fold the nappy: Fold the top of the nappy below the stump to prevent rubbing and to expose it to air.
• Do not pull: Never attempt to pull the stump off. Allow it to detach naturally.
• Avoid alcohol wipes: Current medical guidelines generally recommend dry cord care without routine use of antiseptics in healthy newborns in hygienic settings.
• Bathing: Until the stump has fallen off, sponge baths are recommended to keep the area dry.

Possible Complications

Cord Infection (Omphalitis)

Omphalitis is a bacterial infection of the umbilical stump and surrounding tissue. It is a serious condition requiring prompt medical attention. Warning signs include:

• Redness, swelling, or warmth around the navel
• Pus or foul-smelling discharge from the stump
• Fever in the newborn
• Pain or tenderness when the area is touched

Parents should seek medical advice immediately if any of these symptoms are present.

Umbilical Granuloma

An umbilical granuloma is a small, moist, pinkish-red overgrowth of tissue that can form after the stump has fallen off. It is generally not painful but requires medical evaluation and treatment, as it does not resolve on its own.

Umbilical Hernia

An umbilical hernia occurs when a small gap remains in the abdominal wall after the stump falls off, allowing a portion of the intestine to protrude. It is common in infants and typically resolves on its own by age two.

When to See a Doctor

Parents should consult a healthcare professional if the stump has not fallen off after three weeks, if there are signs of infection, or if persistent moisture or a granuloma develops after the stump detaches.

References

1. World Health Organization (WHO): WHO recommendations on postnatal care of the mother and newborn. Geneva: WHO Press, 2013.
2. Imdad A, Bautista RMM, Senen KAA et al.: Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database of Systematic Reviews, 2013.
3. American Academy of Pediatrics (AAP): Guidelines for Perinatal Care, 8th edition. Elk Grove Village: AAP, 2017.