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Umbilical Granuloma: Causes, Symptoms & Treatment

An umbilical granuloma is a benign overgrowth of tissue at the navel of newborns that can develop after the umbilical cord falls off. It appears as a small, moist, reddish nodule and is easily treatable.

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Things worth knowing about "Umbilical granuloma"

An umbilical granuloma is a benign overgrowth of tissue at the navel of newborns that can develop after the umbilical cord falls off. It appears as a small, moist, reddish nodule and is easily treatable.

What is an Umbilical Granuloma?

An umbilical granuloma (medical term: Granuloma umbilici) is a common, benign overgrowth of tissue at the navel of newborns. It develops when excess granulation tissue – soft, newly formed connective tissue – forms after the umbilical cord has fallen off, instead of the wound healing normally. The granuloma appears as a small, reddish or pink, moist nodule inside the navel and is generally not painful for the infant.

Causes

The exact cause of umbilical granuloma formation is not fully understood. The following factors are thought to contribute:

Delayed or incomplete healing of the navel wound after cord separation
Moisture and lack of ventilation in the umbilical area
Mild inflammatory reactions at the navel
Individual differences in wound healing of the newborn

Umbilical granuloma occurs in approximately 1 in 500 newborns and is considered one of the most common umbilical conditions in infants.

Symptoms

Typical characteristics of an umbilical granuloma include:

A small, soft, reddish or pink nodule in the navel (usually 3–10 mm in size)
Moist, slightly glistening surface
Occasional mild weeping or discharge
No pain for the child in uncomplicated cases

An umbilical granuloma typically does not resolve on its own without treatment. If signs of infection are present – such as redness of the surrounding skin, warmth, foul-smelling discharge, or fever – a doctor should be consulted promptly, as omphalitis (umbilical infection) may be present and requires immediate treatment.

Diagnosis

The diagnosis of an umbilical granuloma is usually made through a clinical examination. The doctor assesses the appearance and texture of the nodule. It is important to distinguish it from other conditions:

Umbilical polyp: Consists of mucosal tissue, is firmer and paler than a granuloma, and requires different treatment.
Omphalitis: A bacterial infection of the navel with a pronounced inflammatory reaction.
Umbilical hernia: A protrusion of abdominal contents through the abdominal wall at the navel.

In uncertain cases, an ultrasound examination or tissue biopsy may be performed to confirm the diagnosis.

Treatment

Treatment of umbilical granuloma is generally straightforward and effective. The following methods are used:

Silver Nitrate Cauterization

The most common treatment is cauterization with silver nitrate. The excess tissue is chemically destroyed using a silver nitrate stick. This leads to the breakdown of the granuloma tissue. The procedure is typically performed in 1–3 sessions by a pediatrician and causes little to no pain for the infant, as granuloma tissue does not contain pain nerves. The surrounding skin must be carefully protected, as silver nitrate can cause skin discoloration.

Salt Treatment

Recent studies have shown that the regular application of concentrated sodium chloride (NaCl) solution can be a safe and effective alternative to silver nitrate cauterization. This method can be applied by parents at home under medical supervision.

Surgical Removal

In rare cases involving very large or persistent granulomas, surgical removal may be necessary.

Watchful Waiting

For very small granulomas, a watchful waiting approach with regular monitoring may sometimes be appropriate, as some granulomas can resolve spontaneously.

Care and Prevention

Careful umbilical cord care can help reduce the risk of granuloma formation:

Keep the navel area clean and dry
Allow the navel to air and avoid covering it with diapers
Avoid moist compresses or excessive moisturizing around the navel
Seek medical advice promptly at signs of inflammation or delayed healing

References

Daniels B, Khan A. Umbilical Granuloma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560884/
Netter FH. Atlas of Human Anatomy. 7th ed. Philadelphia: Elsevier; 2019.
Lotan G, Klin B, Efrati Y. Silver nitrate treatment of umbilical granulomas in infants. J Pediatr Surg. 2002;37(3):427-428. https://doi.org/10.1053/jpsu.2002.30823

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