What is the purpose of the umbilical cord?
Babies receive nourishment and oxygen in the womb through the placenta, which is connected to the inner wall of the mother's uterus. The placenta is connected to the baby by the umbilical cord through an opening in the baby's stomach. After your baby is born, the umbilical cord is clamped and cut in a painless procedure, leaving a 2-3 cm umbilical stump. The cord may be clamped and cut immediately after birth or when the cord has stopped pulsating; as part of a natural or physiological third stage of labour, this allows time for blood in the placenta to transfuse to the baby.
How long will my baby have an umbilical stump?
Some time between five and 15 days after birth, the stump will dry up, turn black, and drop off; leaving a small wound that may take a few days to heal.
Does the stump require special care?
It must be kept clean and dry to prevent infection. Harmful bacteria that live naturally on our skin can track up the cord stump causing infection. In developing countries where hygiene is poor, it is common for contaminated cord stumps to lead to tetanus infection, which can be very dangerous for newborn babies.
Always wash your hands before handling your baby's cord stump, before and after nappy changes and other care. Avoid the cord stump getting urine or poop on it by folding the nappy down away from it, leaving the stump exposed to the air. If the stump gets urine or poop on it, wash it off using clean water and soap, or just water alone. It's better to use a mild soap to wash poop off, as the higher percentage of fatty deposits found in baby feces can make it difficult to remove with just water.
While waiting for the cord to fall off and heal, it is safe to bathe your newborn if you want to. After the stump falls off, it usually takes about seven to 10 days for the area to heal over completely. When the stump falls off, you may see a little blood on the diaper shirt, which is normal. Sometimes, when the umbilical stump takes a long time to heal, bits of lumpy flesh (a type of connective tissue) appear in the wound. They're not a cause for concern and will soon disappear.
In the past, cord stumps have been cleaned with antiseptic tissues or sprinkled with an antiseptic powder. The use of antiseptics or antibiotics may still be relevant in less industrialized societies, where umbilical cord infections continue to cause many deaths, but in most Western countries where standards of cleanliness are high this is not necessary. Studies of the healing process have found no advantage to using antiseptics over simply keeping the cord clean; unless the baby is premature or in intensive care. Antiseptics also cause the cord to take longer to fall off, which causes anxiety to mothers and increases the number of post natal visits to the pediatrician.
What are the signs of infection?
Consult your pediatrician if:
- Your baby develops a fever, becomes lethargic, starts to feed poorly, or appears unwell generally.
- The navel and the surrounding area become swollen or red.
- The cord stump becomes swollen or smelly.
It is normal for the cord stump to look a bit "mucky", or appear to have pus at the base, as it dries up and heals but this does not mean that it is infected. Ask your doctor to check your baby's cord stump if you are worried about its appearance or smell.
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