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Umbilical Cord Care

Expert Pediatrics Q&A

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Updated July 30, 2007

Q. How do I take care of my newborn baby's umbilical cord? The nurses at the hospital said to just leave it alone and not to put alcohol on it. I remember that I was told to put alcohol on it at least twice a day after having my last baby. And my friends say that I am supposed to use alcohol with each diaper change. Priscilla, Dallas, Texas

A. Surprisingly, umbilical cord care is controversial.

While parents used to be told to frequently put alcohol (70% isopropyl alcohol or rubbing alcohol) on their baby's umbilical cord until it falls off, they are just as likely to be told to not put any alcohol on it at all anymore.

Why the change?

Some experts think that too much alcohol can actually make the umbilical cord stump stay on longer, which most parents definitely don't want.

And studies have shown that alcohol doesn't have as much of a protective effect against infections over simply allowing an umbilical cord to dry on its own (dry care).

Triple Dye

Some hospitals have also stopped using triple dye on a newborn's umbilical cords. Using triple dye (the purple stuff that is placed on your baby's umbilical cord after he is born) used to be another step that was thought to be important to prevent infections.

Now, some hospitals apply triple dye the umbilical cord and some don't, with seemingly equally good results. Some experts do think that triple dye may increase the time to when the umbilical cord will come off though.

Other antimicrobial agents that have been used to clean a baby's umbilical cord include povidone-iodine, bacitracin, silver sulfadiazine, chlorhexidine, and hexachlorophene.

Umbilical Cord Care

If using alcohol to care for your baby's umbilical cord, it is usually best to apply it with a cotton swab or cotton ball a few times a day.

More frequently these days, you may be told to skip the alcohol. Parents who are told that they don't have to use alcohol often take this advice too far though. They may never clean, or even touch, their baby's umbilical cord at all. Keep in mind that with umbilical cord dry care, you are actually supposed to wash the cord with soap and water when it becomes soiled, wipe it with a dry cotton swap, and then allow it to air-dry.

What You Need To Know

Despite some research on the subject, we still don't have a clear understanding of optimal cord care practices. Fortunately, umbilical cord infections are not very common and often easily treated when recognized quickly. Until more research is done, ask your pediatrician what he or she recommends concerning umbilical cord care.

Personally, I like to use alcohol on the umbilical cord stump about twice a day. This helps remove any discharge that has accumulated around the stump, keeps it clean, and is unlikely to make the cord stay on any longer than simply doing nothing at all.

Keep in mind that the alcohol isn't supposed to help the cord come off sooner. It is just supposed to prevent any infections from developing until it comes off on its own.

  • Your baby's umbilical cord stump should fall off by the time he is two to four weeks old.

  • Call your pediatrician if your baby's umbilical cord stump is showing signs of infection (omphalitis), including having redness around the area, having a foul odor, and/or discharge.

  • Until your baby's umbilical cord stump falls off, be sure to keep it clean and dry. Remember that your baby will only need sponge baths until his cord falls off.



Sources:

Double-blind comparative study on the care of the neonatal umbilical cord using 80% ethanol with or without chlorhexidine. Oishi T - J Hosp Infect - 01-SEP-2004; 58(1): 34-7.

Discharge procedures for healthy newborns. Langan RC - Am Fam Physician - 1-MAR-2006; 73(5): 849-52.

Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence. Mullany LC - Pediatr Infect Dis J - 01-NOV-2003; 22(11): 996-1002.

Changing spectrum of neonatal omphalitis. Sawardekar KP - Pediatr Infect Dis J - 01-JAN-2004; 23(1): 22-6.

Anomalies, abnormalities, and care of the umbilicus. Pomeranz A - Pediatr Clin North Am - 01-JUN-2004; 51(3): 819-27, xii

To dye or not to dye: a randomized, clinical trial of a triple dye/alcohol regime versus dry cord care. Janssen PA - Pediatrics - 01-JAN-2003; 111(1): 15-20.

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