Umbilical Care

What is it?

The "umbilicus" is the word doctors use for the belly button. In newborn babies the umbilicus is still moist and irritated after the umbilical cord has been cut. The umbilicus normally heals all by itself, but it can become infected without proper care. Since newborn babies can’t fight infections very well, it is important to prevent this.

The biggest concern is to prevent infection. Many parents, especially first-time parents, are frightened of the umbilical stump – it isn’t something most people have seen before, and it looks delicate. Parents often worry that they might damage the baby if they clean the area too hard. In reality, it is pretty difficult to damage a baby’s umbilical stump. Under normal conditions, it begins to dry and shrink within a few hours of being clamped and cut. It will normally continue to dry and shrink until it drops off within the first week of life.

There are two different ways to treat the newborn’s umbilical stump. The traditional method is to clean the stump twice daily with an alcohol swab or wipe, and then to allow the alcohol to air dry. This helps to kill germs and may speed the rate at which the stump dries and falls off. Alcohol care is safe when used as directed. Please be careful to use only enough alcohol to moisten the swab (or use pre-packaged alcohol pads). Also, please be sure to put the bottle of alcohol away safely if there are other children in the house.

Some hospitals and pediatricians recommend "dry care" of the umbilical stump. When using "dry care," you will only wipe the stump with a clean, dry cloth to remove any obvious contamination such as stool or urine. You will continue to wash your baby each day as you normally would, and will take care to dry the stump with a soft towel, but you will not apply alcohol or other materials to the stump. "Dry care" is also safe, but in several studies babies who got "dry care" had more infections and more bacteria on their skin than babies whose parents used alcohol on the stump.

It is normal for the tip of the umbilical stump to turn purple or black (if the hospital used "triple dye" the area will certainly be purple). It is also normal for there to be a small rim of redness on the skin next to the stump, and for a tiny bit of yellowish material to ooze from the area. If you are using alcohol to clean the skin, you can pull very gently on the stump to allow yourself to clean all the way to its base. After the stump drops off it is normal for the new belly button to seem red and irritated for a day or so, but this should rapidly clear up.

Here are some things to watch for that would tell you an infection might be developing:

• Redness that spreads away from the rim of skin around the stump, or that spreads onto the baby’s belly
• Foul smell or drainage from the stump or the area around it
• Fever
• Baby becoming very fussy or very sleepy

Some babies develop swelling or little red bumps inside the belly button – these are called "umbilical granulomas," and your doctor may want to treat them.

Please remember that any fever in the brand-newborn baby is always a concern. Please call your doctor right away if your baby has a temperature (rectally) over 100.4 °F or 38.0 °C.

In extremely rare cases, the new belly button can ooze clear or yellowish liquid. This could be an indication of a condition called a "patent urachus," and may require surgical care.