Umbilical Cord Symptoms

Is this your child’s symptom?

  • Umbilical cord or navel questions about newborns
  • The navel is also called the belly button or umbilicus

 

Symptoms

  • Umbilicus (navel) has a cloudy discharge or even some dried pus on the surface
  • Bleeding occurs from cord’s point of separation
  • Separation of cord is delayed past 3 weeks

 

Omphalitis: Serious Complication

  • Definition. Bacterial infection of the umbilical stump with spread to the skin around it. It’s a medical emergency.
  • How Often. 1 out of 200 newborns.
  • Symptoms. Redness spreads around the navel. The area may be tender, swollen and have a foul odor.

 

Umbilical Granuloma: Minor Complication

  • Definition. Small round growth in center of navel after the cord falls off. It’s red. Covered with clear mucus. Not dry like normal skin.
  • How Often. 1 out of 500 newborns.
  • Outcome. Usually grows in size if not treated. Can become an entry point for umbilical infections.
  • Treatment. Easily treated in the doctor’s office by putting on a chemical called silver nitrate.

 

Dry Cord Care or Alcohol Cord Care

  • The AAP and ACOG both advise dry cord care (natural drying). (Guidelines for Perinatal Care, 2012). It has become common practice in US hospitals.
  • The book advises against using alcohol for routine umbilical cord care.
  • Alcohol cord care is advised in less developed countries with high infection rates.

 

When to Call Us for Umbilical Cord Symptoms

Call Doctor or Seek Care Now

  • Age less than 1 month old and looks or acts abnormal in any way
  • Bleeding won’t stop after 10 minutes of direct pressure applied twice
  • Spot of blood more than 2 inches (5 cm) across
  • Red streak runs from the navel
  • Red skin spreads from around the navel
  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Small bleeding lasts more than 3 days
  • Pimples, blisters or sores near navel
  • Lots of drainage (such as urine, mucus, pus) from the navel
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • After using care advice for 3 days, navel is not dry and clean
  • Small piece of red tissue inside the navel
  • Cord stays attached more than 6 weeks
  • You have other questions or concerns

Self Care at Home

  • Normal cord care
  • Normal navel care after cord falls off
  • Minor infection of cord or navel
  • Normal bleeding from cord or navel
  • Normal delayed separation of the cord after 3 weeks

Care Advice

Treatment for Normal Umbilical Cord

  1. What You Should Know About Normal Umbilical Cords:
    • Normal cords don’t need any special treatment.
    • Just keep them dry (called dry cord care or natural drying).
    • Reason: Cords need to dry up, before they will fall off.
    • As they dry up, cords normally change color. They go from a shiny yellowish hue, to brown or gray.
    • The cord will normally fall off between 1 and 3 weeks.
    • Here is some care advice that should help.
  2. Normal Dry Cord Care:
    • Check the skin around the base of the cord once a day.
    • Usually the area is dry and clean. No treatment is needed.
    • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
    • You will need to push down on the skin around the cord to get at this area. You may also need to bend the cord a little to get underneath it.
    • Caution: Don’t put alcohol or other germ killer on the cord. Reason: Dry cords fall off sooner. (Exception: instructed by your doctor to use alcohol).
  3. Bathing:
    • Keep the cord dry. Avoid tub baths.
    • Use sponge baths until the cord falls off.
  4. Fold Diaper Down:
    • Keep the area dry to help healing.
    • To provide air contact, keep the diaper folded down below the cord.
    • Another option for disposable diapers is to cut off a wedge with a scissors. Then seal the edge with tape.
  5. Poop on Cord:
    • Getting some poop on the cord or navel is not serious.
    • If it occurs, clean the area with soap and water.
    • This should prevent any infections.
  6. Call Your Doctor If:
    • Develops a red streak or redness around belly button
    • Fever occurs
    • Your baby starts to look or act abnormal
    • You think your child needs to be seen

 

Treatment for Normal Navel After Cord Falls Off

  1. What You Should Know About Navels After the Cord Falls Off:
    • The cord can’t fall off too early.
    • The average cord falls off between 10 and 14 days. Normal range is 7 to 21 days. Even if it falls off before 7 days, you can follow this advice.
    • After the cord has fallen off, the navel will gradually heal.
    • It’s normal for the center to look red at the point of separation.
    • It’s not normal if the redness spreads on to the belly.
    • It’s normal for the navel to ooze some secretions.
    • Sometimes the navel forms a scab. Let it heal up and fall off on its own.
    • The navel has a small risk of becoming infected.
    • Here is some care advice that should help.
  2. Normal Navel Care:
    • Keep the navel (belly button) clean and dry.
    • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
    • Do this gently to prevent any bleeding.
    • Caution: Don’t use any rubbing alcohol. Reason: can interfere with healing.
  3. Bathing:
    • After the cord falls off, continue sponge baths for a few more days.
    • Help the belly button area dry up.
    • Then, tub baths will be fine.
  4. Fold Diaper Down:
    • Keep the navel dry to help healing.
    • To provide air contact, keep the diaper folded down below the navel.
  5. What to Expect: The belly button should be healed and dry by 7 days.
  6. Call Your Doctor If:
    • Develops a red streak or redness around belly button
    • Fever occurs
    • Cloudy discharge occurs
    • Your baby starts to look or act abnormal
    • You think your child needs to be seen

 

Treatment for Minor Infection of Cord or Navel

  1. What You Should Know About a Minor Infection of Cord or Navel:
    • The belly button will ooze secretions for several days.
    • Normal secretions are clear or blood tinged mucus.
    • A cloudy discharge is usually a mild infection.
    • This can be from normal skin bacteria.
    • A small amount of pus may be present.
    • Here is some care advice that should help.
  2. Clean the Navel:
    • Clean the navel (belly button) 2 times a day.
    • Use a wet cotton swab or cloth.
    • Clean away any dried secretions or pus.
    • Do this gently to prevent any bleeding.
    • Caution: Don’t use any rubbing alcohol. Reason: Can interfere with healing.
  3. Antibiotic Ointment for Pus:
    • If any pus is present, use an antibiotic ointment (such as Polysporin).
    • No prescription is needed.
    • Put a tiny amount on the belly button.
    • Do this 2 times per day after the area has been cleaned.
    • Do this for 2 days. After that, use the antibiotic ointment only if you see more pus.
  4. Bathing:
    • Do not use tub baths until the cord falls off. The navel should be well healed.
  5. Fold Diaper Down:
    • Keep the belly button dry to help healing.
    • To provide air contact, keep the diaper folded down. Keep it below the cord and belly button.
  6. What to Expect:
    • With treatment, the cloudy discharge and pus should be gone in 2 to 3 days.
    • The navel should become dry and healed by 7 days.
  7. Call Your Doctor If:
    • Develops a red streak or redness around the belly button
    • Fever occurs
    • Cloudy discharge not gone after 3 days of using this care advice
    • Your baby starts to look or act abnormal
    • You think your child needs to be seen

 

Treatment for Normal Bleeding Around Cord

  1. What You Should Know About Mild Bleeding Around the Cord:
    • A few drops of blood are normal when the cord falls off or catches on something.
    • The diaper rubbing against the belly button may make it start up again.
    • Here is some care advice that should help.
  2. Bleeding:
    • To stop bleeding, put direct pressure on the navel for 10 minutes. Use a clean cloth.
    • Clean the area beforehand, rather than afterwards.
    • Reason: This helps prevent bleeding from starting back up.
  3. Diaper:
    • Prevent the diaper from rubbing on the belly button.
    • Do this by folding the diaper down away from the belly button.
    • You can also cut a wedge out of the diaper.
  4. What to Expect:
    • The bleeding may come back a few times.
    • It should only be a small smear of blood.
    • The bleeding site should heal up by 2 days.
  5. Call Your Doctor If:
    • Bleeding gets worse
    • Few drops of blood lasts more than 3 days
    • Your baby starts to look or act abnormal
    • You think your child needs to be seen

 

Treatment for Normal Delayed Separation of the Cord Beyond 3 Weeks

  1. What You Should Know Cords Falling Off:
    • Most cords fall off between 10 and 14 days. Normal range is 7 to 21 days.
    • All cords slowly fall off on their own.
    • Continue to be patient.
    • Here is some care advice that should help.
  2. Stop Alcohol:
    • If you have been using rubbing alcohol to the cord, stop doing so.
    • Rubbing alcohol can kill the good bacteria that help the cord fall off.
  3. Diaper:
    • Help the cord dry up faster by keeping the diaper folded below it.
    • Another approach is to cut out a wedge of the diaper (if disposable).
    • Air contact helps the cord stay dry.
  4. Call Your Doctor If:
    • Cord starts to look infected
    • Fever occurs
    • Cord is still on for more than 6 weeks
    • Your baby starts to look sick or act abnormal
    • You think your child needs to be seen

 

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.