Caring for Your Newborn's Umbilical CordDr. Karen Sadler
Umbilical cords do more than mark the future site of a baby’s belly button. They are the unborn baby’s lifeline, providing a connection to the placenta, from which come the oxygen and nutrients needed to survive. Given that those unborn lungs lack access to air, and the gut to food, the essentials diffuse from mother’s circulation to the placenta and through the umbilical cord to the baby’s circulation.
During birth, the baby emerges before the placenta is delivered, still connected to that placenta by its cord. In the first critical moments after birth, the cord may still pulsate, sending its last oxygen delivery while the baby gasps, opens it’s lungs to the outside, and begins to oxygenate itself. The cord is then clamped (and this can sometimes be done by family members), creating separate maternal and newborn circulations. The clamping is painless, as the cord lacks nerve fibers.
Most placentas are discarded, though parents now have the option of collecting about three ounces (70 to 80 mls) of blood from this organ. Called cord blood, this material is rich in versatile stem cells and can be stored in special centers—deep frozen at negative 200 degrees Celsius—for future use.
Stem cells are currently being used to treat over 75 conditions, most of them relatively rare blood cancers and disorders. With today’s technology, the odds of any one child needing those stem cells before the age of 18 is 1 in 2,700, while the odds of using them for any family member is 1 in 400. The cost is steep: $1,000 to $1,500 for the initial collection and another $100 to $150 for yearly storage fee. Though still somewhat controversial, the future of stem cell use is very promising. Research is currently underway looking at this technology to treat illnesses such as diabetes, heart disease, certain kinds of arthritis, as well as spinal cord and nervous system injuries.
Cleaning Your Newborn’s Umbilical Cord
After 24 to 48 hours, when the bleeding has stopped and the remaining cord begins to dry, the clamp is removed, leaving a few inches of yellowish jelly-like stump. This stump then falls off after five to 15 days (almost always by three weeks of age).
Traditionally, rubbing alcohol has been recommended for cord care. A cotton-tipped swab dipped in alcohol or an alcohol pad is used to wipe the area at the base of the cord, where it inserts into the skin. (Wet, sticky material will come off on the swab; this is normal.) Forgoing alcohol and simply keeping the cord area clean and dry has also been suggested for cord care in recent years and has not resulted in more infections or problems. Parents now have both practices as options.
New parents are often squeamish about handling the cord, but needn’t be. Cords have no sensation, so as long as parents don’t tug on the cord or get too much alcohol on the surrounding skin, cord care is painless for the baby.
Umbilical Cord Care Basics
Keep your baby’s umbilical cord area as clean and dry as possible. Folding down the top of the diaper to leave the cord exposed is a good idea and will prevent urine from soaking the cord area. You can also buy special diapers with an indented top seam.
It is important to avoid binding the mid-abdominal area with a bandage or cloth, as is common in some cultures. This keeps moisture in and promotes the growth of germs. Very tight clothing can potentially do this as well, so be sure to dress your baby in loose clothes that won’t rub against the cord and potentially irritate the stump while it heals (onesies are fine as long as they are loosely worn.)
As the umbilical stump decays in preparation for detachment, the tissue begins to look yellow and may smell. This is OK. But, what isn’t OK and may signal an impending infection (which can get very serious very quickly) are the following signs: frank pus at the cord site, reddening of the skin around the insertion site, or obvious tenderness when the area is touched. Any of these signs demands an immediate call to the pediatrician.
After the cord stump detaches (be sure to let it fall off on its own; pulling it off is not advised), the remaining tissue will still appear moist for a few more days. Alcohol wipes should be used until the area becomes completely dry.
On occasion, a small, wet, reddish mass persists after the cord falls off, which may or may not ooze a yellowish material. This is most likely a granuloma, which requires an application of a chemical called silver nitrate at the doctor’s office, but which almost always shrinks with this treatment.
Once the cord is off and the umbilical area looks dry and well-healed, special attention is no longer required. Now your baby can safely get into his infant tub for his first immersion bath and you can gently wash that cute little belly button.