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UMBILICAL CORD PROBLEMS
Symptom Definition
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Umbilicus (navel) has a cloudy discharge or even some dried pus on the surface
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Bleeding occurs from umbilical cord's point of separation
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Separation of umbilical cord is delayed past 2 weeks
WHEN TO CALL YOUR DOCTOR FOR UMBILICAL CORD PROBLEMS
Call Your Doctor Now (night or day) If
- Newborn (< 1 month old) starts to look or act sick
in any way
- Bleeding won't stop after 10 minutes of direct
pressure applied twice
- Spot of lost blood > 2 inches (5 cm)
- Red streak runs from the navel
- Red area spreads beyond the navel
- Fever > 100.4 F (38.0 C) rectally
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
- You think your child needs to be seen
- Small recurrent bleeding continues > 3 days
- Pimples or , blisters or sores in area
- Lots of drainage from navel (urine, mucus, pus,
etc.)
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- After 3 days of treatment, navel is not dry and
clean
- Nubbin of pink tissue inside the navel
- Cord attached > 6 weeks
Parent Care at Home If
- Normal cord or navel, questions about
- Superficial infection of cord or navel and you
don’t think your child needs to be seen
- Normal umbilical bleeding and you don’t think your
child needs to be seen
- Normal early separation of the cord before 10 days
- Normal delayed separation of the cord beyond 2
weeks
HOME CARE ADVICE FOR NORMAL UMBILICAL CORD
- Alcohol: Clean the navel with rubbing alcohol 4 times per day. Use a
cotton swab to clean away the dried pus or debris. Be vigorous about it. The
umbilical area does not have any sensation, so the alcohol won't sting. If the
cord is still present, clean underneath it by lifting it and bending it to
each side. If the cord has fallen off, pour some alcohol into the depression
and remove it after 2 or 3 minutes. (Reason: it takes that long to kill the
bacteria.) There is a minor controversy about using alcohol on the cord. Some
hospitals recommend natural drying of the cord because using alcohol can
delay separation of the cord by 1 or 2 days. However, alcohol prevents
some cord infections and that’s what’s really important.
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Diapers: Keep the umbilical area dry to help healing. To provide air
exposure, keep the diaper folded down below the cord area.
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Dryness: Avoid tub baths until the area is healed.
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Poop on Cord: Getting some poop on the cord or navel is not serious. If
it occurs, clean the area with lots of water, followed by rubbing alcohol.
That should prevent any infections.
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Call Your Doctor If:
- Develops a red streak
- Fever occurs
- Your baby begins to look sick or develops any
of the "Call Your Doctor" symptoms
HOME CARE ADVICE FOR
SUPERFICIAL INFECTION OF THE CORD OR NAVEL
-
Reassurance: A cloudy discharge from the navel is usually a mild
infection from normal skin bacteria. Usually home treatment can clear it up
quickly.
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Alcohol: Clean the navel with rubbing alcohol 4 times per day. Use a
cotton swab to clean away the dried pus or debris. Be vigorous about it. The
umbilical area does not have any sensation, so the alcohol won't sting. If the
cord is still present, clean underneath it by lifting it and bending it to
each side. If the cord has fallen off, pour some alcohol into the depression
and remove it after 2 or 3 minutes. (Reason: it takes that long to kill the
bacteria.)
-
Antibiotic Ointment: If a little pus is present, apply an antibiotic
ointment (OTC) 4 times per day after each cleansing. Bacitracin or Polysporin
ointment will do.
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Diapers: Keep the umbilical area dry to help healing. To provide air
exposure, keep the diaper folded down below the cord area.
-
Dryness: Avoid tub baths until the area is healed.
-
Call Your Doctor If:
- Develops a red streak
- Fever occurs
- Navel is not completely dry and clean
after 3 days using this treatment
- Your baby begins to look sick or develops any of
the "Call Your Doctor" symptoms
HOME CARE ADVICE FOR
NORMAL UMBILICAL BLEEDING
-
Reassurance: A few drops of blood is normal with cord separation.
Friction against clothing may make it recur.
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Bleeding: Apply direct pressure for 10 minutes with a sterile gauze to
stop any bleeding. Clean the area beforehand, rather than afterwards. (Reason:
to prevent rebleeding.)
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Diaper: Prevent friction on the umbilical stump from the diaper by
folding it down or cutting a wedge out of the diaper.
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Call Your Doctor If:
- Bleeding becomes worse
- Few drops of blood continues > 3 days
- Your baby begins to look sick or develops any of
the "Call Your Doctor" symptoms
HOME CARE ADVICE FOR EARLY SEPARATION OF THE CORD BEFORE
10 DAYS
-
Reassurance: The cord can't fall off too early. The average cord falls
off between 10 and 14 days.
-
Alcohol: Clean the navel with rubbing alcohol and a cotton swab 4 times
per day. Pour some alcohol into the depression and remove it after 2 or 3
minutes. (Reason: it takes that long to kill the bacteria.) The umbilical area
does not have any sensation, so the alcohol won't sting.
-
Diapers: Keep the umbilical area dry to help healing. To provide air
exposure, keep the diaper folded down below the navel.
-
Dryness: Avoid tub baths until the area is healed.
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Call Your Doctor If:
- Develops a red streak
- Fever occurs
- Your baby begins to look sick or develops any of
the "Call Your Doctor" symptoms
HOME CARE ADVICE FOR DELAYED SEPARATION OF THE CORD
BEYOND 2 WEEKS
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Reassurance: Most cords fall off between 10 and 14 days. All cords
eventually fall off by themselves. Continue to be patient.
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Stop Alcohol: Stop applying rubbing alcohol to the cord. Rubbing
alcohol sometimes also kills the good bacteria that help the cord dry up and fall
off.
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Diaper: Help the cord dry up faster by keeping the diaper folded below
it. An easier approach is to cut out a wedge of the diaper (if disposable)
with a scissors so the cord is exposed to the air.
-
Call Your Doctor If:
- Cord begins to look infected
- Fever occurs
- Cord is still attached > 6 weeks
- Your baby begins to look sick or develops any of
the "Call Your Doctor" symptoms
Disclaimer:
This information is not intended be a substitute for professional medical
advice. It is provided for educational purposes only. You assume full
responsibility for how you choose to use this information.
Pediatric HouseCalls Online. Copyright © 2000-2005
Barton D. Schmitt, M.D. FAAP
Reviewed 8/2005
Revised 8/2005
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