Umbilical Cord Care: One to Two Weeks After Birth

Before birth, the umbilical cord is a lifeline for the baby, delivering vital oxygen and nutrients. It also takes waste products away. This tubelike structure connects the mother and baby through the placenta. The long, flexible cord comprises blood vessels, connective tissue, and a protective membrane.

Once the baby is born, there's no need for the cord. A healthcare provider clamps and cuts it, leaving a small stump behind. The stump dries out and falls off within a few weeks, at which time you will first glimpse the baby's belly button.

This article discusses caring for the umbilical cord stump, avoiding infection, and when to seek medical attention.

When Will My Newborn’s Umbilical Cord Fall Off?

Your healthcare provider may remove the clamp before you leave the hospital or within a few days. You can expect the stump to fall off five to 15 days after birth.

It's OK if it falls off sooner. It can also take three or four weeks and still be perfectly normal. But it's a good idea to check in with a healthcare provider, such as your baby's pediatrician, if it's still hanging on after the fourth week.

Caring for the Umbilical Cord Stump

Think of the stump as a wound in the process of healing. That makes it a possible route for infection and, if allowed to progress, could enter the baby's bloodstream.

Knowing how the stump generally looks as it's healing is helpful. On the first day, the stump is pale yellow and plump. You can probably see arteries at the cut edge. In some cases, you may notice a few dark stripes. These are clots and no cause for concern. Over the next few days, the stump gets drier, stiffer, and darker as it shrivels. There may be a little bulge of skin around the edge.

One thing to remember is that the belly button will be what it will be. Your care routine won't affect its shape or whether it's an innie or an outie.

How to Take Care of the Stump

Cleaning the stump with a 70% alcohol solution was once common practice. But research suggests that dry cord care is just as safe and effective. Here's how to care for the stump:

• Always wash your hands before touching the stump area.
• Keep the stump dry.
• Change the newborn's diaper frequently because wetness keeps the cord from drying out and may increase the risk of infection.
• Fold the top of the diaper down so it doesn't cover the stump. Some brands of newborn-size diapers have a cutout, or you can make one yourself.
• Clean the stump gently with mild soap and warm water if it gets wet or soiled. You can use a cotton swab, cotton square, or fresh washcloth. Rinse and pat dry.
• Unless your provider advises, don't use lotions, powders, or other products in this area.
• Sponge bathe only. Do not put the baby in a tub until the stump falls off.
• Expose the stump to air whenever possible.
• Avoid clothing that fits tightly or rubs on the belly button area.

When the Stump Falls Off

Should the stump accidentally or partially come off, let it be. Don't try to pull it off because this can cause excessive bleeding.

You may not see it happen, but, eventually, the stump will fall off. You might find a small spot of blood or perhaps some pink or yellow moisture on the diaper or clothing. A little scabbing is normal and temporary, so let that fall off.

You can clean the area as you have been doing. Continue sponge bathing for a few more days. If all looks good, you can start giving tub baths.

Why Is My Newborn’s Umbilical Cord Bleeding?

A few spots of blood usually are not a cause for concern. And minor bleeding when the stump falls off is normal. However, persistent bleeding is not. Excessive bleeding could be a sign of injury or infection. Contact your healthcare provider if:

• It's still bleeding after applying 10 minutes of direct pressure twice.
• There's a spot of blood more than 2 inches (5 centimeters) across.
• Minor bleeding has lasted more than three days.
  

Identifying Symptoms of an Infected Umbilical Cord

A bacterial infection of the stump that spreads to the skin is a condition called omphalitis. It's uncommon in high-resource countries like the United States, occurring in about 1 in 1,000 infants with managed dry cord care.

Without treatment, omphalitis can progress to systemic (throughout-the-body) infection and death. Signs and symptoms include:

• Redness spreading around the navel
• Red streaks running from the navel
• Tenderness
• Swelling
• Foul odor
• Fever
• Persistent bleeding
• Pimples, blisters, or sores near the navel
• Lots of discharge, such as mucus or pus drainage

Treatment may include antibiotics, and serious infections may require hospitalization.

Summary

The umbilical cord stump is a remnant of life in the womb. It's also a wound, so keeping the area dry and clean is important. In most cases, it's not necessary to use alcohol or other products on the stump. Most of the time, the stump falls off naturally within a few weeks of birth. Attempting to remove it can cause excessive bleeding.

Be sure to report signs of infection, such as redness, bleeding, and discharge. Infection of the umbilical cord stump can spread to the skin. Without treatment, it can lead to life-threatening systemic infection. Stick to your provider's instructions and follow up with any questions or concerns about cord stump care.