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
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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
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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
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Care Advice
Treatment for Normal Umbilical Cord
- 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.
- 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).
- Bathing:
- Keep the cord dry. Avoid tub baths.
- Use sponge baths until the cord falls off.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- Fold Diaper Down:
- Keep the navel dry to help healing.
- To provide air contact, keep the diaper folded down below the navel.
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What to Expect: The belly button should be healed and dry by 7 days.
- 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
- 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.
- 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.
- 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.
- Bathing:
- Do not use tub baths until the cord falls off. The navel should be well healed.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.