How do I care for my newborn’s umbilical cord stump?

DEAR DOCTOR K:

I’m expecting my first baby. Can you tell me how to care for the umbilical cord stump? How long will it remain?

DEAR READER:

Why does every baby have an umbilical cord in the first place? Just as with every cell in your body, every cell in your baby’s body requires a constant supply of energy and sustenance, and disposes of its waste material, through the circulation of the blood. However, during the time your baby is a fetus in the womb, your baby isn’t eating or breathing. The energy comes from the food you eat and the oxygen in the air you breathe.

The circulation of blood in and out of the fetus comes through the umbilical cord. One end of the cord enters the baby through its “belly button”; the other end is in the placenta — tissue inside your womb. When your baby is born, the placenta and umbilical cord will leave your body with the baby.

Once your baby is born, he or she no longer needs the umbilical cord and will be eating and breathing on his or her own. So, soon after birth, a doctor or nurse will clamp your baby’s umbilical cord, then cut it, leaving a small umbilical stump.

The umbilical stump usually falls off within two weeks or so after birth. Here are the best ways for you to help the natural healing of the cord:

  • Keep the area clean and dry.
  • Avoid wetting the area when you bathe your baby. Give sponge baths rather than tub baths until the cord has totally separated and fallen off. If the area gets wet, dry it gently.
  • Do not cover the umbilical cord area with a diaper. If the diaper rubs against it, irritation and inflammation may develop. Fold back the top edge of the diaper to expose the cord.
  • If urine or stool gets on the stump, carefully clean the area with mild soap and water. Then dry the area thoroughly.
  • If instructed by your doctor, clean the area around the cord with a cotton-tipped swab or piece of gauze dipped in rubbing alcohol. Some doctors no longer recommend this practice because alcohol does not necessarily prevent infection or speed up healing.
  • The stump may bleed a little just before it falls off. This is normal.
  • ┬áLet the cord fall off by itself. Do not try to pull or twist it off.
  • After the cord falls off, the belly button (navel) area may look pink or yellow. It can take several more days or even weeks to heal completely. Continue to keep the area clean and dry. You may give tub baths, but dry the belly button thoroughly afterward.

In some infants, the belly button area seems to heal slowly and looks moist, pink and lumpy. This is usually harmless. Still, if this occurs, tell your baby’s doctor.