My Baby’s Cord; From Umbilical Cord To Umbilicus.

As a doctor who cares for children of all ages, I often come across mothers who have no clue about their baby’s cords and how to care for it. Your baby’s cord is the part of the baby’s body that connects baby to mother for nutrition and oxygen in the mother’s womb. It is thus a very important part of the baby’s life in the womb. Every one of us has an umbilicus where our cord was attached to the body. The umbilical cord is very important and its state reveals a lot about the health of the baby. A healthy cord looks clean and smells clean.

A healthy cord

In caring for your baby’s cord, it is important to know that a wet cord can attract germs and become infected, thus the cord needs to be kept clean and dry at all times. Newborns whose cords are yet to fall off do not need to be bathed fully as a necessity. They need to wear clothing that allows air around the cord to keep cord dry. It is also important that caregivers maintain the general good hygiene practices including hand washing with soap and water before handling the baby. The diaper or napkin should also not touch the baby’s cord. During diaper change, ensure that the stool does not get into contact with the baby’s cord.

How should the cord be cleaned?
In cleaning the cord, many mothers have used different things. The accepted options are however below;
Methylated spirit: Methylated spirit in cotton wool is what has been used to clean the cord of babies for a long time. Usually done twice a day. Care should be taken to ensure that the spirit comes into contact with the base of the cord well and not just the skin around the cord.
Chlorhexidine gel/ointment: Chlorhexidine has also been highly recommended in recent times by the World Health Organization. It is however not as widely available as the methylated spirit currently. The gel can be applied with a clean finger to the base of the cord once a day.

When should the cord fall off?
Usually, within the first week of life, the cord falls off. If the cord has not fallen off during the second week, especially towards the end of the second week it is a good idea to see your baby’s doctor. Do not apply herbal medications, toothpaste, cow dung, powder or any other thing to try to force the cord to fall off or to clean the cord.

Danger signs to look out for!
A discharging cord, redness around the cord, bleeding from the cord, fever and poor feeding as well as a delay in the cord falling off by the end of the second week, are all signs that your baby’s cord may be infected. Sometimes when the cord falls off, there may be a bit of blood stain on the diaper or clothing but it should not continue bleeding. When danger signs are noticed, see your doctor immediately for baby to be examined and treated.

After your baby’s cord has fallen off and the wound has healed, do not be alarmed if you notice a swelling at the healed area/ base of the cord. This is most likely an umbilical hernia. You can discuss this with your baby’s doctor. A few times an umbilical granuloma may develop around the time of healing, often seen as a small pinkish swelling at the umbilicus. Although in some cases these may go away on their own, it is good to see your baby’s doctor for assessment, reassurance or treatment.

Dr. Hilda Mantebea Boye
hildaboye@gmail.com
Paediatrician
Child Health Department
Korle Bu Teaching Hospital