umbilical cord, care of

I have practiced at a number of hospitals; it seems everybody has their own way of taking care of the umbilical cord. That we have to worry about the thing at all is really a function of the fact that babies wear diapers nowadays. Left to its own devices and allowed to air dry, the cord rapidly withers and separates with very little risk of infection. Diapers allow urine to soak the cord allowing bacterial growth and hence the concern and the various treatments of the cord.

There are various schools of thought:

  • the alcohol school: clean the cord several times a day with alcohol on a swab or cotton ball
  • the antibiotic ointment school: I haven't see this used but have heard of it; would keep the cord too moist and gooky for my taste
  • the triple dye school: some folks get sent home with an extraordinarily messy purple dye that is painted on some variable number of times per day
  • the leave it alone school: this is the one I prefer; I have never had a baby get an infection using this method. Just make an attempt to keep the urine off the cord by bending down the diaper, and if it gets wet or stinky, let it air out and clean it with some alcohol. It might interest you to know that the World Health Organization agrees on this point for babies in developed countries.

Of course, any sign of infection around the umbilical stump is bothersome, and you should let your doctor know about it. This would include

  • spreading redness of the skin around the umbilicus
  • a pus-like discharge that persists after cleaning with alcohol
  • persistent foul smell that persists after cleaning with alcohol
  • any of the above with fussiness or temperature elevation (99-100° rectally is normal, remember)

Now, those criteria will probably have your calling your doctor a bit more often than truly necessary, but better safe than sorry if you are not experienced with this.

Personnally, my problem has always been just to get parents to even touch the cord, much less fret about what to do when they touch it.

One of those things you don't think about too much until the need arises.

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