A Parent's Guide to Umbilical Cord Care

Rajan and Priya were just weeks away from having their first baby and were full of questions. To get some answers and put their thoughts to rest, they contacted their paediatrician, Dr Arora. This is how their conversation went.

Rajan: “Dr. Arora, we are about to have our first child, and a friend mentioned how important it is to take care of the baby's umbilical cord. Could you explain what it is and what we need to do?”

Dr. Arora: “Of course. During pregnancy, the umbilical cord connects your baby to the placenta, acting as a lifeline for nutrients, oxygen, and waste removal. You must have seen it in pictures. It's the tube connected to the baby's stomach. It's no longer needed once your baby is born, so it’s clamped and cut. The belly button we all have is the small stump left behind. This stump needs proper care to prevent infection and promote healing.”

Rajan: "Is it a complicated procedure?”

Dr Arora: “It's typically done by the obstetrician or nurse assisting with the delivery, so you don't need to worry too much. Clamping involves using a special tool to pinch the cord and stop the blood flow. These days, we often do delayed cord clamping, where we wait for the cord to stop pulsating before clamping—usually for about one to five minutes. This allows your baby to get more blood, rich in oxygen and stem cells, which helps boost their iron levels and supports early development.”

Priya: “Is there something we need to do?”

Dr Arora: “Once clamped and cut, the remaining stump will dry out and eventually fall off. This is where your role comes in. Here's what you should do:

1. Keep the cord dry and exposed: Air helps it dry out and wither naturally. Avoid covering it with the diaper.
2. Use sponge baths: Instead of immersing your baby in water, clean them gently with a damp cloth.
3. Avoid unnecessary substances: Don’t use rubbing alcohol or apply creams unless instructed by your doctor.
4. Monitor it closely: Look for redness, swelling, or unusual discharge.

Always ensure it’s completely dry afterwards.”

Priya: “How do we give sponge baths safely?”

Dr. Arora: “I always suggest parents use plain water or mild soap around the area if needed, but not to apply soap directly to the stump. Here’s how you can give your baby a sponge bath:

• Dip a soft cloth in warm water, wring it out, and gently clean your baby’s skin.
• Focus on keeping the cord stump dry. After the bath, gently pat the area around it to remove moisture.
• You can continue to regular baths once the cord falls off and the belly button heals.”

Priya: “You mentioned the stump falling out. How long does the healing process take?”

Dr. Arora: “The stump stays attached for 1-2 weeks. Over time, it dries, shrinks, and darkens in colour. Then, it naturally falls off, sometimes with a little bleeding. So don't worry if you notice that, it's normal. Once the stump has fallen off, the belly button heals within a few days, though some minor oozing is normal.”

Rajan: “Anything we should be concerned about or look out for?”

Dr. Arora: “It's a pretty self-healing process. You don't need to worry too much, but sometimes, a moist red tissue called an umbilical granuloma can form, which may drain light-yellow fluid.

Also, look out for the following symptoms as they could be a sign of infection:

• Redness, tenderness, or swelling around the stump.
• Persistent bleeding or drainage of pus.
• A fever above 100.4°F (38°C).
• Redness spreads beyond the immediate area.

Let me know if you notice any of these so we can address it.”

Priya: “Thank you, Dr. Arora. This has helped us feel more prepared.”

Dr. Arora: “You’re welcome. Umbilical cord care is all about keeping it dry and clean and monitoring for any changes. And I’m always here if you have questions or concerns!”