What is an umbilical cord granuloma. How is it treated. What are the signs of infection. When should you seek medical advice. How can you care for your newborn’s umbilical area at home.

Understanding Umbilical Cord Granulomas in Newborns

An umbilical cord granuloma is a common complication that can occur after the umbilical cord stump falls off in newborns. It presents as a small mass of pinkish-red tissue at the site of the former umbilical cord. This condition, while generally harmless, can cause concern for new parents and requires proper care to prevent potential complications.

What causes umbilical cord granulomas?

Umbilical cord granulomas typically form when there is excess moisture or irritation at the umbilical site after the cord stump falls off. The body’s healing process sometimes produces this extra tissue as it attempts to close the small wound left behind.

Identifying an umbilical cord granuloma

The key characteristics of an umbilical cord granuloma include:

• A small, rounded mass of tissue
• Pinkish-red in color
• Moist appearance
• May produce a clear or yellow drainage
• Slight inflammation or redness around the area

Treatment Options for Umbilical Cord Granulomas

Treating umbilical cord granulomas is generally straightforward and can often be done in a healthcare provider’s office. The most common treatment methods include:

Silver nitrate application

Silver nitrate is a chemical compound that helps dry out the granuloma. This treatment is painless for the newborn and is often the first line of treatment due to its effectiveness and simplicity.

Cryotherapy

In some cases, the healthcare provider may opt to use liquid nitrogen to freeze the granuloma tissue. This method is typically reserved for more persistent granulomas that don’t respond to silver nitrate treatment.

Suture ligation

For larger or stubborn granulomas, the healthcare provider might choose to tie off the tissue using surgical thread. This cuts off the blood supply to the granuloma, causing it to dry up and fall off.

Home Care for Umbilical Cord Granulomas

Proper home care is crucial in managing umbilical cord granulomas and preventing complications. Here are some essential steps to follow:

1. Maintain strict hand hygiene before and after caring for the area
2. Clean the granuloma and surrounding area with a moist cloth or cotton swab
3. Gently pat the area dry and allow it to air out
4. Position diapers below the navel to prevent contamination
5. Avoid submerging the baby in bathwater until the granuloma heals

Can umbilical cord granulomas be prevented?

While not all granulomas can be prevented, maintaining proper umbilical cord care after birth can reduce the risk. This includes keeping the area clean and dry, allowing air circulation, and avoiding the use of alcohol or other irritants on the stump.

Recognizing Signs of Infection in Umbilical Cord Granulomas

Although rare, infections can occur at the site of an umbilical cord granuloma. Parents should be vigilant and watch for the following signs:

• Increased redness or swelling around the granuloma
• Foul-smelling or purulent discharge
• Fever in the baby
• Excessive crying or signs of pain when the area is touched
• Development of a rash or blisters around the navel

How quickly do umbilical cord granulomas typically heal?

With proper treatment and care, most umbilical cord granulomas heal within 1-2 weeks. However, the healing time can vary depending on the size of the granuloma and the treatment method used.

When to Seek Medical Advice for Umbilical Cord Issues

While most umbilical cord granulomas are benign and resolve with treatment, there are situations where immediate medical attention is necessary. Parents should contact their healthcare provider if:

• The baby develops a fever
• The granuloma doesn’t heal within the timeframe provided by the healthcare provider
• There are signs of infection (increased redness, swelling, or unusual discharge)
• Bleeding occurs from the granuloma
• The baby shows signs of discomfort or pain in the umbilical area
• A rash, pimples, or blisters appear around the navel
• The baby seems unusually fussy or ill

Understanding Fever in Newborns and Infants

Fever can be a sign of infection or other health issues in babies. It’s important for parents to know how to properly check their child’s temperature and when to be concerned.

What is considered a fever in newborns and infants?

For newborns and infants under 3 months, a rectal temperature of 100.4째F (38째C) or higher is considered a fever. For older infants and children, a temperature of 100.4째F (38째C) or higher by any method is typically considered a fever.

How to accurately measure a baby’s temperature

There are several methods to check a baby’s temperature, but not all are equally accurate for all ages:

• Rectal thermometer: Most accurate for children under 3 years old
• Forehead (temporal) thermometer: Suitable for children 3 months and older
• Ear (tympanic) thermometer: Accurate after 6 months of age
• Armpit (axillary) thermometer: Least reliable but can be used for initial screening
• Oral thermometer: Not recommended for children under 4 years old

Always use a digital thermometer for accuracy and safety. Mercury thermometers should not be used due to the risk of mercury exposure if broken.

Complications Associated with Umbilical Cord Issues

While umbilical cord granulomas are generally benign, they can sometimes lead to more serious complications if not properly managed. Understanding these potential issues can help parents remain vigilant and seek timely medical attention when necessary.

Omphalitis: A serious umbilical infection

Omphalitis is a bacterial infection of the umbilicus (belly button) and surrounding tissues. It’s a rare but potentially life-threatening condition that requires immediate medical attention. Symptoms of omphalitis include:

• Redness and swelling extending beyond the immediate umbilical area
• Pus or foul-smelling discharge from the umbilicus
• Fever and irritability in the baby
• Abdominal distension or tenderness
• Poor feeding or lethargy

If you suspect your baby might have omphalitis, seek emergency medical care immediately. This condition typically requires hospitalization and intravenous antibiotics.

Umbilical hernia: A common umbilical abnormality

An umbilical hernia occurs when a portion of the intestine protrudes through a weakness in the abdominal muscles near the navel. While not directly related to granulomas, it’s another umbilical complication parents should be aware of. Umbilical hernias are often harmless and may resolve on their own by age 3-4. However, large hernias or those causing symptoms may require surgical repair.

Can umbilical cord granulomas lead to long-term complications?

In most cases, properly treated umbilical cord granulomas do not lead to long-term complications. However, if left untreated or if complications arise, there could be potential issues such as:

• Persistent drainage or discharge from the umbilical area
• Formation of a sinus tract (an abnormal passageway from the skin to deeper tissues)
• Development of an umbilical polyp (a more organized growth of tissue)
• Scarring or cosmetic concerns around the navel

These complications are rare when granulomas are promptly and properly treated.

The Role of Pediatric Care in Umbilical Health

Regular pediatric check-ups play a crucial role in monitoring your newborn’s overall health, including the healing of the umbilical area. These visits provide an opportunity for healthcare providers to assess the umbilical site, identify any potential issues early, and provide guidance on proper care.

What to expect during pediatric visits

During routine check-ups, your pediatrician will typically:

1. Examine the umbilical area for signs of proper healing or complications
2. Provide guidance on umbilical care and hygiene
3. Address any concerns or questions you may have about your baby’s health
4. Monitor your baby’s growth and development
5. Administer necessary vaccinations according to the recommended schedule

How often should newborns visit the pediatrician?

The American Academy of Pediatrics recommends the following schedule for well-child visits in the first year:

• 3-5 days after birth
• At 1 month
• At 2 months
• At 4 months
• At 6 months
• At 9 months
• At 12 months

This schedule may vary based on individual needs and your healthcare provider’s recommendations.

Promoting Overall Newborn Health and Umbilical Care

While focusing on umbilical cord care is important, it’s just one aspect of maintaining your newborn’s health. Here are some general tips for promoting overall newborn well-being:

Nutrition and feeding

Whether you’re breastfeeding or formula-feeding, ensuring proper nutrition is crucial for your baby’s growth and development. Consult with your pediatrician about feeding schedules, proper techniques, and any concerns you may have about your baby’s feeding habits.

Sleep safety

Follow safe sleep practices to reduce the risk of Sudden Infant Death Syndrome (SIDS):

• Always place your baby on their back to sleep
• Use a firm sleep surface in a safety-approved crib
• Keep soft objects, loose bedding, and toys out of the crib
• Avoid overheating by dressing your baby appropriately for the room temperature
• Consider room-sharing (but not bed-sharing) for the first 6-12 months

Hygiene and skin care

Newborns have delicate skin that requires gentle care:

• Use mild, fragrance-free soaps and lotions
• Bathe your baby 2-3 times a week, or as needed
• Keep the diaper area clean and dry to prevent diaper rash
• Trim your baby’s nails carefully to prevent scratching

Bonding and emotional development

Emotional bonding is crucial for your baby’s development:

• Engage in skin-to-skin contact
• Talk, sing, and read to your baby regularly
• Respond promptly to your baby’s cues and needs
• Create a calm and nurturing environment

By focusing on these aspects of newborn care alongside proper umbilical care, you can help ensure your baby’s healthy start in life.

Umbilical Cord Granuloma (Newborn)

The umbilical cord connects the unborn baby to the mother in the uterus. After birth, the cord is no longer needed. It is clamped and then cut. This leaves a small stump.

In most cases, the umbilical cord stump dries up and falls off the newborn in the first few weeks of life. But sometimes after the stump falls off a granuloma forms. This is a small mass or stalk of pinkish-red tissue. The granuloma may be moist and drain fluid. The area around it may be slightly inflamed or infected.

Granulomas may be treated with silver nitrate. This chemical dries the granuloma. It is not painful to the newborn. In rare cases, the granuloma may need to be removed with a procedure. For instance, liquid nitrogen may be put on the granuloma to freeze the tissue. Or the granuloma may be tied off with thread used for stitches (sutures). Your provider will give you more information if these procedures are needed.

Home care

Medicines

A granuloma itself does not need any prescribed medicines.  The healthcare provider may prescribe medicine if the granuloma looks infected. If so, follow the provider’s instructions for giving this medicine to your child.

General care

• Wash your hands well before and after you clean the area around the granuloma. This will help prevent infection.

• Care for the area around the granuloma as directed. Use a clean, moist cloth or cotton swab. Be sure to remove all drainage and clean an inch around the base. Pat the area with a clean cloth and let it air-dry. 

• Roll your child’s diapers down below the belly button (navel) until the granuloma has healed. This helps prevent contamination from urine and stool. If needed, cut a notch in the front of the diapers to make a space for the belly button.

• Don’t put your baby in bathwater until the granuloma has healed. Instead, bathe your baby with a sponge or damp washcloth.

• Watch for signs of infection. See “When to call your child’s healthcare provider” below.

Follow-up care

Follow up with your child’s healthcare provider as advised. Let the provider know if you have other questions or concerns.

When to get medical advice

Call your child’s healthcare provider right away if any of these occur:

• Your child has a fever (see “Fever and children” below).

• Your child’s granuloma does not heal in the timeframe given by the provider.

• Your child has signs of infection around the granuloma, such as increased redness, swelling, or cloudy or bad-smelling drainage.  

• There is bleeding from the granuloma.

• Your child cries or seems to be in pain when you touch the area around the cord and belly button.

• Your child develops a rash, pimples, or blisters around the navel.

• Your child seems ill or has any other symptoms that concern you.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• 
  Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• 
  Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• 
  Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• 
  Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• 
  Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37. 2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° F (38° C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Umbilical Granulomas: Causes, Treatments, and Prevention

Written by WebMD Editorial Contributors

In this Article

• Causes of Umbilical Granulomas
• Impact of Umbilical Granulomas on Health
• Treating Umbilical Granulomas
• Preventing Umbilical Granuloma Infections
• When to Go to the Doctor

‌An umbilical granuloma is a small red bump of tissue that can form in a newborn’s belly button during the first several weeks after they’re born. Many babies will develop a granuloma and have no problems. However, some umbilical granulomas can become infected. In rare cases, adults can also form painful umbilical granulomas. Here’s what you need to know about how they can affect your health.

Umbilical granulomas are a type of scar tissue that forms in the belly button. Most umbilical granulomas form when the belly button is healing after the umbilical cord falls off. They look like small red lumps in your child’s navel. Unlike the rest of their skin, the granuloma will be a little shiny and covered in a clear discharge.

After the umbilical cord is cut, a small stump remains on your baby’s stomach. Typically, the stump will fall off on its own and heal without a problem. However, in rare cases, an umbilical granuloma will form where the stump fell off. Only about 1 in 500 babies will develop an umbilical granuloma.

Rarely, an adult may develop an umbilical granuloma. These lumps are caused by trauma to the bully button. One of the most common causes of an adult umbilical granuloma is navel piercing. While granulomas in babies are not painful, they may be painful for adults.

Granulomas are relatively minor complications. However, they do require treatment because they won’t resolve on their own. Most granulomas will continue to slowly grow until they’re treated. These lumps can easily become infected.‌

An infected granuloma is a critical health problem. Since granulomas are connected to the umbilical opening, infection can spread quickly. If you believe your child has an infected granuloma, reach out for medical care right away to keep the infection from getting worse.

In most cases, treating granulomas is simple. Your child’s pediatrician will probably be able to treat and remove the lump in their office. Granuloma treatments include:

Silver nitrate: Umbilical granulomas in babies don’t have nerve endings, so they can be treated with a small amount of silver nitrate. The doctor will place the silver nitrate on the granuloma, and it will burn off the tissue. Your baby will not feel any pain during the process. Adults may need a topical anesthetic to numb the area before the same treatment.

Liquid nitrogen: If silver nitrate isn’t an option, then liquid nitrogen can also be used. The liquid is very cold and freezes the lump immediately. After it’s frozen, the granuloma tissue dissolves away.‌

Suture thread ties: In some cases, your doctor may tie off the granuloma with suture thread. This cuts off blood flow to the lump. Over time, it will dry up and shrivel until it disappears.

Salt: Another way to dry out the granuloma is by using salt. Since granulomas are covered in clear mucus, the salt dries them out and causes them to shrivel away. Your doctor will give you instructions on how to apply salt to the granuloma safely.‌

Surgery: In rare cases, an umbilical granuloma may need to be surgically removed. This is most common for infected granulomas, because surgical removal is the quickest treatment. If your baby’s granuloma is infected, surgery will help stop the spread of infection and help them recover more quickly.

Since granulomas are a type of scar tissue, they’re difficult to prevent. However, if your baby develops a granuloma, you can often prevent infections.

The best way to prevent infections is to protect your baby’s belly button and keep the area clean. Gently wiping the area down with warm soap and water can prevent drainage and bacteria from building up. Your child’s doctor may have other recommendations, as well. Always follow their instructions for taking care of your baby’s navel.

All granulomas should be treated by a doctor. However, if a granuloma gets infected, it needs to be treated immediately. Your baby may need antibiotics to prevent the infection from getting worse. Signs your baby needs to go to the doctor right away include:

• ‌A fever of more than 100. 4 degrees Fahrenheit
• ‌A rash around the belly button
• ‌The granuloma is bleeding
• ‌The belly button is draining a bad-smelling liquid
• ‌The area around the granuloma is swollen or red
• ‌Your baby seems to be in pain when you touch their belly button

Top Picks

How and with what to treat the navel of a newborn: treatment of the umbilical wound

The expression “navel of the earth” did not appear by chance, because in the first weeks after the birth of a baby, it is the navel that becomes the center of attention of a young mother. There is a simple explanation for this: this place on the body is very susceptible to injury and infection. Therefore, it is very important to carefully monitor the healing process and treat the wound in a timely manner.

HOW THE UMBILIC WOUND IS FORMED

When a baby is born, the umbilical cord is immediately fixed with a special clamp and tightly bandaged near the future navel. Only after that it is cut off. An incision is made between the ligation site and the clamp. The remaining small area dries up and disappears on its own, and an umbilical wound appears in this place and later the navel itself. If all hygiene rules and doctor’s recommendations are followed, complete healing occurs approximately 2 weeks after birth. If the newborn is seen by a health visitor from a local clinic, she can help with the first home treatment and show how to continue to do this for parents.

MAIN RECOMMENDATIONS

Treatment of the umbilical wound in a newborn is primarily aimed at protecting against inflammation and infection. To do this, follow a few simple rules.

1. Air baths and free access of air to the umbilical cord is one of the main conditions for wound healing. The main danger is the constant wearing of a diaper. This is a hygiene product that makes life much easier for parents, but closes the navel and often rubs it. To avoid problems, you should either buy diapers with special slots, or make holes yourself.

2. Humidity is an ideal environment for bacteria and infection to develop. Therefore, the navel should always remain dry (of course, with the exception of bathing). Parents need to constantly monitor the cleanliness and dryness of diapers and undershirts, if necessary, immediately change them to new ones. By the way, after washing, the baby’s things should be carefully ironed.

3. Many mothers are afraid to bathe a baby with an unhealed navel. But water procedures are not just allowed, but are an integral part of hygiene (unless the doctor has given other instructions on this matter).

4. More recently, doctors advised treating the umbilical wound with brilliant green and hydrogen peroxide. However, recent studies have shown that there is a need for this procedure only if a crust has formed after the umbilical residue falls off. In this case, it is worth treating the wound once a day. First, drop a little hydrogen peroxide into the navel, remove the softened crusts with a cotton swab or disc, and gently blot the umbilical cavity with a cotton swab dipped in brilliant green.

5. Bathing is important, but don’t do it too often. Hygiene procedures are needed by the baby on average once a day. The less often you disturb the wound, the faster it will heal.

6. Since the care of the umbilical wound requires constant air access, it cannot be covered with a plaster or bandage. For speedy healing, the skin needs to breathe.

7. Be sure to call your doctor if you notice that the skin around your navel is red and swollen. It is also necessary to contact a specialist if unpleasant purulent discharge appears inside the navel. Another reason for concern is the long healing of the umbilical wound (normally, this process usually takes 10-14 days, a maximum of 3 weeks).

Following this simple procedure for treating an umbilical wound can help protect your baby from infection and speed up the healing process.

Newborn navel care

What procedures are required to be carried out with the navel of a newborn will be described in this article by the pediatrician of the DocDeti clinic Alexandra Zhukovskaya.

Do I need to treat the navel with green? Glue a patch with a coin to the umbilical hernia? Should I sprinkle salt on a healed belly button with a granuloma?

After birth, the umbilical cord is cut with a sterile instrument and a plastic clip is applied to it. The rest of the umbilical cord will dry up, turn black and fall off without further intervention in about 2 weeks.

What kind of belly button care is required?

“Dry cord management” is accepted worldwide:

1. Before touching an unhealed navel, be sure to wash your hands with soap and water.

2. It is not recommended to touch the navel even with clean hands.

3. The navel should be open in the air, for this, turn up the diaper or use diapers that have a cutout.

4. Avoid getting wet. If urine/feces gets on the navel, rinse gently with water and pat dry with a clean towel.

5. Postpone bathing until the umbilical cord falls off. Before that, wipe the baby with a damp sponge or wash only the face and wash the ass.

6. No need to interfere with the normal microflora to do its job: DO NOT smear the navel with brilliant green, peroxide, alcohol antiseptics.

This approach is safe and effective – this has been proven by large scientific studies.

If all of the above hygiene measures are observed, then antiseptics will only increase the healing time by disrupting natural processes.

Because of the green, in addition, you can not notice the redness and skip the inflammation.

In the case when the birth did not take place in the maternity hospital and the umbilical cord was cut with a non-sterile instrument, a doctor’s consultation will be required. Usually in such situations it is recommended to treat the navel with chlorhexidine.

The rest of the umbilical cord fell off, what’s next?

• After that, at the bottom of the navel, a mucous viscous discharge will be visible (without redness, unpleasant odor, swelling). It usually takes 1-2 days to dry.

• If ​​there are bloody crusts, then you do not need to pick them out, they will fall off on their own.

In what situations should you be concerned?

1. The umbilical cord has not fallen off after 2-3 weeks.

2. The navel bleeds, as if the wound is fresh (does not just leave a mark, as with an accidental touch).

3. The navel is red and swollen.

4. A purulent discharge with a pungent odor is seen in the navel.

If you suspect that the navel has become inflamed, it is recommended to immediately consult a doctor. Omphalitis – inflammation of the navel – is a very serious thing, but with timely treatment they can cope with it.

Let’s move on to the umbilical hernia, which is a hole in the muscular frame of the abdomen at the site of the former umbilical cord. Every fifth newborn has an umbilical hernia.

A patch with a coin, a bandage, a bandage – do not accelerate the overgrowth of the hernial opening.

Often passes on its own by 1-1.5 years (in extreme cases, by 4 years).

It happens that in place of the fallen off umbilical cord there is a “mushroom” / “pimple” with a smooth surface – this is called an umbilical granuloma.

It occurs when the connective tissues “overdone”, healing the wound.

It is treated using a simple and affordable method: pour a pinch of salt on the granuloma, cover with a dry cotton pad for half an hour 3 times a day, repeat the steps for 3 days.